long lasting neuropathy

Overview

Neuropathy is damage to the nerves outside the brain and spinal cord. When it lasts a long time (months or years), it is called chronic neuropathy. It can cause pain, numbness, tingling, or weakness, often in the hands and feet.

Yes, neuropathy is fairly common, especially among people with diabetes and older adults. About 1 in 3 people with diabetes may develop it.

It can affect anyone, but is more common in people with diabetes, those over 55, heavy alcohol users, and people with vitamin deficiencies or autoimmune diseases.

Symptoms

Common symptoms

• Numbness or reduced sensation in the hands or feet
• Tingling, burning, or 'pins and needles' feeling
• Sharp, stabbing, or shooting pain
• Weakness or clumsiness in the hands or feet
• Increased sensitivity to touch

Symptoms in children

• Trouble walking or running
• Complaints of pain in the hands or feet
• Clumsiness or dropping things

Symptoms in older adults

• Loss of balance and falls
• Difficulty feeling pain or temperature changes
• Difficulty with fine motor tasks like buttoning clothes

Causes

Main causes

• Diabetes (most common cause)
• Vitamin B12 deficiency
• Chronic alcohol use
• Infections such as shingles or Lyme disease
• Autoimmune diseases like rheumatoid arthritis or lupus
• Side effects of certain medications, such as some chemotherapy drugs

Risk factors

• Poorly managed diabetes
• Heavy alcohol use over many years
• Family history of neuropathy
• Chronic kidney disease
• Exposure to toxins like lead or mercury

When to see a doctor

See a doctor urgently if:

• If you lose bladder or bowel control
• If you have sudden, severe pain or weakness that makes it hard to move

Book a routine appointment if:

• If you have persistent numbness, tingling, or pain in your hands or feet
• If you have diabetes and notice any changes in sensation
• If symptoms interfere with your sleep or daily activities

Diagnosis

Your doctor will ask about your medical history, do a physical exam, and check your nerve function. They may refer you to a neurologist (nerve specialist).

Tests that may be done

• Blood tests to check for vitamin deficiencies, diabetes, and infections
• Nerve conduction studies to measure how fast electrical signals travel through your nerves
• Electromyography (EMG) to check the electrical activity of your muscles
• In rare cases, a nerve biopsy (taking a small sample of nerve tissue)

What to expect at your appointment

A complete evaluation can take time. Keep a diary of your symptoms to share with your doctor. Treatment may begin while testing continues.

Treatment

Treatment aims to manage pain, treat the underlying cause, and slow nerve damage. Most people need a combination of self-care, medical treatments, and lifestyle changes.

Self-care at home

• Protect your feet and hands from injury – check them daily for cuts or sores
• Keep blood sugar under control if you have diabetes
• Avoid alcohol and smoking
• Stay active with gentle exercise like walking, swimming, or yoga
• Practice good foot care – wear comfortable shoes and keep nails trimmed

Medical treatments

Doctors may prescribe medications for nerve pain, such as certain antidepressants or anticonvulsants that are used for nerve pain. Physical therapy can help with strength and balance. Topical creams or patches that numb the skin may also be used. Always discuss treatment options with your healthcare provider – do not use any medication without a prescription.

When is surgery considered?

Surgery is rarely needed for neuropathy itself. However, if a nerve is being compressed by a herniated disc or other structure, surgery may help relieve pressure and symptoms.

Living with this condition

Living with chronic neuropathy can be challenging, but many people find relief with a combination of treatments. Work closely with your healthcare team to create a plan that fits your life.

Lifestyle tips

• Manage your blood sugar and blood pressure if needed
• Eat a balanced diet with plenty of fruits, vegetables, and whole grains
• Get enough sleep to help manage pain
• Avoid smoking and limit alcohol

Diet and exercise

A healthy diet can help control conditions like diabetes. Gentle exercises such as stretching, tai chi, or walking can improve balance and reduce pain. Ask your doctor before starting any new exercise program.

Mental health and emotional wellbeing

Chronic pain and loss of function can lead to anxiety or depression. It is important to talk about your feelings with your doctor or a mental health provider. You are not alone – help is available.

Prevention

Some causes can be prevented. Managing diabetes well, avoiding excessive alcohol, eating a balanced diet rich in B vitamins, and staying active can lower your risk. If you have a condition that increases risk, regular check-ups are important.

Vaccines

Vaccinations for shingles (herpes zoster) and other infections may help reduce the risk of neuropathy from those illnesses. Talk to your doctor about recommended vaccines.

Screening programmes

If you have diabetes, your doctor should check your feet and sensation at every visit. People at high risk may benefit from periodic nerve checks.

Complications

If left untreated

• Falls and injuries due to loss of balance or numbness
• Foot ulcers and infections, especially in people with diabetes
• Permanent nerve damage that does not improve
• Difficulty walking or performing everyday tasks

Long-term outlook

With proper care, many people with neuropathy can manage their symptoms and maintain a good quality of life. The outlook depends on the underlying cause, but early diagnosis and treatment make a big difference. It is possible to live well with neuropathy.

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