Peripheral neuropathy 

Introduction 

Electron micrograph of a section through nerve tissue, showing peripheral neuropathy or nerve damage. A dying nerve axon is at the centre.

Note on terms

Many neurologists now prefer to use the term ‘polyneuropathy’ rather than ‘peripheral neuropathy’ as the former term makes clear that multiple nerves are damaged simultaneously. 

In clinical terms, peripheral neuropathy could be used to describe cases where only one nerve is damaged.

However, as peripheral neuropathy is more widely used and understood by the public, this term will be used for the rest of this article.

Peripheral neuropathy is a term for damage to the peripheral nervous system.

The peripheral nervous system

The nervous system consists of two main two parts:

  • the central nervous system, which includes the brain and spinal cord
  • the peripheral nervous system, which includes all parts of the nervous system that lie outside the central nervous system, including the motor nerves, which the brain uses to control the muscles

The peripheral nervous system is made up of three main types of nerves, each with its own specific function:

  • Automatic nerves help regulate the automatic functions of the body, such as blood pressure, bladder function and sweat levels.
  • Motor nerves control the muscles of the body.
  • Sensory nerves pass sensations, such as cold, heat or pain, from the affected area of the body to the brain.

Peripheral neuropathy can cause one or more of the following symptoms:

  • numbness and tingling in the feet and hands
  • a burning, stabbing or shooting pain
  • loss of co-ordination in the affected body parts
  • muscle weakness

How common is peripheral neuropathy?

Peripheral neuropathy is a relatively common condition that affects around 1 in 50 people in England. Peripheral neuropathy usually affects older people, with 8% of people who are 55 years of age or over being affected by it.

In England, diabetes (both type 1 diabetes and type 2 diabetes) is the most common cause of peripheral neuropathy.

Over time, the high blood sugar levels associated with diabetes can damage the nerves. This type of nerve damage is known as diabetic polyneuropathy.

It is estimated that around one in five people with diabetes has diabetic polyneuropathy.

As well as being caused by diabetes, peripheral neuropathy can have a wide range of other causes. For example, it can be caused by a viral infection, such as HIV, or as a side effect of certain medications.

See Peripheral neuropathy - causes for more information.

Outlook

The outlook for peripheral neuropathy can vary widely depending on the underlying cause and what sort of peripheral nerves have been damaged.

For example, if the sensory nerves of the hands or feet are affected, the outlook is generally good. However, it is important that the underlying cause (diabetes) is aggressively treated.

This is because over time, diabetic polyneuropathy can cause a diabetic foot ulcer, an open sore that develops in the foot. If the ulcer becomes infected, there is a risk that the foot tissue will begin to die and it may be necessary to amputate the foot.

The outlook is not so good in cases where neuropathy affects the automatic functions of the heart and circulation system (cardiovascular automatic neuropathy). This is because the condition can increase the risk of sudden death as a result of the heart suddenly stopping beating (cardiac arrest).

Last reviewed: 03/08/2010

Next review due: 03/08/2012

Comments

10 Comments

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Comments are personal views. Any information they give has not been checked and may not be accurate.

slymp said on 15 February 2012

Hi, I have a bit of peripheral neuropathy following kidney failure. I haven't tried the following cream yet, but Google:

capsaicin cream

I think you can only get it on prescription. It might work for some.

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amazinggrace2505 said on 24 January 2012

I recently found out that I was also suffering from peripheral neuropathy, something i did not even know before.... the pain is excliciating especially at night is the worse time. My mobility has gone from bad to worse now. I am 39 years old, but feel like I am much older! I am currently being given gabapentin to ease the pain... I have undergone all sorts of tests during my week in the hospital but the doctors were amazed by my condition.... I would not wish this pain to my worse enemy! It depresses me now to see myself slowly becoming less able. I refuse to walk with a stick which was given to me on my discharge at the hospital. All i can do is just make sure my legs are well covered as they get very cold and painful when they are cold.

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Liggie said on 18 November 2011

By chance I discovered that an alkaline diet improved things - much less pain. Also avoiding smoked meats and preserved meats is worth trying

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Broadsman said on 05 July 2011

I have had PN in my feet for over 12 years. I am now 60. The cause is unknown although I do suffer with degenerative spine disease. In the earlier, poorly controlled stages, I suffered a lot with burning, tingling and shooting pains, which were almost unbearable. Parts of my feet are now numb and the muscles in my legs ache. Over the years, I have tried everything from gels, foot baths, various zombie producing drugs . . . the list goes on.
In recent years the pain has been controlled with a neuropathic painkiller. Three years ago I was referred to a pain clinic and was given epidurals, which helped for a few weeks. Eventually the pain clinic suggested I take a homeopathic dose of Methadone (4.5ml a day). I have been on this for over two years and combined with the neuropathic painkiller, it makes a huge difference to the quality of my life. It makes you feel a bit tired but you get a really good nights sleep - the latter a real benefit at 60 !

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chris222 said on 18 March 2011

Hi I'm a podiatrist and some of my patients who experience hot and tingly feet at night often report some relief using a deep cooling gel. Another tip is to stand up and try walking on a cold surface like the kitchen floor for a couple of minutes. Hope this helps.

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guenon said on 11 March 2011

I have Type 2 diabetes and have had neuropathy for 18 months - worse at night. A cradle to keep bedclothes off feet is helpful. I had NHS acupuncture and laser treatment with no relief. Specialist said it's successful in two-thirds of cases. I get good sleep after taking sugar-free Amitriptyline prescribed by GP but next day I'm left feeling like a zombie.

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blenkin123 said on 11 January 2011

I am 45 years old and have had peripheral neuropathy for almost 3 years. I have type 1 diabetes, which was diagnosed sixteen years ago. By my own admission my diabetes was not well controlled in the early years, but for the past 3 years has been well controlled. I suffer very badly all the time, the only time I ever get any relief from it is when I finally manage to drop off to sleep from sheer exhaustion. I can't remember the last time I had a good nights sleep. I too have been on Tramadol, Duloxetine, Meptazinol, Pregabalin and Gabapentine. I have also been treated with creams, TENS machines and last month I also had injections in my spine, which I had high hopes for but unfortunately only lasted for the day I had it. I am at my wits end with pain and everyday is just another day of suffering, which is making me extremely depressed. If anybody has any ideas or suggestions, I would love to hear from them.

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donniemurdo said on 21 December 2010

I have Common Variable Immune Deficiency (CVID) 22 years, and 6 years ago was diagnosed with type 1 diabetes. Like 123davec I have suffered with diabetic neuropathy for over 12 months, and similarly have great difficulty getting a decent nights sleep. My GP has prescribed all manor of pain killers including Tramadol but nothing works. I also suffer from lower back pain and pain in some of my joints but that has been attributed to the CVID. I try to maintain good diabetic control but frequently have high sugars. I find that the pain in my legs and feet is worse at night, even an evening in front of the TV can be uncomfortable and sleep is almost impossible. I would give anything for some relief from this and I hope that I will gain some information through this site.

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123davec said on 28 September 2010

i have had diabetic neuropathy for over 12 months,i have been diabetic type 1 for 25 years ,recently i have been having a very lot of pain in my feet and cannot get more than 2 hours sleep a night and no pain killers that my doc has prescribed works,also my diabetes is well controlled but i am starting to sweat a very lot during night,could this be a new problem,i also suffer from a lot of back pain and pain in my shoulders could you please help

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rachel007 said on 08 August 2010

I find this very interesting! I didnt know <a href="http://www.whatisneuropathy.org/">what is neuropathy</a> before this. My family member has neuropathy and it really makes me sad. I appreciate all of your wonderful information.

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