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 Peripheral Neuropathy
Understanding nerve damage, recognizing symptoms, and protecting everyday function.
Peripheral neuropathy occurs when nerves outside the brain and spinal cord become damaged or do not work normally. Symptoms often begin in the feet and may include numbness, tingling, burning pain, weakness, or difficulty with balance.
 Understanding Peripheral Neuropathy
 SENSORY NERVES
 MOTOR NERVES
 AUTONOMIC NERVES
How You Feel
Sensory nerves help you feel touch, temperature, pain, vibration, and the position of your body.
When affected, you may experience numbness, tingling, burning, pain, or unusual sensitivity to touch.
How You Move
Motor nerves carry signals from the brain and spinal cord to your muscles.
Damage may cause weakness, muscle cramps, difficulty walking, loss of coordination, or foot drop.
Automatic Body Functions
Autonomic nerves help control functions your body performs automatically, including blood pressure, heart rate, digestion, sweating, and bladder function.
Damage to these nerves can cause symptoms such as dizziness when standing, digestive changes, or abnormal sweating.
Peripheral neuropathy is not one specific disease.
It describes nerve damage that can result from many different conditions. Identifying the type and possible cause helps guide treatment.
 Signs & Symptoms
 SENSORY CHANGES
 STRENGTH & MOVEMENT
 BALANCE
What You May Feel
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Numbness or decreased sensation
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Tingling or “pins and needles”
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Burning sensations
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Sharp, shooting, or electric-like pain
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Increased sensitivity to touch
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Difficulty feeling heat or cold
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Common pattern: Symptoms often begin in the toes or feet and gradually move upward. Some people describe the sensation as feeling like they are wearing socks or gloves when they are not.
What You May Notice
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Muscle weakness
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Muscle cramps
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Difficulty walking
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Trouble climbing stairs
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Foot drop
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Difficulty with fine hand movements
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Muscle loss in more advanced cases
Changes in Stability
Reduced sensation in the feet can make it harder to know where your feet are positioned.
This may cause unsteadiness, difficulty walking in the dark or on uneven surfaces, and an increased risk of falls.
 Symptoms on both sides?
Many common polyneuropathies begin symmetrically in both feet. Symptoms that are sudden, rapidly worsening, or significantly different on one side should be discussed with your healthcare provider.
 What Causes Peripheral Neuropathy?
01
Diabetes & Metabolic Conditions
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Diabetes is one of the most common causes of peripheral neuropathy. Thyroid disorders, kidney disease, and other metabolic conditions may also damage peripheral nerves over time.
Deficiencies—particularly vitamin B12—can affect nerve health. Certain medications, chemotherapy treatments, excessive alcohol use, and exposure to some toxins may also cause neuropathy.
03
 Autoimmune, Infectious & Hereditary Conditions
04
 Injury, Compression & Unknown Causes
 Autoimmune diseases can cause the immune system to attack peripheral nerves. Some infections and inherited neurological disorders may also lead to neuropathy.
Nerves can be damaged by trauma or prolonged compression. In some people, extensive testing does not identify a specific cause; this is known as idiopathic neuropathy.
 Peripheral neuropathy can have many different causes. Identifying the underlying cause is important because some conditions can be treated or managed to help prevent further nerve damage.
Vitamin, Medication & Toxin Exposure
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Not all neuropathy is the same. Determining the pattern of nerve involvement and identifying potentially treatable causes can help guide the next steps in care.
 Treatment & Management
Manage Neuropathic Symptoms
Improve Strength & Function
Managing diabetes, vitamin deficiencies, autoimmune disease, medication effects, or other contributing conditions when possible.
Treatment may include medications and other strategies aimed at reducing burning, tingling, electric-shock sensations, and nerve pain.
Physical or occupational therapy may help with balance, walking, weakness, coordination, and maintaining independence.
Treat the Underlying Cause
 Protect the Feet & Prevent Injury
 Reduced sensation can make injuries harder to notice. Routine skin and foot checks, appropriate footwear, and fall-prevention strategies are important.
 Treatment is individualized. Peripheral neuropathy can have many causes, so the best treatment plan depends on the nerves affected, the underlying cause, symptom severity, and how the condition affects everyday function.
Living Well With Peripheral Neuropathy
Small changes in daily routines can make a meaningful difference when living with peripheral neuropathy. Protecting areas with reduced sensation, staying active, and making the home environment safer can help maintain independence and reduce the risk of injury.
Protect Your Feet & Skin
Regular movement can help maintain strength, flexibility, balance, and circulation. Choose activities appropriate for your abilities and follow recommendations from your healthcare or therapy team.
Prevent Falls
Keep walkways clear, use good lighting, wear supportive footwear, and use handrails or assistive devices when recommended. Report new balance problems or falls to your healthcare team.
Neuropathy can affect sensation before an injury is noticed. A quick daily check of your feet and skin can help identify problems early.
 Protect Your Feet &  Skin
Check your feet and other areas with reduced sensation regularly for cuts, blisters, redness, swelling, or sores. Wear properly fitting shoes and avoid walking barefoot when sensation is decreased.
Prevent Falls
Be Careful With Temperature
Reduced sensation can make it difficult to recognize temperatures that are too hot or cold. Test bath water carefully and avoid direct heating pads or other heat sources on areas with decreased sensation.
When Should I Seek Medical Care?
Peripheral neuropathy can affect sensation, strength, balance, and everyday activities—but understanding the cause and developing the right management plan can make a meaningful difference. Stay aware of changes in your symptoms, protect areas with reduced sensation, and work with your healthcare team to maintain safety, mobility, and independence.
Contact your healthcare provider if you notice:
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New or worsening numbness, tingling, burning, or pain
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Increasing weakness or difficulty using your hands or feet
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New balance problems or repeated falls
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A sore, blister, cut, or wound that is not healing
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Increasing swelling, redness, or changes in the skin
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Symptoms beginning to interfere with walking, sleep, or everyday activities
Seek prompt medical attention for:
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Sudden or rapidly worsening weakness
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New difficulty walking or inability to stand
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New loss of bladder or bowel control
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Severe dizziness, fainting, or significant changes in blood pressure
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A foot or skin wound with spreading redness, drainage, fever, or other signs of infection
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Sudden neurological symptoms such as facial drooping, difficulty speaking, or weakness on one side of the body
