About peripheral neuropathy
Peripheral neuropathy means damage to the nerves outside the brain and spinal cord. These nerves carry sensation, control muscles, and help manage things like sweating and blood pressure. When they are damaged, signals get lost or scrambled, which can cause numbness, pins and needles, or burning pain.
Neuropathy usually starts in the longest nerves, so the feet are often affected first, followed later by the hands. It can also affect a single nerve or a small group of nerves. The pattern of symptoms gives useful clues about the cause.
Many cases have an identifiable driver, such as diabetes, a vitamin shortage, or a medication side effect. Finding and addressing that driver is an important part of care, along with keeping you moving safely and easing the symptoms that bother you most.
Common symptoms
- Numbness or reduced feeling in the feet or hands
- Burning, stabbing, or electric pain, often worse at night
- Pins and needles or a feeling of wearing socks or gloves that are not there
- Poor balance or unsteadiness, especially in the dark
- Weakness in the feet, ankles, or hands
- Cuts or blisters on the feet that go unnoticed
Common causes and risk factors
- Diabetes or prediabetes, the most common cause
- Low vitamin B12 or other nutritional shortfalls, sometimes linked to alcohol use
- Certain medications, including some chemotherapy drugs
- Thyroid, kidney, or autoimmune conditions
- Inherited nerve conditions, or no identifiable cause in some people
How we diagnose it
Dr. Chen starts with a detailed history and an exam of strength, reflexes, sensation, and balance. An EMG and nerve conduction study, paired with nerve ultrasound, shows which nerves are involved, how severely, and whether the pattern fits a widespread neuropathy or a single trapped nerve that may be more treatable. Blood work is often used to look for causes such as diabetes, low B12, or thyroid problems, and we coordinate with your primary care physician on any findings.
How Propel treats peripheral neuropathy
Care starts with the basics: addressing the underlying cause where possible, reviewing medications, and choosing nerve pain medicines carefully when they are needed. Staying active matters a great deal. A progressive strength and balance program helps protect against falls and keeps you exercising, and we pay attention to sleep, foot care, and blood sugar control because they all affect how nerves feel and function.
When pain remains difficult despite these steps, Dr. Chen may consider botulinum toxin injections for select areas of nerve pain, or peripheral nerve stimulation, in which a thin lead near a nerve delivers mild electrical pulses to reduce pain signals. These options are chosen based on where the pain sits and how it responds, and they work best alongside continued activity and rehab.
What to expect at your visit
- 1.
We listen first
Your visit opens with a real conversation: how the problem started, what you have already tried, and the activity you want back.
- 2.
Exam and in-office ultrasound
A hands-on exam, then ultrasound at the exam table, often while you move, so your physician can see the tendon, joint, or nerve involved.
- 3.
A clear diagnosis and plan
You leave knowing what is wrong and what your options are, from strength-based rehab to procedures, and why we recommend each one.
- 4.
Treatment and follow-through
Most procedures happen here in the office. We coordinate with your physical therapist and check progress against the goals you set.
Questions about peripheral neuropathy
- Can peripheral neuropathy get better?
- It depends on the cause. When a driver such as low B12 or a medication is found and corrected, symptoms may improve over months as nerves recover. In other cases the goal is to keep the neuropathy from progressing and to reduce pain and fall risk.
- Why is a nerve test needed when neuropathy has already been diagnosed?
- An EMG and nerve conduction study shows how much nerve damage is present and what type it is. It can also reveal a separate, treatable problem, such as a pinched nerve at the wrist or elbow, hiding within the neuropathy symptoms.
- Is it safe to exercise with neuropathy in my feet?
- For most people, yes, and exercise is one of the most helpful things you can do. We tailor the plan to your balance and sensation, and we ask you to check your feet regularly for blisters or wounds you might not feel.
- When is neuropathy an urgent problem?
- Weakness that spreads quickly over days, especially if it moves from the feet upward, or trouble breathing or swallowing, needs emergency care right away. A foot wound that is red, warm, or draining should also be seen promptly.