In short
Peripheral neuropathy is damage to the nerves outside the brain and spinal cord, usually starting in the feet with numbness, tingling or burning. Diabetes is the most common cause in Australia. Treatment focuses on finding and managing the cause, protecting your feet, and easing nerve pain.
On this page
What is peripheral neuropathy?
Peripheral neuropathy is damage to the peripheral nerves, the nerves that run from the spinal cord to the arms, legs and organs. The most common pattern starts in the toes and feet and slowly moves up the legs, and later can affect the fingers and hands. Doctors call this a “glove and stocking” pattern.
Symptoms
- Numbness or reduced feeling in the feet
- Tingling, pins and needles or a feeling of walking on cotton wool
- Burning, stabbing or electric pains, often worse at night
- Sensitivity to touch, such as bedsheets on the feet
- Poor balance, especially in the dark
- Weakness in the feet or ankles in some types
Numb feet can stop you noticing cuts, blisters or burns, which can turn into ulcers. That’s why foot care is so important.
Nerve pain getting in the way?
Talk it through with an Australian doctor online. No referral needed.
Common causes
- Diabetes. The most common cause. Up to half of people with diabetes develop nerve damage over time, and it can also occur with prediabetes.
- Heavy alcohol use.
- Vitamin B12 deficiency, which can be linked to diet, gut conditions or some long-term medicines.
- Some cancer treatments.
- Kidney disease, an underactive thyroid and some autoimmune and inflammatory conditions.
- Inherited neuropathies, which often run in families.
In a proportion of people, no cause is found even after testing. This is called idiopathic neuropathy.
How it’s diagnosed
A doctor will ask about your symptoms, health, alcohol use and family history, and examine sensation, reflexes and strength. Blood tests usually check blood sugar, B12, kidney, liver and thyroid function, and sometimes other markers. Nerve conduction studies can confirm the type of neuropathy. If symptoms are unusual, come on quickly or affect one side, a referral to a neurologist is common.
Treatment for neuropathy in the legs and feet
- Treat the cause. Good blood sugar control can slow progression in diabetes. Correcting low B12 and reducing alcohol help when those are the cause.
- Protect your feet. Check them daily, wear well-fitting shoes, never walk barefoot, test bath water with your elbow, and see a podiatrist regularly if you have diabetes.
- Stay active. Exercise, including balance training, helps strength and reduces falls.
- Manage nerve pain. If pain is a problem, some medicines that act on the nervous system can help. Your GP can explain options and side effects.
- Look after sleep and mood, which both affect how nerve pain feels.
Lost nerve function doesn’t always come back, but the right care can stop it getting worse, reduce pain and prevent complications.
When to see a doctor
See a GP if you have numbness, tingling or burning in your feet, a foot wound that isn’t healing, or worsening balance. Get urgent help if weakness or numbness spreads quickly over days, which can be a sign of a rare but serious condition called Guillain-Barré syndrome.
Next step: talk to a doctor
Answer a few quick questions and you’ll get an email about your eligibility. A consultation doesn’t guarantee any particular treatment.
References
- Feldman EL, Callaghan BC, Pop-Busui R, et al. Diabetic neuropathy. Nat Rev Dis Primers. 2019;5(1):41.
- Hicks CW, Selvin E. Epidemiology of Peripheral Neuropathy and Lower Extremity Disease in Diabetes. Curr Diab Rep. 2019;19(10):86.
- Colloca L, Ludman T, Bouhassira D, et al. Neuropathic pain. Nat Rev Dis Primers. 2017;3:17002.
- healthdirect. Peripheral neuropathy.
This guide is general information, not medical advice. It doesn’t replace a consultation with a doctor who knows your history. In an emergency, call 000.