Peripheral neuropathy refers to nerve damage, often causing numbness, tingling, or pain in the hands and feet. Symptoms may worsen over time and can interfere with balance, coordination, and mobility if left untreated.

Neuropathy can result from many conditions and environmental factors. The most common cause is diabetes, which can lead to nerve damage due to prolonged high blood sugar. Other causes include:

• Vitamin deficiencies (especially B12 or folate)
• Alcohol use disorder
• Autoimmune diseases such as lupus, rheumatoid arthritis, or Sjögren’s syndrome
• Vein disease and poor circulation
• Infections (such as shingles or Lyme disease)
• Inherited conditions (like Charcot-Marie-Tooth disease)
• Bone marrow or thyroid disorders
• Certain medications or exposure to toxins
• Physical injury or pressure on nerves, and low vitamin levels

Poor circulation from vein disease (varicose veins, deep vein thrombosis) can lead to nerve damage due to reduced oxygen and nutrient supply.

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Treatment depends on the underlying cause and severity of symptoms. Our neurologists often recommend a combination of therapies such as:

• Medications: Pain relievers (gabapentin, duloxetine)
• Lifestyle changes: Blood sugar control, compression stockings
• Physical therapy & exercise
• Vein procedures: Sclerotherapy, laser therapy

Early treatment (e.g., controlling diabetes) may improve symptoms, but severe nerve damage is often permanent.

Chronic vein diseases (like varicose veins, chronic venous insufficiency, or deep vein thrombosis) can impair blood circulation, leading to reduced oxygen and nutrient supply to nerves. Over time, this can contribute to nerve damage (neuropathy), causing symptoms like pain, tingling, and numbness—especially in the legs.

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Diagnosis typically involves a physical exam and specialized tests to assess both nerve and vein function:

• Physical exam (checking for varicose veins, swelling)
• Doppler ultrasound (to assess blood flow)
• Nerve conduction studies (NCS) / EMG (to confirm neuropathy)
• Blood tests (to rule out diabetes, vitamin deficiencies)

Look for:

• Leg heaviness, swelling, or aching
• Visible varicose or spider veins
• Skin changes (darkening, ulcers, or thickening near ankles)
• Worsening neuropathy symptoms when standing or sitting for long periods

Lifestyle changes can make a significant difference in managing pain and preventing symptom progression. These include:

• Exercise regularly (walking, swimming—improves circulation)
• Elevate legs when resting to reduce swelling
• Wear compression stockings (if recommended)
• Avoid prolonged sitting/standing
• Maintain a healthy weight (reduces vein pressure)

See a vascular specialist or neurologist if you experience:

• Persistent leg pain, swelling, or visible vein issues
• Numbness, tingling, or burning sensations that worsen over time
• Unexplained falls, skin injuries, or slow-healing wounds on your feet or legs

Neuropathy symptoms vary depending on which nerves are affected. They typically fall into three main categories:

• Sensory (pain-related) symptoms: Tingling, burning, sharp pain, or loss of sensation in hands or feet.
• Motor symptoms: Muscle weakness, twitching, or difficulty walking and balancing.
• Autonomic symptoms: Dizziness, changes in blood pressure, digestive issues, or abnormal sweating.
  
  

Early signs of neuropathy may start with mild tingling or “pins and needles” sensations and progress to significant loss of feeling or muscle coordination over time.