Peripheral Neuropathy: Symptoms, Causes & Treatment Guide

Peripheral Neuropathy

30 April 2025

Written and medically reviewed by Dr Sareesh Kumar M.K., Senior Consultant and Head, Neurosurgery & Spine Surgery, Mar Sleeva Medicity Palai. Last updated: 5 August 2026

Peripheral neuropathy is nerve damage affecting the peripheral nerves, the network that carries signals between the brain and spinal cord and the rest of the body. When these nerves are injured, the messages travelling to and from the hands, feet and internal organs are disrupted, producing numbness, tingling, burning pain and weakness. Diabetes is the single most common cause, but the condition has many triggers, and early diagnosis makes a real difference to how well the nerves recover.

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What is peripheral neuropathy?

Peripheral neuropathy develops when the nerves that lie outside the brain and spinal cord, the peripheral nerves, are damaged. These nerves are responsible for carrying signals in both directions: instructions from the brain out to the muscles, and sensory information from the skin, joints and organs back to the brain. When that two-way communication breaks down, the affected part of the body may lose sensation, feel abnormal pain, or stop responding to muscle commands properly.

The problem can involve a single nerve or many nerves at once. In most patients it begins in the longest nerves first, which is why the feet and hands are usually affected earliest and most noticeably.

The three types of peripheral nerves

Each group of peripheral nerves carries out a specific job, and the symptoms a patient notices depend on which type is damaged.

Sensory nerves carry sensations such as touch, temperature and pain. Damage here causes numbness, tingling and burning discomfort.

Motor nerves control muscle movement. When they are affected, the result is weakness, cramps and muscle wasting.

Autonomic nerves manage the involuntary functions the body runs automatically, including blood pressure, heart rate, sweating, digestion and bladder control. Damage to these nerves produces dizziness, abnormal sweating and bladder or bowel problems.

Symptoms to watch for

Symptoms usually build up gradually and often start in the feet before spreading upward. Common signs include:

Numbness, stabbing or burning pain in the hands and feet.
Pain that often worsens at night, especially while lying down.
Loss of balance and frequent falls.
Muscle weakness and wasting, sometimes with a constant sensation of wearing gloves or socks that are not there.
Reduced ability to feel heat or cold, which raises the risk of unnoticed burns and injuries.
Excessive sweating, loss of bladder control, swings in blood pressure and dizziness when autonomic nerves are involved.

Because reduced sensation can hide small cuts and burns, especially in people with diabetes, an ordinary foot injury can go unnoticed and turn into a serious infection. Any persistent numbness or tingling in the feet deserves a medical check rather than being dismissed as tiredness.

What causes peripheral neuropathy?

Peripheral neuropathy is not a single disease but the end result of many different conditions. The most frequent causes include:

Diabetes is the most common cause. Long-standing high blood sugar gradually damages the small nerves, most often in the feet and legs.

Autoimmune disorders such as rheumatoid arthritis and Guillain-Barre syndrome, in which the body's own immune system attacks the nerves.

Leprosy, an infection that directly targets peripheral nerves and remains an important cause in this region.

Kidney and liver disease, including liver damage from hepatitis, which allows toxins to build up and injure the nerves.

Chronic alcohol consumption, which harms nerves both directly and through the vitamin deficiencies it causes.

Chemotherapy, where certain cancer-treatment drugs damage nerves as a side effect.

Vitamin deficiencies, particularly of B-group vitamins essential for nerve health.

How to prevent it

Many cases can be prevented or slowed by protecting nerve health and controlling the conditions that damage nerves. A healthy lifestyle is the foundation.

Eat a nutritious diet rich in fruits and vegetables, and include adequate protein from fish, meat and eggs to support nerve repair.

Exercise regularly, aiming for 30 to 60 minutes a day on at least five days a week to improve circulation to the nerves.

Avoid harmful habits, especially smoking and excessive alcohol.

Control diabetes tightly, since keeping blood sugar in range is the most effective single step for anyone at risk.

How it is diagnosed

Diagnosis begins with a clinical examination and is confirmed with tests that pinpoint which nerves are affected and why. At Mar Sleeva Medicity Palai these include:

Blood tests to check for diabetes, vitamin deficiencies, kidney and liver problems and other underlying causes.

Electromyography (EMG) and nerve conduction studies (NCS) to measure how well electrical signals travel through the nerves and muscles.

MRI of the spine to look for nerve compression or structural problems as a source of the symptoms.

Nerve biopsy, in selected cases, where a small nerve sample is examined to establish the exact cause.

Treatment options

Treatment aims to address the underlying cause, relieve pain and protect nerve function. The right combination depends on what is driving the neuropathy and how far it has progressed.

Pain management using medicines such as paracetamol, pregabalin and gabapentin to control burning and stabbing nerve pain.

Physiotherapy to maintain muscle strength, improve balance and reduce the risk of falls.

Surgical treatment, offered when a compressed or entrapped nerve needs to be released, or when a structural problem in the spine is causing the damage.

Controlling the root cause, most often blood sugar, matters as much as treating the pain. Nerves recover slowly, so the earlier treatment begins, the better the chance of preserving sensation and strength.

Frequently asked questions

Can peripheral neuropathy be cured?

It depends on the cause. When neuropathy comes from something reversible, such as a vitamin deficiency or a compressed nerve, treating that cause can allow the nerves to recover. In long-standing conditions like diabetes, the goal is usually to control symptoms and stop the damage from getting worse rather than reverse it completely. Early treatment gives the best results.

Why is the pain worse at night?

Nerve pain often feels more intense at night because there are fewer daytime distractions and the body is at rest, making the burning and tingling more noticeable. Some patients also find that skin temperature changes while lying down aggravate the discomfort.

Is peripheral neuropathy linked to diabetes?

Yes. Diabetes is the most common cause of peripheral neuropathy. Persistently high blood sugar damages the small nerves over time, usually beginning in the feet. Good long-term blood sugar control is the most important way for people with diabetes to protect their nerves.

When should I see a doctor?

See a doctor if you have persistent numbness, tingling, burning pain or weakness in your hands or feet, if you are losing your balance or falling, or if you notice reduced sensation that could hide injuries. A timely evaluation can identify the cause and start treatment before the nerve damage advances.

This article is for general information and awareness only. It is not a substitute for professional medical advice, diagnosis or treatment. Please consult a qualified doctor for any health concern.