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Peripheral Neuropathy (Peripheral Nerve Damage) 

Peripheral neuropathy is a condition that occurs when the nerves outside of the brain and spinal cord become damaged or irritated. These nerves help control sensation, movement, and certain automatic body functions. When they are affected, patients may experience numbness, tingling, burning pain, or changes in strength and balance. 

While diabetes is one of the most common causes of peripheral neuropathy, many other conditions can contribute to nerve damage, including vitamin deficiencies, certain medications, alcohol use, autoimmune disorders, and other medical conditions. 

At Fortera Health, we evaluate the underlying cause of your symptoms to help determine the most appropriate approach for managing nerve pain, improving function, and protecting your quality of life. 

Common Symptoms 

Peripheral neuropathy most commonly affects the feet and hands and may include: 

  • Numbness or decreased sensation in the feet, legs, hands, or fingers 
  • Tingling, pins-and-needles sensations, or burning pain 
  • Sharp, stabbing, or electric-like nerve pain 
  • Increased sensitivity to touch or temperature 
  • Feeling unsteady or having difficulty with balance 
  • Muscle weakness in more advanced cases 
  • Symptoms that become worse at night and interfere with sleep 

Symptoms often begin in the toes and feet before gradually progressing upward. In some cases, the hands may also become affected, creating a “stocking-and-glove” pattern. 

What Causes Peripheral Neuropathy? 

Peripheral neuropathy can develop from many different causes. Common contributing factors include: 

  • Diabetes and abnormal blood sugar levels 
  • Vitamin deficiencies, especially vitamin B12 deficiency 
  • Alcohol use 
  • Certain medications, including some chemotherapy treatments 
  • Thyroid disorders 
  • Kidney disease 
  • Autoimmune conditions that affect the nerves 
  • Infections that can damage nerve function 
  • Genetic conditions that affect nerve health 

In some cases, no specific cause is identified even after evaluation. This is known as idiopathic peripheral neuropathy. 

How Is Peripheral Neuropathy Diagnosed? 

Diagnosis begins with a detailed review of your symptoms, medical history, and physical examination. Your provider will evaluate sensation, strength, reflexes, balance, and areas of discomfort. 

Testing may include: 

  • Blood tests to identify underlying causes such as diabetes, vitamin deficiencies, thyroid disorders, or other medical conditions 
  • Nerve conduction studies or electromyography (EMG) to evaluate nerve function 
  • Specialized testing for small fiber neuropathy when symptoms are present but routine nerve testing is normal 

Because many conditions can cause similar symptoms, identifying the underlying cause is an important part of creating an effective treatment plan. 

Treatment Options 

Treatment depends on the cause of the neuropathy and the type of symptoms you are experiencing. Options may include: 

  • Treating the underlying cause, such as improving blood sugar control or correcting vitamin deficiencies 
  • Medications designed to reduce nerve-related pain 
  • Topical treatments for localized discomfort 
  • Physical therapy to improve strength, balance, and mobility 
  • Lifestyle changes that support overall nerve health 
  • Foot care strategies to prevent injuries when sensation is reduced 
  • Spinal cord stimulation (SCS) or other advanced pain management options for patients with persistent nerve pain that has not improved with other treatments 

While nerve damage cannot always be completely reversed, early evaluation and appropriate treatment can help reduce symptoms, improve function, and prevent complications. 

Clinician performing a nerve conduction study, with electrodes placed along a patient's forearm and hand

At Fortera Health, we recognize that nerve pain can affect sleep, independence, and everyday activities. Through a comprehensive evaluation and personalized treatment approach, our team helps patients better understand their condition and explore options to improve their comfort and quality of life. 

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