Peripheral Neuropathy

Peripheral neuropathy describes damage to your peripheral nerves, that is, the nerves to your hands and feet. Any damage to these nerves disrupts the important sensory information pathway between the limbs and the brain, resulting in changes to sensation. Nerve damage can occur in any part of the body. In the lower limbs, the primary cause for neuropathy is diabetes, and so is otherwise known as diabetic neuropathy, although diabetic neuropathy also describes other types of neuropathy including autonomic, radiculoplexus and mononeuropathy.  

What causes peripheral neuropathy?

In diabetes, it is the prolonged exposure to high levels of blood sugar that causes nerve damage. It is estimated that almost half of people with diabetes will develop neuropathy. Other causes of neuropathy can include:
  • Trauma/injury to the nerves
  • Infections
  • Alcoholism
  • Systemic conditions, autoimmune diseases and other diseases
  • Exposure to toxins
  • Effects of certain medications
  • Poor nutrition and vitamin deficiency

What are the symptoms?

The symptoms of peripheral neuropathy usually worsen progressively, because of the continued effect of elevated blood sugar in diabetes. They are often felt at the feet and toes. Symptoms generally include:
  • Numbness
  • Tingling
  • Burning
  • Pins and needles
  • Reduced ability to detect hot and cold sensations
  • Pain
  • Muscle weakness
  • Impaired reflexes
  • Absence of sensation
Because these symptoms are largely focused on impaired sensation, this can place you at risk of complications. Complications can occur when an injury is sustained but not felt because of the effects of the neuropathy. This places you at risk for infection, ulceration and worse.  

How is it treated?

Because damage to the nerves is generally irreversible, it’s all about managing the symptoms, preventing their onset and delaying their progression. With diabetes, this is done by keeping your blood sugar in check and maintaining a healthy and active lifestyle. Management also needs to focus on addressing the symptoms that neuropathy is having on your feet. If you’re experiencing numbness in regions of your feet that is limiting your ability to detect any cuts or wounds, a daily check of your feet will greatly reduce your risk of infection and complications. Checking your feet daily, wearing shoes outside the house and slippers inside the house, and being aware of any new or unusual symptoms to report to your practitioner is a great place to start. Ensure you’re wearing good, comfortable shoes, keeping your feet clean and are careful when cutting toenails to not sustain injury. Any other condition or ailment that impacts sensation, such as callus and dry skin, should also be managed accordingly. If you do notice anything abnormal, it’s important that you report it to your practitioner. Your podiatrist will perform annual foot screening tests that include assessing your sensation. This must be done regularly due to the progressive nature of neuropathy, so you can be aware of all of your risks and how to best manage them.