preventing neuropathy

Overview

Neuropathy (ner-OP-uh-thee) is damage to the nerves that carry signals between your brain and the rest of your body. When these nerves are harmed, you can feel pain, tingling, numbness, or weakness, most often in the hands and feet.

Yes. It is estimated that over 10% of adults experience some form of neuropathy, and it is especially common among people with diabetes.

Neuropathy can affect anyone, but it is more common in older adults, people with diabetes, people who consume too much alcohol, and those with certain vitamin deficiencies or inherited conditions.

Symptoms

Common symptoms

• Numbness or reduced ability to feel pain or temperature, especially in the feet or hands
• Tingling, burning, or a 'pins-and-needles' feeling
• Sharp, stabbing, or electric-shock-like pain
• Muscle weakness or trouble walking
• Sensitivity to touch, even light touch
• Loss of coordination or balance

Symptoms in children

• Children may not describe symptoms clearly but may show clumsiness, frequent trips or falls, or complaints of 'feet feel weird'
• Parents may notice a child avoiding wearing shoes or unusually sleepy or irritable
• Difficulty taking part in physical activities they used to enjoy

Symptoms in older adults

• Burning or shooting pain in the feet at night
• Unsteady walking and increased risk of falls
• Numbing that can mask injuries, so minor cuts or blisters go unnoticed
• Weakness in the hands, leading to difficulty holding items

Causes

Main causes

• High blood sugar (diabetes) — the leading cause of peripheral neuropathy
• Vitamin B12 deficiency or other vitamin imbalances
• Excessive alcohol consumption over many years
• Autoimmune diseases such as lupus or rheumatoid arthritis
• Physical injury, such as a herniated disc or compressed nerve
• Infections like shingles (herpes zoster) or Lyme disease

Risk factors

• Diabetes or prediabetes
• Chronic kidney disease or liver disease
• Family history of neuropathy
• Long-term alcohol misuse
• Smoking or inactive lifestyle
• Exposure to certain toxins or heavy metals

When to see a doctor

See a doctor urgently if:

• If you suddenly develop weakness in your legs or feet and cannot stand or walk
• If you have a fever with redness and swelling around a foot wound
• If you experience sudden bladder or bowel control problems

Book a routine appointment if:

• If you have persistent tingling, burning, numbness, or weakness that does not go away
• If you have diabetes and have any foot problems or loss of sensation
• If you are over 50 and notice balance or coordination changes

Diagnosis

Your doctor will ask about your symptoms, medical history, and lifestyle. They will examine your nerves, muscles, and reflexes, and may order blood or other tests to find the cause.

Tests that may be done

• Blood tests to check blood sugar, vitamin levels, and thyroid function
• Nerve conduction study – measures how fast electrical signals travel along your nerves
• Electromyography (EMG) – tests the electrical activity of your muscles
• Neurological exam – checks reflexes, coordination, sensation, and muscle strength

What to expect at your appointment

You may be referred to a neurologist, a doctor who specialises in nerves and the brain. Most tests are painless, though the nerve conduction study can cause mild temporary discomfort, like a small electric shock.

Treatment

Treatment focuses on stopping or slowing further nerve damage and relieving symptoms. The first step is often to treat the underlying cause – for example, improving blood sugar control in diabetes, taking supplements for a deficiency, or reducing alcohol intake.

Self-care at home

• Check your feet every day for cuts, blisters, or redness, especially if you have diabetes
• Wear comfortable, well-fitting shoes and non-slip slippers at home
• Avoid walking barefoot, even indoors
• Inspect your shoes for stones or rough edges before putting them on
• Keep your skin moisturised but avoid cream between toes

Medical treatments

There are medicines that help calm nerve pain, such as certain types of antidepressants or anti-seizure drugs – your doctor will choose one based on your situation. Your doctor may also recommend topical skin treatments, physical therapy, or techniques like nerve blocks. Always ask your doctor what is best for you.

When is surgery considered?

Surgery is only needed when neuropathy is caused by a physical pressing on a nerve, such as a herniated disc or a trapped nerve in the wrist (carpal tunnel syndrome). Most neuropathies do not require surgery.

Living with this condition

Living with neuropathy means looking after your body and being extra careful with your feet and hands. Use handles where possible, keep floors clear, and avoid extreme temperature to reduce discomfort. Many people find that gentle stretching or walking helps.

Lifestyle tips

• If you smoke, get help to stop – smoking damages blood flow to nerves
• Limit alcohol to no more than what is recommended by your health adviser
• Keep your blood sugar within the target range if you have diabetes
• Maintain a healthy weight to reduce pressure on your legs and feet

Diet and exercise

Eat a balanced diet rich in fruits, vegetables, whole grains, and lean protein. Foods naturally high in B vitamins, such as eggs, dairy, beans, and leafy greens, can support nerve health. Regular exercise, like walking, swimming, or cycling, improves blood flow and keeps muscles strong. Aim for at least 30 minutes of activity on most days, unless your doctor advises otherwise.

Mental health and emotional wellbeing

Living with chronic pain, numbness, or physical limitations can take a toll on your mood. It is common to feel anxious, frustrated, or low. Remember that these feelings are normal, and talking to your doctor, a counsellor, or a trusted friend can help. Your mental health matters as much as your physical health.

Prevention

Many cases of neuropathy can be prevented or delayed. The most important step is controlling your blood sugar if you have diabetes. Keeping blood pressure healthy, eating well, exercising, avoiding smoking, and limiting alcohol also reduce your risk.

Vaccines

Getting vaccinated against shingles can reduce your risk of developing a painful nerve complication called post-herpetic neuralgia. Ask your doctor whether the shingles vaccine is right for you.

Screening programmes

If you have diabetes, ask your doctor for at least one foot check every year. Your doctor may also do a simple nerve test, called a monofilament test, to check if you can feel light pressure on your feet.

Complications

If left untreated

• Foot ulcers (open sores) and serious infections, which may sometimes lead to amputation
• Falls and injuries due to balance problems
• Muscle wasting and long-term disability
• Permanent loss of sensation that can make it hard to detect injury

Long-term outlook

With early detection, careful management, and a healthy lifestyle, many people with neuropathy can slow its progression and keep good quality of life. Symptoms may not fully disappear, but treatment can reduce pain and help you stay active and independent.

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