Peripheral neuropathy often starts with numbness, pricking, or tingling in your toes or fingers. It can then spread to your feet or hands, causing burning, freezing, throbbing and/or shooting pain that typically worsens at night. The pain might be constant or intermittent but usually affects both sides of your body equally—both hands and both feet. Some forms of peripheral neuropathy appear suddenly, while others gradually develop over many years.

The symptoms of peripheral neuropathy often include:

• Difficulty walking or moving the arms
• Muscle weakness
• Loss of balance and coordination
• A sensation of wearing an invisible “glove” or “sock”
• Sharp, jabbing or electric-like pain
• Burning sensation or freezing pain
• Extreme sensitivity to touch
• Difficulty sleeping because of feet and leg pain
• Unusual sweating
• Abnormalities in blood pressure or pulse

The symptoms of peripheral neuropathy can vary based on which types of nerves—motor, sensor, or autonomic—are damaged. Some neuropathies might impact all three types of nerves, but others may only affect one or two.

Motor nerves transmit impulses from the brain and spinal cord to muscles, enabling activities like walking. When motor nerve damage occurs, it can result in muscle weakness, difficulties in walking, and trigger cramps and spasms. This showcases the vital role motor nerves play in our mobility and muscular health.

Sensory nerves send messages from our muscles to the spinal cord and brain, letting us know if something is sharp, rough, smooth, hot, or cold. These sensors in our skin and deeper within can also tell if a body part is moving. When sensory nerve damage occurs, it often leads to tingling, numbness, pain, or extreme sensitivity to touch in that body part.

Autonomic nerves manage involuntary or semi-voluntary functions such as heart rate, blood pressure, digestion, and sweating. Damage to these nerves can lead to an irregular heartbeat and make a person feel dizzy when standing. It may also cause issues with too much sweat or not being able to sweat, difficulties in swallowing, nausea, vomiting, diarrhea or constipation, problems with urination, abnormal pupil size, and sexual dysfunction.

Source: Peripheral Neuropathy Center

Peripheral neuropathy can strike many nerves (polyneuropathy) or just one nerve or a nerve group at once (mononeuropathy).

Mononeuropathy happens when damage affects a single nerve or a nerve group due to trauma, injury, local compression, prolonged pressure, or inflammation. Examples include:

• Carpal Tunnel Syndrome: A wrist and hand disorder resulting from repetitive tasks such as using a computer keyboard, leading to discomfort and pain.
• Bell’s Palsy: This facial nerve disorder triggers sudden weakness or paralysis of the facial muscles, making the face droop on one side, impacting the ability to smile and close an eye.

Polyneuropathy, an umbrella term, refers to the condition where many nerves are damaged at the same time.

Celiac disease, an inherited condition, significantly impairs the small intestine, obstructing the absorption of nutrients and potentially causing disorders such as peripheral neuropathy. This digestive disease makes it impossible for those affected to tolerate gluten, a protein found in wheat, rye, and barley. Despite its prevalence, celiac disease often remains undiagnosed in many individuals across the United States.

For those genetically susceptible to celiac disease, eating gluten triggers an autoimmune reaction in the intestines. This disrupts their gastrointestinal systems, blocking the absorption of nutrients and food properly. Interestingly, a study found that before these gastrointestinal issues start, some individuals with celiac disease may have neuropathic symptoms, affecting their nerve functions.

Doctors have found that many diabetic patients often get peripheral neuropathy, which is damage to the nerves. Now, they’re also looking into how this nerve damage might be linked to prediabetes, sometimes called impaired glucose tolerance or IGT. This condition, also known as borderline diabetes, affects around 20 million people in the U.S. and means someone’s blood sugar levels are higher than normal but not high enough to be considered Type 2 diabetes yet. If people with prediabetes don’t get treatment, they could end up with Type 2 diabetes, heart disease, and even more nerve damage that leads to peripheral neuropathy.

Individuals with prediabetes often have no symptoms, making it a silent precursor to diabetes, which can lead to conditions like peripheral neuropathy. The symptoms of diabetes itself—frequent urination, constant thirst, blurred vision, fatigue, cuts and bruises that heal slowly, and tingling or numbness in the hands or feet—can develop slowly and go unnoticed. Screening for prediabetes is particularly crucial for those over 45, overweight, inactive, with a family history of diabetes, or who are part of an at-risk ethnic or minority group, to prevent the progression to diabetes.

Research indicates that achieving modest weight loss, specifically 5-10% of total body weight, along with engaging in moderate physical activity like walking for 30 minutes daily, five days a week, can slash the risk of developing Type 2 diabetes by 58%.