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Peripheral Neuropathy: Causes, Symptoms, Diagnosis, Treatment, and Prevention


Peripheral neuropathy encompasses a wide range of disorders related to the nerves outside the brain and the spinal cord. It occurs when there is a problem with the peripheral nervous system.

The peripheral nervous system is the network of nerves that transmits information from the central nervous system (brain and spine) to the rest of the body.

Polyneuropathy, mononeuropathy, mononeuritis neuropathy and autonomic neuropathy are the four cardinal patterns of peripheral neuropathy. In fact there are more than 100 types of peripheral neuropathy. Each has its own symptoms and prognosis.

In a person affected by polyneuropathy, many peripheral nerves throughout the body malfunction simultaneously. Mononeuropathy is a disorder that affects a single nerve. Mononueritis multiplex is a painful disorder involving at least two separate nerve areas. Autonomic neuropathy involves damage to the nerves that manage body functions like bowel emptying, heart rate, sweating, blood pressure, bladder emptying and digestion.

Nervous System



Some people inherit this condition from their parents. Peripheral neuropathy may be caused due to genetic diseases like Charcot-Marie-Tooth disease and Freidreich’s ataxia. Medical conditions like multiple sclerosis, chronic renal failure, erythematosis, porphyria, liver failure, Sjögren’s syndrome, amyloidosis, Lyme disease, Guillain-Berré syndrome, leprosy, systemic jupus, sarcoidosis and hyphothyroidism are known to cause peripheral neuropathy.

Vitamin B6 (pyridoxine) is necessary for the normal functioning of the human body. However, excess intake of this vitamin may cause peripheral neuropathy. Deficiency is vitamin A, vitamin B1, vitamin B12 or vitamin E may cause peripheral neuropathy.

Drugs like metronidazole, vincristine, phenytoin, isoniazid, nitrofurantoin, statins and ethyl alcohol can cause this condition. It may also be caused by organic metals and heavy metals. Neuropathy is a possible side effect of fluoroquinolone drugs.

Peripheral neuropathy may also be caused by physical trauma like cutting, compression, strokes, pinching, projectile injuries and electric shock. It may also be caused by exposure to radiation, HIV, shingles, malignant disease and chemotherapy. Around 60 percent of diabetics suffer from peripheral neuropathy.


Symptoms of peripheral neuropathy range from mere tingling to paralysis. Extreme sensitivity to touch, difficulty in moving the arms, unable to hold on to something, electric-like pain, burning sensation, sharp pain, not knowing where your foot is, feeling as if you are wearing an invisible sock or glove, loss of bone, abnormal pulse, freezing pain, jabbing pain, inability to sleep due to pain in the legs, loss of muscles, loss of balance, weakness in the muscles, tiredness, difficulty in walking, cramps, muscle twitching, unusual sweating and abnormal blood pressure are common symptoms of peripheral neuropathy. Symptoms depend on the kind of peripheral nerves (motor, sensor or autonomic) that are damaged.





Diagnosis begins by a neurologist taking a history of your symptoms and the patient’s examination for signs of impaired reflexes, numbness and muscular weakness. Urine and blood tests may be performed. This is to check for metabolic or vitamin deficiencies and also to check for diseases or genetic defects.

Electromyogram (EMG) and nerve conduction velocity (NCV) tests may be performed. These tests help in assessment of muscle and nerve function. They measure the electrical properties of the nerves. These tests help neurologists identify the affected nerves and the extent of damage caused.

Muscle and nerve biopsies help neurologists to determine the type and cause of peripheral neuropathy. Some neurologists recommend spinal tap or lumbar puncture. This helps them to check for inflammation or infection.


The goal of treatment of peripheral neuropathy is to control the underlying medical condition that is causing it. Another goal is to provide relief from pains. Effectiveness of treatment depends on the origin of the nerve damage.

For instance nerve damage caused by excessive alcohol consumption can be improved by abstaining from alcohol. It is very important to diagnose peripheral neuropathy as soon as possible. Treatment should start immediately after diagnosis.

Delays usually result in complications. This is because peripheral nerves have a limited capacity to regenerate. Treatment may only stop progression, not reverse the damage. If the patient is severely impaired, physical therapy is recommended to avoid spasms and muscle cramping. Analgesics are used to provide relief from pains.

Neurologists recommend surgery in cases of nerve damage due to nerve compression or injury. Mobility aids like wheelchair, walker or cane are recommended depending on the extent of the damage.

Natural Remedies

Due to high treatment costs and many side effects of medicines that are used to treat peripheral neuropathy, natural remedies are gaining in popularity.

N-Acetyl Cysteine helps the body to produce glutathione. It aids in detoxification. Wheat, oats, cereals, broccoli, onion, red peppers, legumes and Brussels sprouts contain N-Acetyl Cysteine.

Alpha Lipoic Acid is an antioxidant present in each cell of the body. It is used in some parts of the world to treat peripheral nerve degeneration caused by diabetes. Broccoli, spinach, Brussels sprouts, peas, tomatoes and brewer’s years contain alpha lipoic acid.

Some people have experienced relief from neuropathic pain after a massage of cayenne into the skin. Skullcap is a herbaceous perennial mint with ridged leaves and tiny flowers. It has a soothing effect on the nervous system. It is advisable to take fifteen drops of tincture in a glass of water three to six times in a day or when there is pain.

Magnesium is an essential mineral that soothes the nervous system. Dark leafy greens (like spinach, chard and kale), nuts and seeds (like sesame seeds, Brazil nuts, almonds, cashews, pine nuts, mixed nuts, peanuts, pecans and walnuts), beans and lentils (like white beans, French beans, black eyed peas, kidney beans, chickpeas, lentils and pinto beans), avocado, whole grains (quinoa, millet, bulgur, buckwheat, wild rice, whole wheat pasta, barley and oats), dry fruits (apricots, raisins and dates), banana and dark chocolate are rich in magnesium.

Evening primrose oil prevents nervous damage, thereby preventing the medical condition from worsening. Castor oil packs provide relief from some symptoms of peripheral neuropathy.




Unfortunately not all forms of peripheral neuropathy can be prevented. However, some forms can be prevented by developing healthy habits. Consume a balanced nutritious diet daily. Include omega 3 and omega 6 fatty acids in your diet.

Avoid sugars, processed foods, fast food, junk food, sodas, trans-fatty acids and foods sprayed with pesticides. Sweeteners and additives in diet soda and processed foods harm the nervous system. Aspartame and MSG are some examples of dangerous substances in these food items. Avoid them.

It is advisable to perform moderate exercises regularly. This strengthens the nervous system. Avoid injuries by staying alert. Avoid contact with toxic chemicals. If you are affected by diabetes, discipline is necessary when it comes to diet.

Peripheral neuropathy can affect anyone. More than 20 million Americans are affected by this medical condition. Awareness is the key to deal with peripheral neuropathy successfully. Governments and NGOs should play an active role in spreading awareness about this condition.

Peripheral neuropathy quiz

For each question, choose the best answer. The answer key is below.

  1. Peripheral neuropathy encompasses a wide range of disorders related to the nerves ________________________
    • in the brain and the spinal cord
    • in the brain
    • outside the brain and the spinal cord.
    • in the spinal cord
  2. What is peripheral nervous system?
    • the network of nerves that transmit information from brain of one person to brain of another.
    • the network of nerves that transmits information from the central nervous system (brain and spine) to the rest of the bo
    • the network of nerves that transmit information from heart to heart
    • the network of nerves that transmit information from eye to eye
  3. There are more than _______ types of peripheral neuropathy.
    • 100000
    • 10000
    • 1000
    • 100
  4. Electromyogram (EMG) and nerve conduction velocity (NCV) tests may be performed to diagnose peripheral neuropathy
    • True
    • False
  5. Which of these is a natural remedy for peripheral neuropathy?
    • N-Acetyl Cysteine
    • Alpha Lipoic Acid
    • Magnesium
    • Evening primrose oil
    • All the above

Answer Key

  1. outside the brain and the spinal cord.
  2. the network of nerves that transmits information from the central nervous system (brain and spine) to the rest of the bo
  3. 100
  4. True
  5. All the above


Srikanth R (author) on July 25, 2020:

I am glad that this article was of any help to you.

Sheila P. - Phoenix, AZ on July 24, 2020:

I have peripheral neuropathy and my neurologist was unable to find the cause. Reading your article, I learned that metronidazole can cause peripheral neuropathy. I’ve been using that medication for 20 years. I’m stunned that my doctor missed this!

Srikanth R (author) on November 08, 2019:

Thank you.

taheal on November 08, 2019:

very excellent informative content in given about PERIPHERAL it help me to know about PERIPHERAL NEUROPATHY and how to start its treatment .

Srikanth R (author) on January 13, 2016:

Some experts are of the opinion that gluten is not good for the nervous system.

rims on January 12, 2016:

Avoid foods contains gluteen, help a lot with a problems ralated to neuropathy.

Srikanth R (author) on June 12, 2013:

True. Diagnosis is indeed a challenge.

Curiad on June 11, 2013:

Very interesting. This covers the subject in a broad sense, and is a great beginning at looking at the nervous system. It would appear that there are so many variations on this that diagnosis could be problematic.


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