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Read articlePeripheral neuropathy is damage to the nerves supplying the hands and feet, producing numbness, burning and tingling. In this region diabetes is by far the commonest cause, followed by vitamin B12 deficiency, alcohol and long-standing kidney disease.
Symptoms
Not everyone gets every symptom, and the pattern can differ in older people, in people with diabetes and in children. These are the ones most often reported.
- Burning, tingling or pins-and-needles in the feet, worse at night
- Numbness that starts in the toes and slowly moves upward
- A feeling of walking on cotton wool or sand
- Weakness of the feet, tripping, or difficulty climbing stairs
- Painless ulcers or injuries on the feet that went unnoticed
- Unsteadiness in the dark or with the eyes closed
When to see a doctor
Do not wait these out
If any of the following applies, arrange to be seen the same day. For anything sudden or severe, call 9281862028 or come straight to the emergency department at SIMS — it is open 24 hours and does not need an appointment.
- Any loss of sensation in the feet, particularly if you have diabetes
- A foot ulcer, blister or crack that is not healing
- Rapidly progressing weakness of the legs or arms over days — this needs emergency assessment
- Difficulty passing urine, or weakness with numbness around the groin
Tests that may be advised
Your consultant will order only the investigations that change the plan. Most of the following are available on the SIMS campus, so results usually come back the same visit.
- Clinical examination including monofilament and vibration testing of the feet
- Blood sugar and HbA1c
- Vitamin B12, thyroid function and kidney function
- Nerve conduction studies
- Screening for other causes such as leprosy, alcohol use or medication toxicity
How it is treated
Treatment is decided case by case — by how advanced the problem is, what else you are being treated for, and what you can realistically sustain. Broadly, it involves the following.
- Treating the cause — tight blood sugar control, B12 replacement, stopping alcohol
- Specific medication for nerve pain, which is different from ordinary painkillers
- Daily foot inspection, well-fitting footwear and never walking barefoot
- Prompt attention to any wound, however small
- Physiotherapy for strength, balance and fall prevention
This page is general information, not a diagnosis
Peripheral Neuropathy can look like several other conditions, and the reverse is equally true. Nothing here can replace an examination, your test results and the judgement of the doctor treating you — and no medicine mentioned by name to a friend or relative should be started on the strength of this page. If you recognise yourself in it, book a consultation with the Neurology department. If a symptom is sudden or severe, call 9281862028.
