Peripheral neuropathy is when damaged nerves cause you to feel pain, numbness, or weakness. It affects how your brain communicates with your body.
What is peripheral neuropathy?
Peripheral neuropathy is a set of painful and uncomfortable symptoms that result from nerve damage. These nerves are part of your nervous system and are responsible for sending information from your brain and spinal cord to the rest of your body, as well as carrying sensory information back to your brain. When these nerves are damaged, it can lead to a variety of symptoms, most commonly affecting the hands and feet.
There are dozens of different types of peripheral nerve disorders. And AHN has the experience to treat them all, helping you find relief.
AHN Neuromuscular Program
The AHN Neuromuscular Program, an integral part AHN’s Neuroscience, is dedicated to serving patients with diseases of the peripheral nerves, neuromuscular junction, and muscle.[BH1.1] Our expert staff has decades’ worth of experience in treating these conditions and are certified by both the American Board of Clinical Neurophysiology and the American Association of Electrodiagnostic Medicine. This dual certification illustrates the exceptional quality of care and dedication our staff deliver, performing at the highest standards of practice in clinical neurophysiology and electrodiagnostic medicine.
Why choose AHN for your peripheral neuropathy
At AHN, we understand the profound impact peripheral nerve disorders can have on your life. Peripheral nerves, which connect your brain and spinal cord to every part of your body, are vital for sensation, movement, and organ function. That's why our team brings many years of specialized experience and certifications to provide expert diagnosis and treatment for the wide range of peripheral nerve conditions.
Our approach is built on collaborative, multidisciplinary care. This means a team of highly skilled specialists works together, leveraging the latest medical advances to develop the most effective treatment plan for you.
Peripheral neuropathy symptoms and signs
The symptoms and signs of peripheral neuropathy can vary widely depending on which nerves are affected, the extent of the damage, and the underlying cause. However, they generally fall into categories related to sensory, motor, or autonomic nerve damage.
Sensory
When the nerves that transmit sensations are affected, people often experience
- Numbness: It’s often described as a decreased ability to feel pain, temperature, or touch. Numbness often starts in the feet and spreads upward into the legs, or in the hands and spreads into the arms.
- Tingling or prickling (paresthesias): This is a sensation often described as "pins and needles."
- Burning, sharp, or stabbing pain: You may feel a persistent, often intense, burning sensation.
- Increased sensitivity to touch (allodynia): Even light touch, such as the weight of a sheet, can be excruciatingly painful.
- Loss of proprioception: You may experience difficulty knowing where your body parts are in space, leading to problems with coordination and balance. You might struggle to walk in the dark or feel like you're walking on cotton.
Motor
Peripheral neuropathy can affect the nerves that control muscle movement, which can cause:
- Muscle weakness: It may be difficult to move a limb, lift your foot (foot drop), or grip objects.
- Muscle cramping or spasms: You may experience involuntary tightening of muscles.
- Loss of reflexes: A medical professional might notice diminished or absent reflexes during an examination.
- Loss of balance and coordination: This can happen due to both muscle weakness and sensory loss.
- Difficulty with fine motor skills: You could experience problems with tasks like buttoning a shirt or writing.
- Muscle wasting (atrophy): Over time, affected muscles may shrink in size.
Autonomic
Some peripheral symptoms and signs affect the nerves that control involuntary bodily functions and can cause:
- Heat intolerance and altered sweating: You might sweat excessively or not at all in certain areas.
- Bowel or bladder problems: People can experience constipation, diarrhea, urinary incontinence, or difficulty emptying your bladder.
- Digestive difficulties: You may have nausea, vomiting, feeling full quickly.
- Dizziness or lightheadedness: This is caused by a drop in blood pressure when standing up (orthostatic hypotension).
- Sexual dysfunction: For example, erectile dysfunction in men.
Causes and risk factors
Peripheral neuropathy can stem from a wide array of causes and risk factors. It's often a symptom or complication of another underlying condition. Common periphery neuropathy causes can include:
- Diabetes: This is the most common cause worldwide. High blood sugar levels over time can damage nerve fibers throughout the body, particularly in the feet and legs (diabetic neuropathy).
- Autoimmune diseases: These are conditions where the body's immune system attacks its own tissues, including nerves. Examples include: Guillain-Barré Syndrome, Chronic Inflammatory Demyelinating Polyneuropathy (CIDP), lupus, and rheumatoid arthritis.
- Infections: There are a variety of infections that can cause peripheral neuropathy, including lyme disease, shingles, and HIV/AIDS.
- Alcoholism: Drinking too much alcohol can lead to nutritional deficiencies (especially B vitamins) and directly toxic effects on nerve tissue.
- Kidney or liver disease: Chronic kidney failure leads to a buildup of toxins that can damage nerves.
Common risk factors that can cause peripheral neuropathy often include age, thyroid disorders, exposure to toxins, family history, and vitamin deficiencies.
Given the wide range of potential causes, diagnosing peripheral neuropathy often involves getting a thorough medical history, physical examination, and various tests to pinpoint the underlying issue.
Peripheral neuropathy screening and diagnosis
At AHN Neuroscience, our expert physicians specialize in diagnosing various peripheral nerve disorders. They have completed advanced fellowships and teach neurology residents, which requires ongoing learning and certification. Your physician may order one or more of the following tests to provide a precise diagnosis.
Electromyogram (EMG)
An Electromyography (EMG) test, often combined with nerve conduction studies (NCS), is a crucial tool in the screening and diagnosis of peripheral neuropathy. It provides objective information about the electrical activity of nerves and muscles.
Nerve conduction studies (NCS)
A nerve conduction velocity test measures the nerves’ ability to send electrical signals. We often perform it along with an EMG to help determine whether symptoms are related to your nerves or muscles.
Types and stages of peripheral neuropathy
There are various types of peripheral neuropathy based on the cause, the type of nerve fiber affected, and the number of nerves involved. Understanding the type can also help you understand the stages. There are certain types of peripheral neuropathy based on how they occur.
Neuropathy based on cause
Neuropathies can be caused by a number of different health conditions, environmental factors, and autoimmune diseases, but sometimes, the causes are unknown. Some of the most common causes of neuropathy include:
- Diabetic neuropathy: This is one of the most common types and is caused by high blood sugar levels damaging nerves over time.
- Autoimmune neuropathies: Conditions like Guillain-Barré syndrome, chronic inflammatory demyelinating polyneuropathy (CIDP), and lupus can cause the immune system to attack nerve tissue.
- Infectious neuropathies: Certain infections, such as Lyme disease, shingles (postherpetic neuralgia), HIV, and diphtheria, can damage nerves.
- Traumatic neuropathies: Injury to a nerve from an accident, fall, or repetitive stress can lead to neuropathy.
Based on nerve fiber affected
Your peripheral nerves handle different jobs in the body, and neuropathy can occur in various ways to those nerves. These include:
- Sensory neuropathy: This affects sensory nerves, leading to symptoms like numbness, tingling, pain (burning, shooting, stabbing), or loss of sensation.
- Motor neuropathy: This affects motor nerves, leading to muscle weakness, cramps, spasms, twitching, or paralysis.
- Autonomic neuropathy: This affects autonomic nerves, which control involuntary bodily functions. Symptoms can include problems with blood pressure, heart rate, digestion, bladder function, or sweating.
- Mixed neuropathy: This involves a combination of sensory, motor, and/or autonomic nerve damage, and this is very common.
Based on number of nerves involved
Sometimes, different amounts of nerves are affected. These are classified as the following types of neuropathy:
- Mononeuropathy: This affects a single nerve (e.g., carpal tunnel syndrome or ulnar nerve entrapment).
- Polyneuropathy: This affects multiple nerves, often symmetrically throughout the body (e.g., diabetic neuropathy, Guillain-Barré syndrome). This is the most common type.
- Mononeuropathy multiplex: This affects two or more separate nerves in different areas.
Stages of peripheral neuropathy
Peripheral neuropathy doesn't always progress in distinct, clearly defined "stages" like some other diseases. Instead, it's often described by its progression from mild to severe, or by the increasing impact on daily life. However, we can generally conceptualize its progression:
- Early/mild stage: This may include intermittent numbness, tingling (paresthesias), or mild pain, often in the extremities (hands and feet). Symptoms might come and go, and may not significantly interfere with daily activities.
- Moderate/progressive stage: This often includes persistent symptoms like numbness, tingling, and pain becoming more constant and widespread. Pain can become more severe, burning, sharp, or similar to an electric-shock, and symptoms start to interfere more significantly with work, hobbies, and general well-being.
- Severe/advanced stage: This causes significant numbness, leading to a high risk of unnoticed injuries, ulcers, and infections (especially in the feet). Patients often experience substantial muscle weakness and atrophy, potentially leading to foot drop, difficulty walking, or paralysis. Daily activities become very challenging, often requiring assistive devices or care.
It's important to remember that not everyone with peripheral neuropathy will progress through all these stages, and the rate of progression can vary greatly depending on the cause, the individual's overall health, and the effectiveness of treatment. Early diagnosis and management of the underlying cause are crucial for managing symptoms and slowing progression.
Peripheral neuropathy treatment
While there is rarely a cure for peripheral nerve disorders, our highly skilled specialists use the latest therapies to help you manage your symptoms while addressing the underlying causes of nerve damage. We use a collaborative approach to provide you with personalized peripheral neuropathy treatment recommendations.
We use a combination of medications and rehabilitative therapies, including:
- Medication: Your physician will help determine which medications would most benefit you.
- Plasmapheresis: This therapy, also called plasma exchange, filters your blood through a machine that removes harmful antibodies (similar to dialysis). It's not a common treatment needed in most neuropathies.
- Immunoglobulin therapy: You receive an infusion of doses of good antibodies from healthy donor blood. These new antibodies help block the bad antibodies that may be attacking your peripheral nervous system.
- Physical therapy: Certain exercises or activities may strengthen muscles and help you complete daily activities more easily. Our knowledgeable, caring physical therapists customize a physical therapy plan for your needs.
- Occupational therapy: Our specially trained occupational therapists can help you relearn how to complete daily activities that have become difficult, enhancing your independence at home or work.
- Orthopaedic devices: Devices such as braces support you in everyday movements and help prevent injuries.
Peripheral neuropathy FAQs
Peripheral neuropathy can be caused by a number of different health issues and diseases. It can be challenging to navigate without a trusted partner like your AHN care team. We are here to be your guide and resource, so you feel confident in your care. These frequently asked questions can help you in your future conversations with your AHN care team.
How bad can peripheral neuropathy get?
Peripheral neuropathy can range from a mild annoyance to a condition that significantly impacts daily life. In its most severe forms, it can lead to chronic pain, significant muscle weakness that makes movement difficult, loss of sensation that increases the risk of unnoticed injuries and infections, and problems with basic body functions like digestion or blood pressure.
Is peripheral neuropathy reversible?
Reversibility depends entirely on the cause and how early it's identified. If the underlying cause can be successfully treated or managed (like controlling blood sugar in diabetes, addressing vitamin deficiencies, or removing a toxic exposure), nerve damage can sometimes be stopped, and peripheral neuropathy symptoms may improve or even go away. However, if the nerve damage is extensive or chronic, it may not be fully reversible, and treatment focuses on managing symptoms and preventing further progression.
What causes peripheral neuropathy?
Common peripheral neuropathy causes include chronic diseases like diabetes, autoimmune conditions where the body mistakenly attacks its own nerves, certain infections, exposure to toxins or some medications, vitamin deficiencies, excessive alcohol use, physical injuries, and sometimes genetic factors. In many cases, a clear cause cannot be identified, which is then called idiopathic neuropathy.
Contact us
To schedule an appointment or learn more about AHN Neuroscience services, call 412-359-8850 for the Pittsburgh area and 814-452-7575 for the Erie region.