Peripheral neuropathy Whakamōtī akaaka mōwaho

There are many causes of peripheral neuropathy, but the cause may not be known. Some of the more common causes are:

• diabetes — this is the most common cause
• vitamin B12 deficiency
• heavy alcohol intake, particularly over a long time
• some chemotherapy drugs
• some poisons
• if a nerve gets trapped, for example carpal tunnel syndrome
• chronic kidney disease
• some infections.

Diabetic nerve damage (neuropathy)

Carpal tunnel syndrome

Symptoms of peripheral neuropathy vary depending on:

• the type of nerve involved
• which part of your body is affected.

There are different types or peripheral nerves:

• sensory nerves that affect what you feel (sensations such as touch, pain and temperature)
• motor nerves that affect movement
• autonomic nerves that affect regulation of functions such as heart rate and blood pressure.

Sensory neuropathy

Sensory neuropathy can cause feelings of:

• numbness
• tingling
• pins and needles
• burning pains in your legs (especially in bed at night)
• shooting pains
• being oversensitive to touch.

Motor neuropathy

Motor neuropathy might cause weak muscles, especially in your legs. It can change the shape of your feet and cause problems with shoes. Both of these might lead to problems with walking.

Autonomic neuropathy

Autonomic neuropathy affects the nerves that control internal organs. The symptoms depend on where the problem lies.

You may have:

• a feeling of being sick (nausea) or throwing up if it affects your stomach
• hard poos (constipation) or runny poos (diarrhoea) if it affects your intestines
• difficulty weeing if it affects your bladder
• problems with erections if it affects your penis
• dizziness and palpitations if it affects your heart and blood vessels
• dry skin if it affects your sweat glands, especially in your feet.

The most common complications of peripheral neuropathy are injury, such as a burn if you cannot feel how hot something is when you touch it.

You can also be at risk of infection if you are not aware of an injury so do not look after it properly. This can lead to serious problems. It is more common if you have diabetes and can also be more serious.

Diabetic nerve damage (neuropathy)

If you have weakness and loss of sensation your balance may be affected. This can put you at greater risk of falls.

Your healthcare provider may:

• ask you about your symptoms
• do physical and neurological tests to identify nerve damage
• do blood tests.

You may have specialist tests that measure the speed of the electrical signal in the nerve. In some cases, you may have a nerve or skin biopsy.

Treating peripheral neuropathy involves first finding the cause and correcting that if possible. This might be, for example:

• stopping drinking if alcohol is the cause of your problem
• having physiotherapy or surgery if the cause is an injury squashing the nerve.

If the underlying cause is treated or not known, the next type of treatment is to treat the symptoms.

Treating symptoms

Because normal pain relief medicines do not usually work with nerve pain, peripheral neuropathy may be treated with other types of medicines, including:

• amitriptylineexternal link
• gabapentinexternal link
• nortriptylineexternal link
• carbamazepineexternal link
• sodium valproateexternal link .

Other treatments will depend on what symptoms you have.

If you have difficulty doing your every day tasks, an occupational therapist may be able to help. 

Find a therapist — Occupational Therapy New Zealandexternal link

You can reduce the risk of getting peripheral neuropathy by:

• eating well
• aiming for a healthy weight
• quitting smoking if you smoke
• limiting the amount of alcohol you drink to within or below guidelines
• keeping good control of any disease that can cause peripheral neuropathy, such as diabetes and kidney disease.