Peripheral Neuropathy

What is peripheral neuropathy?

Peripheral neuropathy happens when the nerves in your hands, feet, and arms get damaged. These nerves carry messages between your brain and the rest of your body. When they don't work properly, you might feel pain, numbness, or weakness.

In the UK, almost 1 in 10 people over 55 have this condition. It's quite common, especially as we get older.

What are the symptoms?

The main signs of peripheral neuropathy include:

• Numbness and tingling in your hands or feet - like pins and needles that don't go away
• Burning, stabbing or shooting pain in the affected areas
• Loss of balance - you might feel unsteady when walking
• Muscle weakness, particularly in your feet
• Loss of feeling - you might not notice cuts or injuries

These symptoms can be constant or come and go. They usually start in your feet first, then may spread upwards over time.

When should you see your GP?

Speak to your GP if you notice:

• Pain, tingling or loss of feeling in your feet
• Problems with balance or weakness
• A cut or sore on your foot that isn't healing properly

Don't wait - getting help early gives you the best chance of preventing the condition from getting worse.

If you have diabetes, you should have regular check-ups anyway, as you're at higher risk of developing nerve problems.

What causes it?

In the UK, diabetes (both type 1 and type 2) is the most common cause. High blood sugar levels over time can damage your nerves.

Other causes include:

• Physical injury to nerves
• Viral infections like shingles
• Side effects from some medicines
• Drinking too much alcohol regularly

How is it treated?

Treatment depends on what's causing your nerve damage and which symptoms you have.

If you have diabetes, better control of your blood sugar levels can help. This might mean:

• Taking your diabetes medicines as prescribed
• Following a healthy diet
• Stopping smoking
• Cutting down on alcohol

For nerve pain, your GP might prescribe special medicines called neuropathic pain medicines. Regular painkillers like paracetamol often don't work well for nerve pain.

Other treatments might include:

• Physiotherapy for muscle weakness
• Walking aids if you have balance problems
• Specific treatment for other symptoms you might have

What could happen if it's not treated?

Without proper treatment, peripheral neuropathy can lead to serious complications. The most concerning is foot problems - you might develop sores or cuts that don't heal properly. In severe cases, these can become infected and lead to gangrene, which might mean part of your foot needs to be removed.

The condition can also affect nerves that control your heart and blood pressure, which may need special treatment.

The outlook

How well you recover depends on what caused the nerve damage and how early treatment starts. Some people improve if the underlying cause is treated successfully. Others may have permanent damage or find their symptoms gradually get worse.

The key message is: don't ignore symptoms. Speak to your GP as soon as you notice any signs of nerve problems.

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Based on NHS.uk guidance. Written by Dr Krishnan Pasupathi, NHS GP.