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Peripheral Neuropathy

Peripheral neuropathy indicates damage to the peripheral nerves or the nerves that connect to our arms and legs. Symptoms generally include weakness, numbness, burning pain and loss of reflexes. It is increasingly common as we age but can also be associated with diabetes mellitus or exposure to toxins such as alcohol or certain chemicals such as chemotherapy.


With injury to the nerves and their blood supply, the nerves begin to short circuit resulting in abnormal sensations that can be mildly irritating to excruciating. In severe cases there is complete numbness.



The initial presentation usually includes pain, weakness and altered sensation. In more advanced cases symptoms can develop into:

• muscle wasting and weakness resulting in the inability to walk

• progressive numbness

• loss of temperature and position sense


Other diseases that can mimic a peripheral neuropathy include:

Cervical- spondylotic myelopathy

Chemicals- solvents, acrylamide and arsenic


Pharmaceuticals- amiodarone, statins, phenytoin, chemotherapy and


Recreational drugs include tobacco, alcohol and cocaine

Spinal cord injury

Spinocerebellar syndromes

Transverse myelitis

Vitamin B12 deficiency



Identifying the underlying cause of your peripheral neuropathy is the most important factor in treating the underlying problem. These include removing the offending chemical or drug, diabetes management, or B vitamin replacement. For neuropathic pain- gabapentin, anticonvulsants, tricyclic antidepressants, and tramadol have been found to be helpful. Generalized strengthening and stretching can also be helpful.



Richardson JK. The clinical identification of peripheral neuropathy among older persons. Arch Phys Med Rehabil. 2002 Nov;83(11):1553-8.

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