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An explanation of peripheral neuropathy

Miller, MD
Why do my hands and feet tingle and burn?

Peripheral neuropathy is one of the primary causes of tingling, burning and/or numbness in hands and/or feet. Nerves in the peripheral nervous system send information from the brain and spinal cord to other parts of the body and back again. If nerves are damaged, peripheral neuropathy can result. It most commonly starts in the longest nerves that reach to your toes. Depending on which nerves are affected, symptoms may vary.

Does peripheral neuropathy affect only hands and feet?

The tingling or numbness usually begins in the hands or feet but it may spread up into the legs and arms. It can turn into burning or jabbing pain. Skin may become extremely sensitive to touch. If motor nerves are impacted, muscle weakness or paralysis is possible. If autonomic nerves are affected, bowel or bladder problems may develop. Peripheral neuropathy can affect only one nerve or it may affect many nerves.

Who is at risk for peripheral neuropathy?

At least 50 percent of people with diabetes develop some form of neuropathy. Others commonly at high risk are alcoholics, who often have vitamin deficiencies due to poor dietary choices; people with autoimmune diseases such as rheumatoid arthritis and lupus; those exposed to toxic substances, certain medications, viral or bacterial infections, and nerve trauma such as repetitive sports injuries or accidents where nerves are damaged.

When should I see a doctor?

Any time you notice tingling, weakness or pain in your hands or feet, you should make an appointment with a primary care doctor or a neurologist, a doctor that specializes in disorders of the nervous system. Because peripheral neuropathy isn't a single disease, it can be difficult to diagnose. Determining the location of the nerve damage and its cause is important for successful treatment.

How does a doctor treat peripheral neuropathy?

When your doctor determines the cause of your peripheral neuropathy and treats that underlying cause, the neuropathy often improves. Several different prescription medications can reduce the pain. Your doctor will evaluate the degree of your neuropathy and work with you to find the best medications for your particular symptoms and type of neuropathy.

What can I do to reduce symptoms?

Wear soft cotton socks and shoes with good padding and support. A hand or foot massage improves circulation, stimulates nerves and may decrease pain. If you have diabetes, good control of your sugar is necessary. If you smoke, quit. Smoking affects circulation, increasing your risk of foot problems and possible amputation. Healthy eating is essential because vitamin deficiencies can cause or increase neuropathy symptoms. Preventing further nerve damage is essential. The right kind of regular exercise can reduce pain. Talk to your doctor about a healthy eating and exercise plan.

Stephanie Miller, MD is a neurologist at Sanford Clinic. A graduate of the University of North Dakota School of Medicine and Health Sciences at Grand Forks, she completed an internship in internal medicine and a residency in neurology at Mayo School of Graduate Medicine, Rochester, Minn.


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