How Peripheral Neuropathy Affects the Nervous System
To understand the meaning of peripheral neuropathy, it helps to know a little about the nervous system, and how it is structured.
The nervous system is made up of two main parts:
The central nervous system—consisting of the brain and spinal cord.
The peripheral nervous system—the network of nerve fibers that send and receive signals between the rest of the body and the central nervous system.
When the nerves that make up the peripheral nervous system are damaged, it can disrupt the transmission of signals.
Imagine that your nerve fibers are electrical cables carrying signals all around your body. If the cables are damaged, the flow of electricity is disrupted, or they could even short-circuit. A similar thing can happen to your nerves—this is what causes the symptoms of peripheral neuropathy such as numbness, tingling, pain and muscle weakness.
Peripheral Neuropathy Symptoms
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Common symptoms of peripheral neuropathy are:
Pamamanhid (numbness)
Tusok-tusok (tingling)
Pangangalay (muscle weakness)
Pins and needles
Burning sensations
Extreme sensitivity to touch
Loss of balance and coordination
Cramps, muscle twitching or spasms.
Shooting or stabbing pains
Other possible symptoms include:
Fainting or dizziness
Copious sweating or an inability to sweat
Nausea and/or vomiting
Diarrhea or constipation
Low blood pressure
Erectile dysfunction
Incontinence.
What Causes Peripheral Neuropathy?
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There are many potential causes of nerve damage, so it’s not always possible to pinpoint a single factor. However, some of the most common causes of peripheral neuropathy include:
Diabetes. 1 in 2 people with diabetes develop neuropathy.
Vitamin B deficiency. Low levels of B vitamins can result in peripheral nerve damage.
Obesity. Being overweight increases the risk of diabetes. Bariatric surgery to treat obesity also can affect the absorption of essential vitamins, leading to peripheral neuropathy.
Toxins. Prolonged exposure to toxins like mercury, arsenic or lead can cause nerve damage.
Injuries. Physical trauma, for example from an injury or surgery, can result in permanent or temporary damage to nerve fibers.
Some hereditary conditions. In rare cases, peripheral neuropathy may be caused by disorders such as Charcot-Marie-Tooth (CMT) disease, which runs in families.
Long-term alcohol use. Drinking high quantities of alcohol for many years is a potential cause of peripheral neuropathy.
Idiopathic Peripheral Neuropathy
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In some cases, peripheral neuropathy develops with no obvious cause at all. When this happens, it is known as idiopathic neuropathy. You might be surprised to learn how common this type of neuropathy is: around 22 percent of all cases of neuropathy have an unknown origin, even after a thorough examination and investigation. This makes it the second most common form of neuropathy after nerve damage caused by diabetes.
Idiopathic neuropathy is common in seniors and typically progresses slowly, or it may appear relatively quickly but not progress any further. Common symptoms of idiopathic peripheral neuropathy include:
Pamamanhid (numbness), tusok-tusok (tingling) or pain in the feet that may spread upwards
Unsteady gait or posture
Pangangalay (weak muscles, for example in the ankles)
Muscle cramps
Diagnosing Peripheral Neuropathy
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If you suspect you may have peripheral neuropathy it’s important to see your doctor, who may consider any or all the following when making a diagnosis:
Duration of the symptoms. Your doctor may ask how the symptoms appear and how long you have been experiencing your symptoms (such as tingling, numbness etc.), whether it develops suddenly and lasts a short time, often only a few days or weeks, or it develops slowly and may worsen over an extended period of time—months to years.
Medical history. If you have diabetes or other conditions associated with peripheral neuropathy, or if you take medicines that are known to cause peripheral neuropathy , your doctor will likely investigate these as possible underlying causes.
Understand more about your symptoms. Describe your symptoms in detail with your doctor, such as numbness, pins and needles, tingling sensation etc; where do you feel the symptoms e.g. finger tips or toes, left/right or both sides of your hands or feet.
Sensory test. To understand how would your respond to a stimulus, your doctor may perform sensory test using simple tools, such as warm or cold feeling, vibration perception, or pin-prick test.
Other laboratory tests. Blood tests and other laboratory tests may be used to help identify the cause of the peripheral neuropathy. If needed, your doctor may refer to specialist for more complex tests.
Complications of Peripheral Neuropathy
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If nerve damage is left untreated, it can lead to complications, which is why early diagnosis and treatment is so important for nerve health.
Possible complications of peripheral neuropathy can include:
Diabetic foot ulcers. 1 in 4 of diabetic patients develop foot ulcers, leading to amputations in severe cases. Diabetes can damage blood vessels, so less blood reaches the feet. Because blood contains the infection-fighting cells, cuts, scratches—or even just blisters caused by badly fitting shoes—can take longer to heal and may develop into ulcers if untreated.
Burns and other injuries. If you can’t feel pain or temperature changes, there’s a risk you could get burned, scalded or otherwise injured without being aware of it.
Falls. Impaired balance and coordination can lead to more frequent falls.
Heart and circulatory problems. Diabetes-related neuropathy can damage the nerves that help control heart rate and blood circulation. The most typical symptoms of this kind of neuropathy, known as cardiovascular autonomic neuropathy (CAN) are being unable to exercise for very long, and low blood pressure that causes faintness of dizziness when standing up.
Infection. If you lose some or all of the sensation in parts of your skin, injuries can go unnoticed and become infected without you knowing. It’s important to check any areas that are numb and treat any small injuries before they can get worse. In the most severe cases, an infection could eventually lead to gangrene and the loss of an extremity such as a toe or foot.
Peripheral Neuropathy Treatment
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Whether you’ve already noticed symptoms or just want to lower the risk of them developing, there’s plenty you can do to help prevent peripheral neuropathy or stop it getting worse. These include:
B vitamin supplements. Peripheral neuropathy can be treated with vitamin B supplements. Your doctor may also advise taking a B vitamin complex in combination with other therapies or lifestyle changes to support your nerve health. Read more about neurotropic vitamins.
Treating or managing underlying conditions. It’s essential to treat or manage any condition—such as diabetes, heavy alcohol use increases the risk of peripheral neuropathy. For example, with diabetes—the most common underlying cause of nerve damage—it’s vital to keep blood sugar levels under control.
A nerve-friendly lifestyle. Healthy lifestyle choices can help prevent or alleviate peripheral neuropathy symptoms. A healthy balanced diet including plenty of fruits, vegetables, wholegrain foods, and low-fat protein is good for your nerves. Exercising for 30 to 60 minutes 3 or more times a week (with your doctor’s approval) is another way of boosting your nerve health, as well as your general fitness and wellbeing. It’s also important to avoid risk factors like repetitive movements, cramped or confined positions, handling toxic substances, smoking or heavy drinking.
Frequently Asked Questions
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Warning signs like tusok-tusok (tingling), pamamanhid (numbness), burning sensations, pins and needles and unexplained falls or ‘butterfingers’ moments should never be ignored. Peripheral neuropathy is usually treatable or manageable—especially if it’s caught in the early stages. Proper diagnosis and treatment of the causes and symptoms of neuropathy can help you live a fuller life and avoid serious complications.
