Peripheral Nerve
Neuropathy Neurologist
Peripheral neuropathy causes numbness, tingling, burning or weakness, usually beginning in the feet. The purpose of evaluation is twofold: confirm that the symptoms come from nerve involvement, and identify the cause, because many causes are treatable and some are progressive if left unaddressed.
Common symptoms
- Burning, tingling or numbness in the feet, later the hands
- Symptoms that are worse at night
- Sharp or electric pain
- Unsteadiness, especially in the dark
- Reduced sensation to temperature or touch
- Weakness or foot drop in more advanced cases
Causes that are evaluated
- Diabetes and prediabetes or metabolic syndrome
- Vitamin B12 deficiency and other nutritional causes
- Thyroid disease
- Alcohol use
- Medication and chemotherapy effects
- Kidney disease, inflammatory and autoimmune causes
- Hereditary neuropathies
Testing
- Neurological examination with sensory and reflex testing
- Targeted laboratory studies
- Glucose tolerance testing when metabolic neuropathy is suspected
- EMG and nerve conduction studies when appropriate
- Imaging of the spine when the pattern suggests nerve root involvement
Exercise, metabolic health and neuropathy
For the most common forms of neuropathy, metabolic health is central. Glucose control, weight management, physical activity and lipid management are directly relevant to nerve health, and activity also helps with pain, sleep and balance.
Walking, cycling, resistance training and balance work are typically well tolerated. Patients with reduced foot sensation should inspect their feet regularly, choose well-fitting footwear, and progress activity gradually. Alcohol reduction and correction of B12 deficiency matter when those are contributors.
Symptom treatment
Symptomatic treatment aims to reduce burning and pain and improve sleep, using medications selected for the individual's other conditions. Physical therapy and balance training reduce fall risk. Expectations are discussed honestly: nerve regeneration is slow, and treating the cause is what changes the trajectory.
Frequently asked questions
- Can neuropathy cause balance problems?
- Yes. Reduced sensation in the feet impairs the position feedback used for balance, which is why falls are more likely, particularly in the dark or on uneven ground.
- Is an EMG always needed?
- No. It is used when it will clarify the type, distribution or severity of nerve involvement, or when the diagnosis is uncertain.
- Can neuropathy be reversed?
- Some causes improve substantially when treated, such as vitamin deficiency or a medication effect. In others, the goal is stabilization, symptom control and fall prevention.
Request a Neurology Appointment
Text 815-276-7050 with your first name and the word "appointment," or call 815-337-7100 to schedule. Our office will follow up to confirm your evaluation.
In-person visits and televisits (telehealth) are both available.
What happens after you text
Text 815-276-7050 with your first name and the word "appointment." Our office calls you back to schedule — you do not need to fill out a form.
When you'll hear back
Texts and calls received during office hours are typically returned the same business day. You can also call 815-337-7100 directly.
Insurance and referrals
Insurance participation and referral requirements vary by plan. Our office will confirm what your plan requires before your visit.
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