Peripheral Neuropathy


Peripheral neuropathy affects over two million people in the United States. Typically middle-aged and elderly individuals are most frequently affected. It is a neurological disorder that affects the sensory, motor and/or autonomic nerves, and is caused by abnormal function of these nerves due to various etiologies.

The nervous system is classified into two parts: the central nervous system (CNS) and the peripheral nervous system (PNS). The CNS is made up of the brain and the spinal cord, and the PNS is composed of the nerves that lead to or branch off from the CNS.

The peripheral nerves relay information from our central nervous system (brain and spinal cord) to muscles and other organs and from our skin, joints, and other organs back to our brain. Peripheral neuropathy occurs when these nerves fail to function properly, resulting in pain, tingling, loss of sensation, or inability to control muscles.


In its most common form, peripheral neuropathy is seen as a result of diabetes, and causes pain and numbness in ones hands and feet. The pain typically is described as tingling or burning, while the loss of sensation often is compared to the feeling of wearing a thin stocking or glove.

Researchers believe that the increased amounts of the sugars glucose and sorbitol, which are found in the blood of diabetics, adversely affect the lining and fibers of the peripheral nerves.  Eventually, these nerves fail to function properly, resulting in the symptoms of peripheral neuropathy.

Other causes of peripheral neuropathy include:

  1. Vitamin deficiencies
  2. Alcoholism
  3. Metabolic Diseases
  4. Autoimmune diseases
  5. Exposure to some poisons
  6. Trauma or pressure on a nerve


Most commonly, peripheral neuropathy begins in the longest nerves — the ones that reach to your toes. Specific symptoms vary as to which nerves are affected, and to the duration of the disease. Common symptoms may include:

  1. Gradual onset of numbness and tingling in your feet or hands, which may spread upwards into your legs and arms
  2. Burning pain
  3. Sharp, jabbing or electric-like pain
  4. Extreme sensitivity to touch, even light touch
  5. Lack of coordination
  6. Muscle weakness or paralysis if motor nerves are affected


The first goal of treatment is to manage the condition causing the neuropathy. If the underlying cause is corrected or properly controlled, the neuropathy may improve on its own. The second goal of treatment is to relieve the symptoms. The symptoms can vary from a great deal of pain to complete absence of sensation and lack of pain.

If your feet and legs are affected, some of the symptoms of peripheral neuropathy can be relieved by:

  1. Wearing comfortable socks that do not bind the feet. Also, socks without seams are better than those with seams. Click here for some doctor recommended socks and stockings.
  2. Wearing therapeutic shoes which are made with extra foam padding to protect the top of the feet and cushion the heels and soles.  Men’s therapeutic shoes and women’s therapeutic shoes can look stylish and still be “foot friendly.”
  3. Custom made orthotics can be made to add comfort, support, and stability to ones feet and legs; thus, improving gait and reducing fatigue and pain.
  4. Check both feet carefully every day, and be sure you check between your toes. Look for signs of redness, blisters, sores, and infection. With peripheral neuropathy, these problems may not be felt until they have become dangerous issues.
  5. Many types of medications can be used to relieve the pain of peripheral neuropathy.
    1. Pain relievers. Mild symptoms may be relieved by over-the-counter pain medications. For more severe symptoms, your doctor may recommend prescription painkillers. Drugs containing opiates, such as codeine, can lead to dependence, constipation or sedation, so these drugs are prescribed only when other treatments fail.
    2. Anti-seizure medications. Drugs such as gabapentin (Neurontin), topiramate (Topamax), pregabalin (Lyrica), carbamazepine (Tegretol) and phenytoin (Dilantin) were originally developed to treat epilepsy. However, doctors often also prescribe them for nerve pain. Side effects may include drowsiness and dizziness.
    3. Lidocaine patch. This patch contains the topical anesthetic lidocaine. You apply it to the area where your pain is most severe, and you can use up to three patches a day to relieve pain. This treatment has almost no side effects except, for some people, a rash at the site of the patch.
    4. Antidepressants. Tricyclic antidepressant medications, such as amitriptyline and nortriptyline (Pamelor), were originally developed to treat depression. However, they have been found to help relieve pain by interfering with chemical processes in your brain and spinal cord that cause you to feel pain. The selective serotonin and norepinephrine reuptake inhibitor duloxetine (Cymbalta) also has proved effective for peripheral neuropathy caused by diabetes.

The use of Folic Acid has been shown to be effective in treatment of peripheral neuropathy, especially in those patients who are diabetic. Folic Acid may not be absorbed by approx. 25% of the population in the standard form due to a genetic quality not allowing the conversion of folic acid to a usable state. Metanx tablets have taken the conversion to the next step and have rendered as Methylfolate and most everyone readily absorbs that. Metanx also contain Vit. b12 and Vit. B6. Vitamin B6 has long been considered helpful in neurological issues. Although Metanx is only available by prescription it is considered a neutraceutical (Vitamin. If you are unable to obtain it, consider the use of over the counter Folic Acid.

Alpha Lipoic Acid in strengths of 600mg. daily has been shown in several studies to be very effective in the treatment of Peripheral neuropathy.