Can You Feel Your Feet? Understanding Peripheral Neuropathy

by Dr. Emily Splichal, DPM MS

Often taken for granted, foot sensation is necessary for optimal movement, balance, and performance. Over 20 million adults in the United States live with decreased foot sensation, also known as peripheral neuropathy. 

From diabetes to multiple sclerosis and autoimmune disease, there are various types of peripheral neuropathy which can affect the individual. This article breaks down the most common types of peripheral neuropathy plus associated symptoms and treatment options.

Types of Peripheral Neuropathy

There are more than 100 types of peripheral neuropathy, each associated with its own cause, symptoms and prognosis. To help classify the different types of neuropathy, let’s break them down into four main categories:

• Motor neuropathy. This is damage to the nerves that control the muscles and movement in the body.
• Sensory neuropathy. Sensory nerves control what you feel, such as pain, temperature, or light touch.
• Autonomic neuropathy. Autonomic nerves control functions that you are not conscious of, such as breathing and heartbeat.
• Combination neuropathies. You may have a mix of 2 or 3 of these other types of neuropathies and is referred to as sensory-motor neuropathy.

Of the above categories the most prevalent type are sensory neuropathies with diabetic peripheral neuropathy (DPN), chemo-induced neuropathy, autoimmune and idiopathic being the most common.

Symptoms of Peripheral Neuropathy

The symptoms of peripheral neuropathy vary based on the category and type that you have, as well as what part of the body is affected. Symptoms can range from tingling or numbness to burning pain and weakness.

Additional symptoms may include:

• Muscle weakness
• Muscle twitching
• Changes in skin, hair, or nails
• Numbness or loss of sensation
• Loss of balance or increased fall risk
• Trouble sweating and heat intolerance

Treatment for Peripheral Neuropathy

Usually peripheral neuropathy cannot be cured, but there are a lot of things that can be done to prevent it from getting worse.  If an underlying condition such as diabetes is at fault, control of blood sugar is the most important step in preventing the progression of DPN.  

In more severe cases and those with painful symptoms, prescription medications such as gabapentin or pregabalin may be needed.  These medications block the brain’s perception of the pain signal and typically need to be taken long-term.

Recently there has been increasing research in the benefits of vitamin supplementation in reducing neuropathic pain and increasing nerve growth factor.   Some of the most studies supplements include R-lipoic acid, acetyl-l-carnitine, B-vitamins and bromelain.

To learn more about alternative treatment options for neuropathy please speak to your healthcare provider.