neuropathy risk reduction

Overview

Neuropathy is damage to the nerves outside your brain and spinal cord. These nerves help you feel touch, heat, cold, and pain, and they also help control your muscles. When they are damaged, you may feel numbness, tingling, burning, or weakness, most often in your hands and feet.

Yes, neuropathy is quite common. Around 1 in 30 people may have some form of it, and the risk increases as you get older or if you have certain conditions like diabetes.

It can affect anyone, but it is more common in people with diabetes, people who drink large amounts of alcohol over many years, people with vitamin deficiencies, older adults, and people who have had certain infections or exposure to toxins.

Symptoms

Common symptoms

• Numbness, tingling, or a 'pins and needles' feeling in the hands, feet, legs, or arms
• Burning, stabbing, or sharp pain, often worse at night
• Muscle weakness or difficulty lifting the front part of the foot
• Feeling like you are wearing gloves or socks when you are not
• Extreme sensitivity to touch even from light pressure
• Loss of balance or coordination

Symptoms in children

• Children may complain of unusual tingling, clumsiness, or not liking the feel of certain textures on their feet or hands.
• Parents may notice a child tripping more often, dropping things, or having trouble with activities that were previously easy.
• Foot or hand pain in children with diabetes or other health conditions should be evaluated early.

Symptoms in older adults

• Older adults may notice burning foot pain at night, trouble feeling their feet on uneven floors, or an increased risk of falling.
• Loss of feeling can make minor cuts or blisters go unnoticed, which can lead to infections.
• Weakness in the legs can make daily tasks like climbing stairs harder.

Causes

Main causes

• Diabetes — the most common cause, especially when blood sugar levels stay high over time
• Heavy alcohol use, which can damage nerves directly and interfere with vitamin absorption
• Vitamin deficiencies, particularly vitamin B12 and folate
• Certain infections, such as shingles or Lyme disease
• Autoimmune conditions, where the body's immune system attacks its own nerves
• Certain medications or exposure to toxic substances
• Injury or pressure on a nerve, such as from a slipped disc or narrow spaces in the spine

Risk factors

• Having diabetes for many years
• Poorly controlled blood sugar levels
• Heavy alcohol use
• Being over 40 years old
• Having kidney disease
• Having an underactive thyroid (hypothyroidism)
• Family history of neuropathy
• Undergoing chemotherapy or taking certain other medications

When to see a doctor

See a doctor urgently if:

• If you suddenly cannot move a limb or part of your face
• If you have trouble speaking, seeing, or thinking clearly
• If you lose control of your bladder or bowels
• If a skin sore on a numb area becomes red, warm, or drains fluid

Book a routine appointment if:

• If you have ongoing tingling, numbness, burning, or pain in your hands or feet
• If you notice tripping, dropping things, or losing your balance more often
• If you have diabetes and have not had a foot check recently
• If you have symptoms that get worse over several weeks or months

Diagnosis

A healthcare provider will ask about your symptoms, medical history, and lifestyle. They will examine you, checking your strength, reflexes, feeling, and balance. Based on what they find, they may order tests to help find the cause of the nerve damage.

Tests that may be done

• Blood tests to check for diabetes, vitamin levels, thyroid function, and other conditions
• Nerve conduction studies to measure how quickly electrical signals move along your nerves
• Electromyography (EMG) to test how well your muscles respond to nerve signals
• Skin biopsy to examine small nerve endings under a microscope
• Magnetic resonance imaging (MRI) or other scans of the brain or spine

What to expect at your appointment

Testing process is usually not painful, though some tests may feel slightly uncomfortable. You may be asked to stop taking certain medicines before the test. It may take a few weeks to get all the results. Your provider will explain what your results mean and work with you to create an action plan.

Treatment

Treatment for neuropathy generally focuses on treating the underlying cause, relieving symptoms, and preventing further nerve damage. With early and consistent care, many people can manage symptoms and stay active.

Self-care at home

• Check your feet daily for cuts, blisters, redness, or swelling, especially if you have diabetes
• Keep your skin clean and moisturized, and trim toenails carefully
• Limit alcohol or avoid it completely
• Quit smoking, as smoking narrows blood vessels that keep nerves healthy
• Protect numb feet with well-fitting, cushioned shoes
• Use warm (not hot) water for bathing and always test the temperature with your hands or elbow

Medical treatments

Your healthcare provider may suggest treatments based on the cause. For example, if you have diabetes, better blood sugar control is key. If you have a vitamin deficiency, supplements may help. Physical therapy can improve strength and balance. For nerve pain, there are medications designed for nerve-related pain — your doctor or a pain specialist can talk with you about options and any possible side effects.

When is surgery considered?

Surgery is not usually needed for neuropathy, but it may be considered in rare cases when a nerve is being compressed by a slipped disc or a narrowed spine. Your specialist can explain if surgery might help your situation.

Living with this condition

Living with neuropathy can mean making small changes to protect yourself. Take your time when standing up or walking, use handrails, place non-slip mats in the bathroom, and choose shoes that fit well. If your hands are affected, be careful with sharp objects and hot surfaces. An organised home and good lighting can also reduce the risk of falls.

Lifestyle tips

• Stay active with safe activities like walking, swimming, or chair exercises
• Set a schedule for regular health check-ups, especially if you have diabetes
• Aim for 7 to 8 hours of sleep a night to help your body recover
• Manage stress with relaxation techniques such as breathing exercises or gentle stretching
• Wear warm socks and gloves in cold weather to protect your extremities

Diet and exercise

A balanced diet rich in fruits, vegetables, whole grains, lean proteins, and healthy fats supports nerve health. Make sure you get enough vitamin B12 from foods like eggs, fish, dairy, or fortified cereals, or ask your provider about supplements if needed. Regular moderate exercise — such as 30 minutes of walking most days — improves blood flow, helps control blood sugar, and can reduce pain over time.

Mental health and emotional wellbeing

Living with chronic pain or numbness can be emotionally draining. It is common to feel frustrated, anxious, or low. These feelings are not a sign of weakness. Talking to a trusted friend, family member, or mental health professional can help. If you are struggling, reach out for support — you do not have to handle it alone.

Prevention

Not all cases of neuropathy can be prevented, but you can lower your risk significantly. If you have diabetes, keeping your blood sugar, blood pressure, and cholesterol in a healthy range is one of the most important steps. Limiting alcohol, eating a balanced diet, staying physically active, and avoiding toxins can also help protect your nerves.

Vaccines

Some infections that may lead to neuropathy, such as shingles, can be prevented with vaccines. Ask your healthcare provider which vaccines are recommended for you based on your age and health history.

Screening programmes

If you have diabetes, ask for an annual foot examination that checks sensation, pulses, and skin health. Regular check-ups that include blood tests can catch conditions like vitamin B12 deficiency before nerve damage happens.

Complications

If left untreated

• Worsening numbness, tingling, and pain that interfere with daily life
• Lack of feeling in the feet, leading to unnoticed injuries, calluses, or ulcers
• Serious foot infections that could become deep, infected, or lead to amputation
• Balance problems with a higher risk of falls and fractures
• Muscle weakness and wasting, especially in the hands and legs

Long-term outlook

The outlook for neuropathy depends on the cause and how early it is addressed. For many people, treating the underlying condition — such as managing diabetes or correcting a vitamin deficiency — can slow down or even halt progression. With good self-care, the right support, and regular check-ups, many people continue to live full, active lives. It is never too late to ask for help and start protecting your nerves.

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