Peripheral Neuropathy: Symptoms, Causes, Treatments

Peripheral neuropathy is a condition where the peripheral nerves (those are the nerves outside of your spinal cord and brain) are damaged.

The most common symptoms of peripheral neuropathy are numbness, pain, weakness or tingling in the hands or feet, and sometimes also in the arms and legs. You may feel more touch sensitivity, or find activities painful that would otherwise be pain-free. 

Peripheral neuropathy can give you an odd sensation that you have gloves or socks on, even if you are wearing nothing on your hands or feet.

Movement problems may be involved if you have damage to your motor nerves.

When peripheral neuropathy involves autonomic nerves, symptoms can include sweating excessively or not at all, intolerance to heat, blood pressure drops, digestive issues, or bowel or bladder problems.

Peripheral neuropathy can be quite a challenging condition, and understanding its symptoms is key to recognizing it early and seeking help.

The symptoms can vary widely depending on which nerves are affected, with primary symptoms affecting sensory, motor, or autonomic nerves. Let’s break down what you might experience for each variety.

Peripheral neuropathy can significantly impact motor nerves, which are responsible for sending signals from the brain to the muscles. When these nerves are damaged, it can lead to a variety of symptoms that affect movement and coordination. Here are some of the most common motor nerve symptoms:

Muscle Cramps and Twitching: Involuntary muscle contractions, such as cramps or twitching, can occur due to the misfiring of damaged motor nerves. This can be uncomfortable and may further contribute to muscle weakness.

Atrophy: Over time, if the motor nerves are severely damaged, the muscles they control may begin to shrink or atrophy due to lack of use. This can lead to noticeable changes in muscle size and strength.

Fatigue: Individuals may experience increased fatigue during physical activities because the muscles are not functioning optimally due to nerve damage.

Sensory symptoms of peripheral neuropathy can be quite distressing and significantly affect daily life. These symptoms arise from damage to the sensory nerves, which are responsible for transmitting sensations from the body to the brain. Here’s a closer look at the common sensory symptoms associated with peripheral neuropathy:

• Numbness or Tingling: Many people experience a "pins and needles" sensation, often starting in the toes or fingers and potentially spreading upward into the legs and arms. This numbness can make it difficult to feel sensations properly.
• Burning or Sharp Pain: Individuals may describe their pain as sharp, jabbing, or burning. This type of pain can be particularly intense and may interfere with daily activities.
• Extreme Sensitivity to Touch: Some people develop a heightened sensitivity to touch, where even light contact can cause discomfort or pain. This condition is known as allodynia.
• Loss of Coordination: Damage to sensory nerves can lead to difficulties in coordination, making it harder to perform tasks that require balance and fine motor skills.
• Feeling of Wearing Gloves or Socks: A peculiar sensation that some individuals report is feeling as if they are wearing gloves or socks, even when they are not. This can be disorienting and may affect mobility.

Autonomic neuropathy occurs when there is damage to the autonomic nerves, which control involuntary bodily functions such as heart rate, blood pressure, digestion, and bladder function. This condition can lead to a variety of symptoms, depending on which nerves are affected.

1. Dizziness and Fainting: A sudden drop in blood pressure can cause dizziness or fainting, especially when standing up.
2. Urinary Problems: Individuals may experience difficulty starting urination, loss of bladder control, or the inability to sense a full bladder, which can lead to urinary tract infections.
3. Sexual Dysfunction: This can include erectile dysfunction in men and issues such as vaginal dryness or difficulty reaching orgasm in women.
4. Digestive Issues: Symptoms may include feeling full after only a few bites, loss of appetite, nausea, vomiting, diarrhea, constipation, and abdominal bloating.
5. Inability to Recognize Low Blood Sugar: Damage to the autonomic nerves can prevent the body from signaling low blood sugar levels, making it harder to recognize hypoglycemia.
6. Sweating Problems: Individuals may sweat too much or too little, affecting their ability to regulate body temperature.
7. Sluggish Pupil Reaction: This can make it difficult to adjust from light to dark, impacting vision, especially at night.
8. Exercise Intolerance: Some may find that their heart rate does not adjust appropriately during physical activity, leading to fatigue or discomfort.

Diabetes is the most common cause of peripheral neuropathy. High blood sugar levels can damage the small blood vessels that supply nerves, leading to diabetic neuropathy. More than half of people with diabetes will develop some form of neuropathy over time.

Conditions where the immune system attacks the body’s own tissues can lead to peripheral neuropathy. Examples include:

• Sjogren's syndrome
• Lupus
• Rheumatoid arthritis
• Guillain-Barré syndrome
• Chronic inflammatory demyelinating polyneuropathy

Certain viral and bacterial infections can cause nerve damage. Notable examples include:

• Lyme disease
• Shingles
• Hepatitis B and C
• HIV
• Diphtheria

Thankfully, there are treatments available for peripheral neuropathy. Keep in mind that if you have another underlying health condition, it is crucial that you treat that condition too in order to protect your health now and in the future.

Peripheral neuropathy is sometimes treated with immunosuppressive drugs. Individual responses to immunotherapy are highly variable, and having a thorough understanding of the risks and benefits is key.

Lidocaine is a popular topical treatment for peripheral neuropathy. Along with its analgesic effects, it has anti-inflammatory properties. It is not addictive, and can be used daily over the long term with 12-hour breaks between applications. 

You can buy lidocaine as a cream or ointment, or on patches. The patches may seem expensive, but you can wear one for many hours, and you may be able to cut them up, depending on the area you need to cover. So, a box of patches may last quite a bit longer than you would think, and arguably offers a superior value in some cases.

Most patients use over-the-counter lidocaine, though a slightly stronger form is available through prescription. Is it worth it? Well, it is quite a bit pricier than the OTC variety, but many patients swear by it. You may want to try it if you like OTC lidocaine, but still feel you could use something stronger.

It can be difficult to maintain a healthy lifestyle when you have peripheral neuropathy. The pain, numbness and other unpleasant sensations can make it challenging to stay active.

Getting to the point where you can walk with neuropathy regularly can be beneficial. It can boost your circulation, strengthen your muscles, and reduce your stress. It can also help you to maintain your overall wellness. 

You can start by doing some simple, gentle stretches and balance exercises for neuropathy, and then progress to things like swimming, walking and cycling when you are ready.

One thing that can help you out a lot is choosing suitable shoes for neuropathy, such as the Cadense Original Adaptive Shoe. 

This shoe’s patented variable friction technology helps you to “glide” across uneven surfaces, even if you have difficulty fully lifting your feet due to your nerve damage.

The shoes are made out of breathable, lightweight material, minimizing fatigue and preventing an uncomfortable build-up of heat and sweat. Cushioning provides comfort and support, and the wide base offers improved stability. 

Along with exercise, something else you can do is improve your diet. A healthy diet for neuropathy includes B vitamins, magnesium, omega-3 fatty acids and antioxidants. 

Remember that lifestyle changes are most effective if you make them a long-term commitment. You may need to eat better and stay more active for weeks or months to start noticing improvements. So, be patient, and stick with your new routines. Hopefully you will start feeling better soon.

Peripheral neuropathy can shorten life expectancy. A research study found a strong association between peripheral neuropathy and earlier mortality among an older population. The researchers suggest that the reason for the association might be problems with balance, but say that further investigation is needed.

In some cases, peripheral neuropathy may also be associated with underlying health conditions that can shorten lifespan.

Another possibility is that the impact that peripheral neuropathy has on mental health or lifestyle could lead to earlier mortality. 

If your peripheral neuropathy is mild, you have no underlying health conditions, and you can maintain a healthy lifestyle, the effect on your lifespan could be negligible.

But in severe cases or those where an underlying health condition is involved, you may be at risk for earlier mortality.

Let’s take a look at some underlying health conditions that are commonly associated with peripheral neuropathy.

The most common cause of peripheral neuropathy is diabetes, affecting around half of diabetes patients. 

You should note that patients with diabetes can also get other types of neuropathy, including autonomic neuropathy, proximal neuropathy and mononeuropathy.

Diabetic neuropathy can be mild, moderate, or severe, causing different levels of disability. 

Diabetes itself is associated with a shortened lifespan. Researchers have found that the earlier the age of the diagnosis, the shorter the life expectancy. For every decade, life expectancy is shortened by 3-4 years.

In addition, research shows that peripheral neuropathy is linked to higher rates of cardiovascular disease (CVD) events in patients with diabetes. 

Cardiovascular disease events such as heart attacks and strokes can be deadly, so this is another connection between peripheral neuropathy and shortened lifespan.

Diabetes, high blood pressure, and other conditions can lead to chronic kidney or renal failure. It is estimated that anywhere between half and all of people with chronic kidney disease develop a type of peripheral neuropathy called “uremic neuropathy” as a complication. 

The symptoms are similar to those occurring in other types of peripheral neuropathy: pain, numbness, tingling, weakness, loss of balance, and a heat sensation in the feet and legs. Sometimes, the patient may experience restless legs syndrome.

Research shows that people who exercise may experience less neuropathic pain than those who do not. 

Alas, staying active can be a challenge with peripheral neuropathy, because the pain and numbness can make it difficult to keep moving. 

Not only that, but underlying health conditions associated with peripheral neuropathy also may make it harder to work out. 

We will offer some recommendations for safer, easier exercise with peripheral neuropathy later on in this post.

There is a high prevalence of depression among people with peripheral neuropathy. Depression can worsen pain, but of course, feeling pain can also feed into depression.

This can create a positive feedback loop that continues to amplify both pain and depression. Patients who receive both treatment for their physical pain and their psychological symptoms may benefit more than those who only receive one or the other.

Depending on the nerves that are affected as well as the severity of the condition, some patients experience complications of neuropathy that may lead to the risk of earlier mortality.

Most people with peripheral neuropathy will never experience this complication, but it does show up in some cases, especially those involving Guillain-Barré syndrome (GBS). The neuropathy leads to weakness in the muscles used for breathing, which in turn causes the difficulties with breathing.

If you have numbness in your feet or legs, it can be harder to know where your feet are at in space. As a result, you are more likely to misstep and lose your balance.

In some cases, peripheral neuropathy can lead to atrophy of the muscles. In severe cases, the loss of muscle tissue in the hands and feet can be severe enough to cause deformity.