What is peripheral neuropathy

Peripheral neuropathy is a complex condition resulting from damage to the nerves outside of your brain and spinal cord (the peripheral nervous system). Because these nerves act as the "wiring" for your body, damage can disrupt everything from how you feel a soft touch to how your heart beats.

Types of Nerve Damage

The symptoms you experience depend entirely on which of the three types of peripheral nerves are damaged:

• Sensory Nerves: These carry sensations like temperature, pain, and touch. Damage often causes tingling ("pins and needles"), numbness, or extreme sensitivity (where a bedsheet feels painful).

• Motor Nerves: These control muscle movement. Damage leads to muscle weakness, cramps, twitching, or even loss of muscle mass (atrophy).

• Autonomic Nerves: These control involuntary functions like blood pressure, heart rate, and digestion. Damage can cause dizziness when standing up, excessive sweating (or an inability to sweat), and bowel/bladder issues.

Common Causes

While there are over 100 known causes, they generally fall into these major categories:

Diagnosis & Evaluation

Doctors typically use a combination of methods to identify the source of the nerve damage:

• Physical & Neurological Exams: Testing your reflexes, muscle strength, and ability to feel different sensations (vibration, light touch, heat).

• Blood Tests: To check for diabetes, vitamin levels, and markers of inflammation or immune system activity.

• Nerve Function Tests: 

  • EMG (Electromyography): Measures the electrical activity in your muscles.

  • Nerve Conduction Study (NCS): Measures how fast and strong electrical signals travel through your nerves.

• Skin or Nerve Biopsy: Taking a tiny sample to look at the density of nerve endings.

Current & Emerging Treatments (2026)

As of early 2026, treatment focuses on two goals: managing the underlying cause and relieving the symptoms.

• Underlying Cause: Controlling blood sugar in diabetics or providing B12 injections for deficiencies can sometimes stop the progression and even allow nerves to slowly repair.

• Pain Management: Common medications include anti-seizure drugs (gabapentin, pregabalin) and certain antidepressants (duloxetine).

• Neuromodulation: Recent advancements include Scrambler Therapy and Spinal Cord Stimulation, which use electrical currents to "block" or "reprogram" pain signals before they reach the brain.

• Lifestyle Support: Physical therapy helps with balance and muscle weakness. Specialized footwear and regular foot exams are critical to prevent "silent" injuries that can lead to ulcers.

Managing Daily Life

Because neuropathy often affects the feet and hands (the "stocking and glove" distribution), safety is a priority:

• Foot Care: Inspect your feet every night for cuts or blisters you may not have felt.

• Fall Prevention: Remove trip hazards (like throw rugs) and use bright lighting, as your sense of balance may be compromised.

• Temperature Safety: Be cautious with hot water; use your elbow or a thermometer to test bathwater to avoid burns.

  
  

Note: In about 30% to 50% of cases, no specific cause is found; this is called Idiopathic Neuropathy