Americans estimated to have some form of peripheral neuropathy. NINDS notes that the true number may be higher.1
Types of peripheral nerve disorders, with different causes and patterns.2
Of people with diabetes have peripheral neuropathy, according to NIDDK.3
What is peripheral neuropathy?
Your peripheral nerves carry signals between your brain and spinal cord and the rest of your body. When nerves are damaged, those signals may be reduced, disrupted, or sent when they should not be. Diabetes is a common cause. Chemotherapy, vitamin B12 deficiency, alcohol, injuries, and some medications can also play a part. Sometimes no single cause is found.2
In many common forms, longer nerves are affected first. Symptoms may begin in the toes and feet and later involve the lower legs and hands. Clinicians may describe this as a “stocking-and-glove” pattern, but not every nerve condition follows it.
A common pattern: toes and feet first; lower legs and sometimes hands later.
The location and timing are clues for an examination—not a diagnosis on their own.
The 7 early warning signs
These signs can have more than one cause. The descriptions below are examples of how symptoms may feel, not patient testimonials.
Tingling or “pins and needles” in your toes or feet
This is a common early sign. It may come and go at first, then show up more often, especially when you are resting.
“Like my foot is waking up after falling asleep, but it never fully wakes up.”
Numbness, or feeling like you are wearing socks when you are not
You may not feel the floor clearly or have trouble telling hot water from warm. Numbness matters because small cuts and blisters can go unnoticed.
“Like walking on cotton,” or “like my feet are wrapped in a thin layer.”
Burning, stabbing, or electric pain that is worse at night
Many people notice these symptoms while lying in bed. Discomfort can interrupt sleep and make it harder to find a comfortable position.
“Like my feet are on fire,” or “like little electric shocks.”
Extreme sensitivity to light touch
Bedsheets, socks, or a light brush against the skin may hurt when they normally would not. Pain from a normally painless touch is called allodynia.
Balance problems, especially in the dark
Your feet send position information to your brain. When that information is reduced, walking at night, on stairs, or on uneven sidewalks can feel less steady.
Weakness, tripping, or dropping things
When motor nerves are involved, you may catch your toes on curbs, have trouble with buttons or jar lids, or notice that your grip has changed. Weakness also has other possible causes and should be evaluated.
Symptoms in both feet that slowly spread upward
Many common forms affect both feet and move upward over time. Not all neuropathy follows this pattern. One-sided symptoms can also be nerve-related, including irritation at the low back, and deserve an evaluation.
Do you recognize any of these changes?
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Use any symptoms or health-history concerns to guide a conversation with a health professional.
This is not a validated screening test, diagnosis, or severity score. Even one new or worsening symptom can deserve attention. Your selections are not submitted, saved, or sent to our office. This checklist does not test sensation or balance.
Why catching changes early matters
Some forms of neuropathy can progress, especially when an underlying cause is not addressed. Finding the cause can guide care and help you protect your feet and daily function. Numbness may hide small injuries, and reduced sensation or balance can increase the risk of falls.3
A historical 10-year study of people newly diagnosed with type 2 diabetes found an increase in nerve-conduction abnormalities in the legs and feet. Here is what the study reported:4
Source: Partanen et al., New England Journal of Medicine, 1995. These figures describe one study group and a specific nerve test. They do not predict your course or measure results from our care.
Some causes are treatable, but improvement depends on the cause and extent of nerve damage. An evaluation can help you understand what should be addressed rather than assuming that every change is part of aging.
What to do next
- Write down your symptoms. Note where they are, when they started, and what makes them better or worse.
- Check your feet daily. Look at the soles and between the toes, using a mirror if needed. Ask your health care team for help if you cannot check safely.6
- Talk with your primary care doctor about testing. Blood sugar, A1C, and B12 testing may help identify common causes. Other tests depend on your history and examination.5
- Arrange a hands-on examination. Sensation, reflexes, strength, and balance checks help assess the problem and whether further testing or a referral is needed.3
At Cordima Chiropractic Center, you can discuss non-drug, non-surgical care for neuropathy symptoms and find out whether you are a candidate. Care options, including restorative laser therapy when appropriate, are discussed after an evaluation. Learn about our neuropathy evaluation and care or read the free peripheral neuropathy patient guide.
Noticing changes? Let’s take a closer look.
Schedule a neuropathy evaluation with Dr. Cordima in Somerville. We will review your history, examine the areas involved, and explain the findings in plain language.
Results vary. Not every patient is a candidate.
Sources
- National Institute of Neurological Disorders and Stroke (NINDS), Peripheral Neuropathy educational booklet (PDF).
- MedlinePlus, Peripheral Neuropathy: types, causes, and symptoms.
- National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), Peripheral Neuropathy.
- Partanen J, et al. Natural history of peripheral neuropathy in patients with non-insulin-dependent diabetes mellitus. N Engl J Med. 1995;333:89–94. doi:10.1056/NEJM199507133330203.
- NHS, Peripheral neuropathy: diagnosis.
- NIDDK, Diabetes & Foot Problems: foot checks and when to contact your health care provider.
- Centers for Disease Control and Prevention (CDC), Signs and Symptoms of Stroke.
This article is for general education and is not a substitute for a medical diagnosis. Neuropathy has many possible causes, some of which need care from a physician or specialist. If you have diabetes, keep your primary care doctor or endocrinologist involved in your care.