Peripheral Nerve Disease

Peripheral nerve disease, also known as peripheral neuropathy, occurs when damage affects nerves of the body (limbs).  This is outside of the brain or spinal cord. This can lead to weakness, numbness or possibly pain, typically felt first in the hands and feet. In some cases, it can affect muscles of the limbs. People with peripheral neuropathy who have pain often describe the pain as stabbing, burning or tingling.

The peripheral nervous system is made up of three key types of nerves: motor nerves, sensory nerves and autonomic nerves. 

• Motor nerves act like messengers, carrying instructions from the brain and spinal cord (central nervous system) to control muscle movement. 
• Sensory nerves function like scouts, relaying information about touch, taste and sight back to the brain.
• Autonomic nerves manage automatic functions like your heartbeat, freeing you from having to think about them.

Essentially, these nerves create a communication highway connecting your brain and spinal cord to the rest of your body.

Peripheral neuropathy symptoms

When these nerves get damaged, depending on which types of nerves are affected, you may notice symptoms of peripheral neuropathy like:

• Numbness or tingling sensations that often starts in the hands or feet and spreads to other areas
• Burning or shooting pain
• Muscle weakness 
• Loss of sensation
• Difficulty with walking because of decreased sensation or leg weakness
• In some cases, the autonomic nervous system is affected, causing changes in sweating or blood pressure
• Difficulty with fine motor tasks, such as buttoning shirts or picking up small objects

Symptoms can be mild, moderate or severe. They can affect one or more nerves. If you notice any of these symptoms, contact a health care provider.

Peripheral neuropathy can be categorized in a few ways:

• Affected nerves: motor nerves control muscles (weakness can result), sensory nerves transmit feeling (tingling or numbness are common) and autonomic nerves manage automatic functions (digestion or blood pressure might be affected). 
• Causes: Diabetes, infections, and vitamin deficiencies are frequent culprits. There are also inherited forms of neuropathy, and in some cases, the cause remains a mystery (idiopathic neuropathy).

Causes of peripheral neuropathy

Various conditions can cause peripheral neuropathy, including:

• Diabetes and metabolic syndrome: The most common cause of peripheral neuropathy. More than half of people with diabetes will develop some type of neuropathy.
• Autoimmune diseases: Conditions like Sjogren's syndrome, lupus and rheumatoid arthritis where the immune system mistakenly attacks healthy tissues, including nerves.
• Guillain-Barre syndrome (GBS) and chronic inflammatory demyelinating polyneuropathy (CIDP): Specific autoimmune disorders that directly target the nerves.
• Vasculitis: Inflammation of blood vessels that can damage nerves by reducing blood flow.
• Paraneoplastic syndromes: Rare conditions where some cancers trigger autoimmune responses affecting the nerves.
• Inherited disorders: Some neuropathies are inherited, such as Charcot-Marie-Tooth disease.
• Other diseases: Metabolic conditions such as kidney disease, liver disease, or hypothyroidism.

Risk factors for peripheral neuropathy

Peripheral neuropathy risk factors include:

• Diabetes, especially if your blood sugar levels are not well controlled
• Alcohol use disorder
• Low levels of vitamins, particularly vitamin B-12
• Kidney, liver or thyroid disorders
• Exposure to toxins
• Family history of neuropathy

If you are experiencing symptoms of peripheral neuropathy or feel you may be at risk, talk with your health care provider. 

Learn more about diagnosis and treatment of peripheral neuropathy.