- Peripheral neuropathy causes numbness, tingling, and pain in the feet and hands
- Diabetes is the most common cause, but many other conditions can trigger it
- Early detection is crucial—nerve damage can be slowed but rarely reversed
- Regular foot exams are essential for anyone at risk
What Is Peripheral Neuropathy?
Peripheral neuropathy is damage to the nerves outside your brain and spinal cord. These peripheral nerves carry signals between your body and your brain—including sensations like touch, temperature, and pain.
When these nerves are damaged, signals get disrupted. The result can be numbness, tingling, burning sensations, or pain—most commonly starting in the feet and hands.
An estimated 20 million Americans have some form of peripheral neuropathy. It's especially common in people with diabetes, affecting up to 50% of diabetics over their lifetime. But neuropathy has many causes, and anyone can develop it.
At Central Florida Foot & Ankle Institute, we see patients with neuropathy every day. The earlier it's detected, the better the outcome—which is why knowing the warning signs matters.
Warning Signs: What Does Neuropathy Feel Like?
Symptoms typically begin gradually and may be easy to dismiss at first. Pay attention if you notice:
Numbness and Reduced Sensation
- Feeling like you're wearing socks when your feet are bare
- Not noticing temperature changes (hot bathwater, cold surfaces)
- Stepping on something sharp and not feeling it
- Difficulty feeling the ground beneath your feet
Tingling and "Pins and Needles"
- A persistent tingling sensation, like your foot "fell asleep"
- Buzzing or vibrating feelings
- Electric shock sensations
Burning or Shooting Pain
- Burning sensations, especially at night
- Sharp, stabbing pains
- Aching or throbbing pain
- Pain from light touch (allodynia)
Muscle Weakness and Coordination Problems
- Difficulty lifting the front part of your foot (foot drop)
- Feeling unsteady when walking
- More frequent tripping or stumbling
- Difficulty with balance, especially in the dark
Other Symptoms
- Extreme sensitivity to touch
- Changes in foot shape
- Foot ulcers that heal slowly
- Unusually sweaty or dry feet
The Danger of Ignoring Symptoms
Neuropathy isn't just uncomfortable—it's dangerous. Here's why:
Unnoticed Injuries
When you can't feel pain, small injuries go unnoticed:
- Blisters from ill-fitting shoes
- Cuts from stepping on something sharp
- Burns from hot surfaces
- Pressure sores
Infection Risk
Unnoticed wounds can become infected. In diabetics, this can lead to serious complications, including:
- Cellulitis (skin infection)
- Bone infection (osteomyelitis)
- Gangrene
- Amputation
Falls
Reduced sensation and muscle weakness increase fall risk. Falls are a leading cause of injury in older adults.
Progressive Damage
Nerve damage is often irreversible. Early intervention can slow progression, but waiting too long means losing ground you can't regain.
What Causes Peripheral Neuropathy?
Diabetes (Most Common)
High blood sugar damages blood vessels that supply nerves with nutrients and oxygen. Over time, this causes nerve damage—diabetic neuropathy. Good blood sugar control significantly reduces risk.
See our Guide for more information.
Other Medical Conditions
- Autoimmune diseases: Lupus, rheumatoid arthritis, Guillain-Barré syndrome
- Infections: Shingles, Lyme disease, HIV, hepatitis
- Kidney disease: Toxin buildup damages nerves
- Thyroid disorders: Both overactive and underactive thyroid
- Vitamin deficiencies: B12, B6, E, and other nutrients
Medications and Toxins
- Chemotherapy drugs
- Certain antibiotics
- Heavy alcohol use
- Exposure to heavy metals or industrial chemicals
Physical Causes
- Injuries that damage nerves
- Pressure on nerves (carpal tunnel, tarsal tunnel)
- Repetitive motions
- Tumors pressing on nerves
Inherited Forms
Some types of neuropathy run in families (Charcot-Marie-Tooth disease, for example).
Idiopathic Neuropathy
In about 30% of cases, no cause is found. This is called idiopathic neuropathy.
When to See a Specialist
Don't wait for symptoms to become severe. Schedule an appointment if you:
- Notice any numbness, tingling, or unusual sensations in your feet
- Have burning or shooting pain in your feet
- Experience weakness or difficulty walking
- Have diabetes and haven't had a foot exam in the past year
- Notice wounds on your feet that heal slowly
- Have known risk factors for neuropathy
At Central Florida Foot & Ankle Institute, we conduct thorough neurological evaluations as part of our comprehensive foot care.
How We Diagnose Neuropathy
Comprehensive Foot Examination
We test sensation using various methods:
- Monofilament testing (light touch)
- Vibration perception
- Reflexes
- Muscle strength
Nerve Conduction Studies
Measuring how quickly electrical signals travel through nerves helps identify damage.
Blood Tests
Screening for diabetes, vitamin deficiencies, thyroid problems, and other underlying conditions.
Medical History Review
Understanding your health history, medications, and potential exposures helps identify causes.
Treatment Options
While nerve damage is often permanent, treatment can:
- Slow or stop progression
- Relieve symptoms
- Prevent complications
- Improve quality of life
Address the Underlying Cause
- Blood sugar control for diabetics
- Vitamin supplementation for deficiencies
- Treating infections
- Adjusting medications that may contribute
Pain Management
Medications:- Certain antidepressants (duloxetine, amitriptyline)
- Anti-seizure medications (gabapentin, pregabalin)
- Topical treatments (capsaicin cream, lidocaine patches)
- MLS laser therapy reduces nerve pain and promotes healing
- Physical therapy maintains strength and balance
- TENS units provide electrical stimulation for pain relief
Protective Care
Preventing complications is crucial:
- Daily foot inspections
- Proper footwear
- Regular podiatric care
- Protecting feet from temperature extremes
Lifestyle Modifications
- Quit smoking (smoking reduces blood flow to nerves)
- Limit alcohol
- Exercise regularly (improves circulation and nerve health)
- Maintain a healthy weight
Living with Neuropathy: Daily Foot Care
If you have neuropathy, these habits protect your feet:
Inspect Daily
Check your feet every day for cuts, blisters, redness, or swelling. Use a mirror to see the bottom of your feet, or ask someone to help.
Wash and Dry Carefully
Wash feet daily with warm (not hot) water. Test temperature with your elbow, not your foot. Dry thoroughly, especially between toes.
Moisturize Wisely
Apply lotion to prevent dry, cracked skin—but not between toes, where moisture can cause infection.
Never Go Barefoot
Always wear shoes or slippers, even indoors. You won't feel if you step on something harmful.
Choose Proper Footwear
- Wide toe boxes
- Seamless interiors
- No high heels
- Properly fitted (have feet measured regularly—neuropathy can change foot shape)
Schedule Regular Checkups
See your podiatrist regularly—at least annually for mild neuropathy, more often for moderate to severe cases.
Don't Wait for Complications
Peripheral neuropathy is progressive, but it doesn't have to control your life. Early detection, proper treatment, and vigilant foot care can prevent serious complications.
At Central Florida Foot & Ankle Institute, we have extensive experience managing neuropathy and protecting feet from its consequences. Our comprehensive exams are designed to catch problems early.
📞 Schedule your neuropathy evaluation today. Your feet—and your future mobility—are worth protecting.