Peripheral neuropathy refers to impaired function of nerves outside the brain and spinal cord. It can affect sensory perception, voluntary muscle control, or autonomic functions such as blood pressure, sweating and bowel or bladder activity. This page summarizes common symptoms, frequent causes, typical tests used in diagnosis, and which medical specialties may be involved in evaluation and care planning.
Peripheral neuropathy may involve sensory nerves (tingling, numbness, burning or electric sensations), motor nerves (muscle weakness, cramps, loss of reflexes) or autonomic nerves (dizziness on standing, abnormal sweating, constipation or urinary changes). Distribution can be symmetric (often feet and hands) or focal; onset may be gradual or, in some types, relatively sudden.
Typical complaints include numbness or pins-and-needles in the feet and hands, reduced strength, poor balance, and shooting or burning pain. Red flags that need prompt assessment include sudden, severe weakness, rapidly worsening difficulty walking or breathing, sudden loss of bladder or bowel control, or rapidly spreading sensory loss — in these cases emergency services or immediate specialist evaluation is recommended.
Many conditions can lead to peripheral neuropathy. Common contributors include diabetes and other metabolic disorders, chronic alcohol use, vitamin B12 deficiency, certain medications (for example some chemotherapy agents), kidney disease, autoimmune disorders, infections (such as HIV or Lyme disease), and inherited neuropathies. Identifying risk factors helps guide which tests are most relevant.
Initial assessment is usually by a neurologist. Investigation commonly includes blood tests (glucose, vitamin levels, kidney and liver function, relevant infection markers), nerve conduction studies and electromyography (NCV/EMG), and imaging when structural causes are suspected. For small-fiber neuropathy, a skin biopsy may be considered. Depending on suspected cause, endocrinology, internal medicine, infectious diseases or physical medicine and rehabilitation may participate in evaluation and management planning.
While specific treatments depend on the underlying cause, many people benefit from symptom-directed measures and rehabilitation to improve strength, balance and function. Referral to physiotherapy, occupational therapy or multidisciplinary clinics may be helpful. Discussions about prognosis and long-term monitoring should be coordinated by the treating specialists.
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