“The medical diagnosis underlying the neuropathy must first be established and managed, when possible,” Dr. Strand advised.

As with any comprehensive clinical evaluation, Dr. Strand noted that a complete history should be obtained, as well as physical and laboratory examination, electrodiagnostic studies (which are commonly used), quantitative sensory testing, and any additional testing as indicated (imaging, rheumatologic screen, thyroid function tests, chest radiographs, HIV testing, Lyme titers, skeletal survey).

The etiology of peripheral neuropathy is varied and includes alcoholism, autoimmune diseases, diabetes, exposure to poisons, medications, infections, inherited disorders, trauma or pressure on a nerve, tumors, and vitamin deficiencies. Other disease states include kidney disease, liver disease, connective tissue disorders, and amyloidosis.


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Diabetic peripheral neuropathy is the most common form of diabetic neuropathy. Patients may describe such symptoms as numbness; a reduced ability to feel pain or changes in temperature; a sharp, jabbing pain that may be worse at night; and a tingling or burning feeling. Causes of diabetic peripheral neuropathy include damage to nerves and blood vessels, inflammation in the nerves, smoking, and alcohol abuse. Poor blood sugar control, kidney disease, smoking, and pressure points are risk factors for diabetic peripheral neuropathy.

Complications of peripheral neuropathy include loss of a limb (the worst case scenario), neurogenic arthropathy (Charcot joint), and social isolation (often undertreated), Dr. Strand said.

This article originally appeared on MPR