Peripheral neuropathy is caused by damage to the peripheral nerves.  Most commonly in the foot this is caused by damage to the small nerve fibers, the most common cause is diabetic mellitus.  Other causes include alcoholism, certain medications (flagyl, levaquin and chemotherapy agents) autoimmune diseases, neurological disorders, vitamin B12 deficiency, trauma to the peripheral nerves and heredity.  Peripheral neuropathy may also be idiopathic meaning that it occurs without a cause.

The most common symptoms of peripheral neuropathy include burning, tingling, numbness or shooting pain in the feet and in hands.  Diagnosis of peripheral neuropathy is made by the patients history and clinical exam.  Often a skin biopsy is taken and sent for a test called epidermal nerve fiber density analysis.  This test is usually reserved for patients where the diagnosis is not clear.

Treatment includes nutritional supplements including alpha lipoic acid, benfotiamine, vitamin B6, vitamin B12 and metanx, lyrica and amitriptyline are often helpful.

People with peripheral neuropathy should wear properly fitted shoes and avoid walking barefoot to prevent injury.  For diabetics, it is important to control blood sugar as elevated blood sugars can cause nerve damage.