Neuropathy, peripheral

Peripheral neuropathy is a term for a group of conditions in which the peripheral nervous system is damaged.

The peripheral nervous system is the network of nerves that lie outside the central nervous system (the brain and spinal cord).

It includes different types of nerves with their own specific functions, including:

sensory nerves – responsible for transmitting sensations, such as pain and touch
motor nerves – responsible for controlling muscles
autonomic nerves – responsible for regulating automatic functions of the body, such as blood pressure and bladder function

Signs and symptoms

Damage to the peripheral nerves can cause a wide range of symptoms depending on the specific nerves affected.

In many cases, the condition first develops in the extremities of the body, such as the feet, hands, legs and arms.

The main symptoms of peripheral neuropathy can include:

numbness and tingling in the feet or hands
burning, stabbing or shooting pain in affected areas
loss of balance and co-ordination
muscle weakness, especially in the feet

These symptoms are usually constant, but may fluctuate.

Generally, the sooner peripheral neuropathy is diagnosed, the better the chance of limiting the damage and preventing further complications. It's therefore important to see a GP if you experience symptoms of peripheral neuropathy.

What causes peripheral neuropathy?

In the UK, diabetes (both type 1 and type 2) is the most common cause of peripheral neuropathy.

Over time, the high blood sugar levels associated with diabetes can damage the nerves. This type of nerve damage is known as diabetic polyneuropathy.

Peripheral neuropathy can also have a wide range of other causes. For example, it can be caused by physical injury to the nerves, a viral infection such as shingles, or as a side effect of certain medications.

People who are known to be at an increased risk of peripheral neuropathy may have regular check-ups so their nerve function can be assessed.

Read more about the causes of peripheral neuropathy.

Who is affected?

Peripheral neuropathy is a relatively common condition that affects around 1 in 50 people in the UK. The condition becomes more common as you get older, and has been estimated to affect almost 1 in every 10 people who are 55 or over to some degree.

How peripheral neuropathy is treated

Treatment for peripheral neuropathy depends on the underlying cause and the type of symptoms you are experiencing.

Only some of the underlying causes of neuropathy can be treated. For example, if you have diabetes, controlling your blood sugar better, stopping smoking and cutting down on alcohol may help.

Nerve pain may be treated with special prescribed medication as standard painkillers don't usually work.

If you have other symptoms associated with peripheral neuropathy, these may need to be treated individually. For example, treatment for muscle weakness may involve physiotherapy and the use of walking aids.

If peripheral neuropathy affects the nerves controlling the automatic functions of the heart and circulation system (cardiovascular autonomic neuropathy), you may need treatment to increase your blood pressure, or possibly a pacemaker.

Read more about treating peripheral neuropathy.

Outlook

The outlook for peripheral neuropathy varies, depending on the underlying cause and which nerves have been damaged.

Some cases may improve with time if the underlying cause is treated, whereas for some people the damage may be permanent or may get gradually worse with time.

In cases of peripheral neuropathy caused by diabetes, bringing your diabetes under better control can help prevent further nerve damage and may help improve your existing symptoms.

If the underlying cause of peripheral neuropathy is not treated, you may be at risk of developing potentially serious complications, such as a foot ulcer that becomes infected.

This can lead to gangrene (tissue death) if untreated, and in severe cases may mean the affected foot has to be amputated.

Read more about the complications of peripheral neuropathy.