Neuropathy: Understanding Nerve Damage, Finding Relief, and Treating the Underlying Cause
Numbness, Burning, Tingling or Pain Isn't Just Part of Getting Older
If you’re experiencing numbness, burning, tingling, stabbing pain, weakness, or loss of sensation in your feet or hands, you may be living with peripheral neuropathy.
Neuropathy affects millions of Americans and can make everyday activities—from walking and sleeping to driving and maintaining balance—more difficult and painful.
For many people, neuropathy is not a disease itself—it is a symptom of an underlying medical condition. Identifying and treating the cause is one of the most important steps in managing nerve damage and helping prevent it from progressing.
At Metabolic Centers for Excellence (MCE), we believe effective neuropathy care begins with understanding why the nerves are being damaged, not simply masking the symptoms.
What Is Neuropathy?
Peripheral neuropathy occurs when the nerves outside the brain and spinal cord become damaged.
These nerves control:
- Touch and sensation
- Temperature perception
- Pain signals
- Muscle movement
- Balance and coordination
- Blood vessel function
- Sweating
- Digestion
- Heart rate
- Bladder and bowel function
When nerves become damaged, they may stop sending signals correctly—or send pain signals even when there is no injury.
According to the National Institute of Neurological Disorders and Stroke, more than 20 million people in the United States are estimated to have some form of peripheral neuropathy, although the true number may be significantly higher.
What Causes Neuropathy?
Neuropathy has many possible causes. The most common include:
Diabetes is the leading cause of peripheral neuropathy.
Persistently elevated blood sugar can damage the small blood vessels that supply oxygen and nutrients to the nerves.
Approximately half of people living with diabetes will develop some degree of diabetic neuropathy during their lifetime.
Even before diabetes develops, elevated blood sugar and insulin resistance may begin damaging nerves.
Many patients are surprised to learn they have neuropathy before they have ever been diagnosed with diabetes.
Certain chemotherapy medications may injure peripheral nerves.
This condition, called chemotherapy-induced peripheral neuropathy (CIPN), can continue long after cancer treatment has ended.
Neuropathy may also result from:
- Vitamin B12 deficiency
- Autoimmune disorders
- Kidney disease
- Thyroid disorders
- Alcohol misuse
- Infections
- Certain medications
- Repetitive nerve compression
- Traumatic injury
- Hereditary nerve disorders
- Poor circulation
- Chronic inflammation
- Unknown (idiopathic) causes
For some patients, more than one contributing factor is present.
Common Symptoms of Neuropathy
Symptoms vary depending on which nerves have been affected. Patients commonly report:
Sensory Symptoms
- Numbness
- Tingling ("pins and needles")
- Burning pain
- Sharp or electric shock sensations
- Stabbing pain
- Increased sensitivity to touch
- Pain from bed sheets or socks
- Reduced ability to feel hot or cold
- Loss of vibration sensation
Motor Symptoms
- Muscle weakness
- Foot drop
- Difficulty climbing stairs
- Trouble walking
- Frequent tripping
- Poor coordination
- Muscle cramping
Balance Problems
- Feeling unsteady
- Difficulty walking in the dark
- Falls
- Reduced awareness of foot position
Autonomic Symptoms
- Dizziness when standing
- Digestive problems
- Constipation
- Bladder dysfunction
- Excessive or reduced sweating
- Sexual dysfunction
- Blood pressure changes
Symptoms often begin gradually and may worsen over time if the underlying cause is not addressed.
Frequently Asked Questions
How Is Neuropathy Diagnosed?
No single test can diagnose every form of neuropathy.
A comprehensive evaluation may include:
- Medical history
- Physical examination
- Neurological examination
- Reflex testing
- Sensory testing
- Vibration testing
- Monofilament testing
- Balance assessment
- Muscle strength evaluation
- Blood sugar evaluation
- Vitamin deficiency screening
- Thyroid testing
- Kidney function tests
- Nerve conduction studies (when indicated)
- Electromyography (EMG)
- Imaging studies (when appropriate)
At MCE, we also evaluate metabolic factors that may contribute to nerve damage, including insulin resistance, blood sugar control, circulation, and overall metabolic health.
You should seek medical evaluation if you experience:
- New numbness
- Burning feet
- Tingling hands
- Progressive weakness
- Balance problems
- Frequent falls
- Foot wounds that heal slowly
- Pain that interferes with sleep
- Symptoms that continue to worsen
Early evaluation offers the best opportunity to identify treatable causes and reduce the risk of further nerve damage.
Treatment depends on the underlying cause.
For many patients, treatment involves a combination of approaches.
Treating the Underlying Condition
The most important step is identifying and managing the condition causing the nerve damage.
Examples include:
- Improving blood sugar control
- Treating prediabetes or diabetes
- Correcting vitamin deficiencies
- Managing thyroid disease
- Improving kidney health
- Adjusting medications when appropriate
- Treating autoimmune disorders
Prescription Medications
Your healthcare provider may prescribe medications to help reduce neuropathic pain, including:
- Duloxetine (Cymbalta®)
- Pregabalin (Lyrica®)
- Gabapentin (Neurontin®)
- Tricyclic antidepressants
- Topical lidocaine
- Capsaicin products
These medications may help reduce symptoms but generally do not reverse the underlying nerve damage.
Physical Therapy
Physical therapy may improve:
- Strength
- Balance
- Mobility
- Fall prevention
- Walking mechanics
Lifestyle Changes
Patients are often encouraged to:
- Improve blood sugar control
- Exercise regularly
- Stop smoking
- Reduce alcohol intake
- Maintain a healthy weight
- Follow a nutrient-rich eating plan
- Protect the feet from injury
Nutritional Support
Some patients with documented deficiencies may benefit from vitamin replacement, such as vitamin B12 or other nutrients, when medically appropriate.
How MCE Can Make the Difference
Many patients come to MCE after years of simply being told to “live with it.” Our philosophy is different. Rather than focusing only on pain management, we work to identify and address the metabolic and circulatory factors that may be contributing to nerve dysfunction.
Comprehensive Neuropathy Evaluation
Your evaluation may include:
Medical history review
Blood sugar assessment
A1C testing
Evaluation for insulin resistance
Circulation assessment
Balance evaluation
Foot examination
Neuropathy symptom assessment
Medication review
Review of previous treatments
Functional limitations
Lifestyle and nutrition assessment
MCE's Comprehensive Neuropathy Treatment Approach
Depending on your diagnosis and clinical needs, your personalized treatment plan may include:
Metabolic Infusion Therapy (MIT)
Shockwave Therapy
Class IV Laser Therapy
Nutritional and Metabolic Support
Ongoing Monitoring
Why Patients Choose MCE
Patients choose Metabolic Centers for Excellence because we strive to look beyond symptom management. Our approach emphasizes:
Identifying the underlying cause
Evaluating metabolic health
Comprehensive neuropathy assessments
Individualized treatment plans
Multiple evidence-informed
treatment options
Ongoing monitoring and education
Coordination with your primary care provider and specialists when appropriate
Hormonal, menstrual and fertility outcomes should be monitored with the appropriate reproductive-health provider.
Don't Ignore the Warning Signs
Neuropathy often progresses gradually. The earlier nerve damage is identified and the underlying causes are addressed, the greater the opportunity to preserve function, reduce symptoms, and improve quality of life.
If you are experiencing numbness, tingling, burning pain, balance problems, or diabetic nerve symptoms, our team can help determine the cause and discuss appropriate treatment options.
Medical Disclaimer
This webpage is intended for educational purposes only and should not replace medical advice from your healthcare provider. Neuropathy has many possible causes, and treatment should be individualized based on a comprehensive medical evaluation. MCE’s therapies, including Metabolic Infusion Treatment, Shockwave Therapy, and Class IV Laser Therapy, are offered only when clinically appropriate. Individual results vary, and no treatment can guarantee symptom improvement or reversal of nerve damage.