Neuropathy is nerve damage in the network of nerves outside the brain and spinal cord called the peripheral nervous system. These nerves carry sensation, control movement, and regulate automatic body functions like heart rate, digestion, and sweating. When they are damaged, signals can become weak, confused, or overactive. You may feel numbness, tingling, burning, sharp pain, or notice weakness or balance problems. Early evaluation matters because some causes are treatable and symptoms can improve with the right care.
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Common causes
Many conditions can injure peripheral nerves. The most frequent include
Diabetes and metabolic syndrome
Nerve compression or injury from accidents or repetitive motion
Autoimmune conditions such as Guillain Barre syndrome, chronic inflammatory demyelinating polyneuropathy, lupus, or vasculitis
Infections such as shingles, Lyme disease, hepatitis B or C, and HIV
Vitamin B deficiencies and other nutritional problems
Toxins including heavy metals and some chemotherapy agents
Kidney, liver, or thyroid disease
Genetic conditions such as Charcot Marie Tooth disease
Alcohol use disorder
Tumors that press on or invade nerves Sometimes the cause remains unknown and is called idiopathic neuropathy.
We can coordinate care for neuropathy so you are not alone
Symptoms to watch
Symptoms depend on which nerves are affected.
Sensory nerves Numbness, tingling, pins and needles, burning pain, sensitivity to touch, and reduced ability to feel temperature or pain.
Motor nerves Muscle weakness, cramps, wasting, foot drop, and problems with coordination or falls.
Autonomic nerves Dizziness when standing, sweating changes, stomach or bowel issues, bladder problems, and sexual dysfunction. Tell your clinician right away if you have rapidly worsening weakness, trouble walking, loss of bowel or bladder control, or new severe pain.
When to seek care and how neuropathy is diagnosed
Seek medical care promptly if numbness, burning, or weakness lasts more than a few days, keeps you from daily tasks, or progresses. Clinicians diagnose neuropathy using your history, a neurological exam, and tests chosen for your situation. Testing may include
Blood tests for glucose and A1C, vitamin B levels, thyroid and kidney function, and other markers
Nerve conduction studies and electromyography to measure how nerves and muscles work
Skin biopsy to assess small fiber nerve endings when small fiber neuropathy is suspected
Imaging to look for structural causes of nerve compression Results guide next steps, including treatment of the underlying cause.
An Understood Care advocate can help you find the correct care for your personal needs, connect you with the right specialist, coordinate covered testing, and organize follow up. To get started call us at (646) 904-4027 or book at https://app.understoodcare.com/
You are more than your pain. Support is here to bring relief. Talk to an advocate today
Treatment goals
Treatment focuses on three goals
Address the cause when possible
Reduce pain and other symptoms
Protect function and safety in daily life
Treating the underlying cause
Examples include improving blood sugar control in diabetes, correcting vitamin deficiencies, adjusting or switching medications that affect nerves, and treating autoimmune or infectious causes. Progress checks help your team tailor the plan.
Pain relief options
Several medicine groups can reduce neuropathic pain. Your clinician will match choices to your health profile and other medicines.
Antiseizure medicines such as gabapentin or pregabalin
Antidepressants used for pain relief including duloxetine or certain tricyclics such as amitriptyline or nortriptyline
Topical therapies such as lidocaine patches or capsaicin for localized pain These can cause side effects like sleepiness, dizziness, dry mouth, or skin irritation. Dose adjustments and slow changes can improve tolerability. Opioids are not first choice for long term management because benefits are limited and risks are higher.
Non drug approaches that help
Physical therapy for strength and balance, regular low impact activity such as walking or pool exercise, and protective footwear can support function and reduce falls. Some people benefit from structured pain coping skills such as cognitive behavioral strategies. Devices like braces or canes may prevent injuries during flares. A layered plan that combines several methods is common and often more effective than any single step.
Safety and foot care
Daily foot checks, protective shoes, and early care for small injuries are essential when sensation is reduced, especially if you have diabetes. Keep floors clear, add night lights, and stand up slowly to lower fall risk. Ask about a podiatry visit for nail care and shoe fitting if feet are numb or deformed.
Daily habits that support nerve health
Keep blood sugar near your personalized goal if you live with diabetes
Choose balanced meals with enough B vitamins and other nutrients
Stay active within your limits and build up slowly
Stop smoking and limit alcohol
Sleep on a regular schedule and manage stress
Use a symptom diary to track patterns and triggers These steady routines often improve comfort and can slow progression for some causes.
How caregivers can help
Observe changes in walking, balance, or pain and share notes with the care team
Help with medication timing and refills
Support foot checks and safe home setup with clear pathways and good lighting
Encourage movement, hydration, and meals
Watch for mood changes and sleep problems and mention them during visits
Talk to an Advocate (646) 904-4027
Preparing for your visit
Bring
A list of symptoms with start dates and patterns
All medicines and supplements with doses
A brief medical and family history including diabetes, thyroid, kidney, or autoimmune conditions
Questions about tests, treatment choices, and safety at home
Key takeaways
Neuropathy describes nerve damage outside the brain and spinal cord. Causes vary and many are treatable. Diagnosis uses history, exam, and targeted tests. A personalized plan often includes treating the cause, medicines for nerve pain, non drug strategies, and strong safety steps. Early care and daily habits can improve comfort and protect independence.
Your story is bigger than pain. We can help you find relief.
Finnerup NB, Attal N, Haroutounian S, et al. Pharmacotherapy for neuropathic pain in adults. Lancet Neurology. Open access summary on PubMed Central. https://pmc.ncbi.nlm.nih.gov/articles/PMC4493167
Mailis A, Taenzer P, et al. A comprehensive algorithm for management of neuropathic pain. Pain Research and Management. Open access on PubMed Central. https://pmc.ncbi.nlm.nih.gov/articles/PMC6544553
This content is for education only and does not replace professional medical advice. If you have new weakness, severe pain, fever with confusion, chest pain, or trouble breathing, call emergency services.
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