Peripheral neuropathy
Peripheral neuropathy
Peripheral neuropathy happens when the peripheral nerves are damaged, and the symptoms a person notices depend on which nerves are affected.
In the UK, it is estimated that almost 1 in 10 people aged 55 or over live with peripheral neuropathy.
The peripheral nervous system is the network of nerves lying outside the brain and spinal cord (the central nervous system). This includes the nerves in the feet and hands.
These peripheral nerves carry out several jobs: they transmit sensations such as pain and touch, they control muscles, and they regulate body functions such as blood pressure.
Types of peripheral neuropathy
Peripheral neuropathy comes in 4 types. Sensory neuropathy damages the nerves that carry sensations like touch, temperature and pain. Motor neuropathy damages the nerves that control movement. Autonomic neuropathy damages the nerves that control body functions such as digestion, bladder function and blood pressure. Mononeuropathy damages a single nerve outside the central nervous system.
It is common for a person to have more than one type of peripheral neuropathy at the same time.
Common Symptoms
⚠️ This symptom list is for educational purposes. Having these symptoms does not mean you have this condition. See a doctor for proper diagnosis.
Medicines Commonly Used
⚠️ These medicines are commonly used for confirmed diagnoses of this condition. This is NOT a recommendation or prescription. Treatment must be determined by your doctor.
No medicines have been linked to this condition yet.
Causes
Causes of peripheral neuropathy
Diabetes (both type 1 and type 2) is the most common cause of peripheral neuropathy. This is called diabetic polyneuropathy
The high blood sugar levels associated with diabetes can damage the nerves, causing diabetes.
Peripheral neuropathy becomes more likely the longer you’ve had diabetes.
Your risk of diabetic polyneuropathy is higher if:
- your blood sugar is poorly controlled
- you smoke
- you regularly consume large amounts of alcohol
- you’re over 40 years old
There are many other possible causes of peripheral neuropathy. These can include:
- monoclonal gammopathy of undetermined significance (the presence of abnormal protein in the blood)
- cancers like lymphoma (cancer of the lymphatic system) and multiple myeloma (bone marrow cancer)
- low levels of vitamins like vitamin B12
- drinking too much alcohol for a long period of time
- malnutrition (poor diet)
- some types of chemotherapy for cancer, particularly those used for bowel cancer, breast cancer, lymphoma or myeloma
- genetic conditions that cause nerve damage, like Charcot-Marie-Tooth disease
- some medications when taken for a long time, like metronidazole, nitrofurantoin, phenytoin, amiodarone and thalidomide
- physical injury to the nerves
- infections like shingles, lyme disease, diphtheria, botulism and HIV
- hypothyroidism (an underactive thyroid gland)
- chronic kidney disease or liver disease
- conditions caused by an overactive immune system, like rheumatoid arthritis, lupus, Sjogren’s disease or vasculitis (inflammation of the blood vessels)
- rare conditions like Guillain-Barré syndrome and amyloidosis
- exposure to high levels of toxins, like arsenic, lead or mercury
Diagnosis
If you notice symptoms of peripheral neuropathy, make an appointment with your GP. They'll ask about your symptoms and may arrange some tests to help find out what's causing it.
If you're taking a medication known to cause peripheral neuropathy, your GP may temporarily stop it or lower your dose to see whether your symptoms improve.
Do not stop taking any prescribed medication without checking with your GP or healthcare provider first. Doing so could make you very ill.
If your GP isn't sure what's causing your peripheral neuropathy, you may be referred to a neurologist, a specialist in conditions affecting the nervous system. They may carry out further tests.
Generally, the sooner peripheral neuropathy is diagnosed, the better. Early diagnosis gives you the best chance of limiting the damage and preventing further complications.
Contact your GP practice if you have:
- pain, tingling or loss of sensation in the feet
- loss of balance or weakness
- a cut or ulcer on your foot that isn't healing
Complications
The outlook for peripheral neuropathy can vary quite a bit from person to person. It usually depends on a few things:
- what is causing the nerve damage in the first place
- which nerves are affected
- how severe the damage has become
If the underlying cause behind your peripheral neuropathy can be treated, there is a good chance it will improve with time and proper care. For instance, if your diabetes is kept well under control, it can stop the neuropathy from getting worse, and you may even notice your symptoms easing over time.
On the other hand, if the underlying cause cannot be treated, the nerve damage may end up being permanent, and it could gradually worsen as time goes on.
Possible complications of peripheral neuropathy
Peripheral neuropathy can sometimes lead to further health complications, and a few of these can be quite serious. They include:
- cardiovascular autonomic neuropathy, where damage to the peripheral nerves leads to problems with your heartbeat and blood circulation
- diabetic foot ulcers, where damage to the blood vessels causes wounds to heal unusually slowly, which can then lead to further problems