Peripheral neuropathy is a common condition that affects the nerves outside the brain and spinal cord. These nerves are responsible for carrying messages between your brain and the rest of your body. When they become damaged, you may experience numbness, tingling, burning pain, weakness, or loss of sensation—most often in the feet.

Because the feet are usually affected first, podiatrists are often among the first healthcare providers to identify peripheral neuropathy. Early diagnosis can help reduce the risk of complications, including falls, foot ulcers, infections, and long-term nerve damage.

At Dr. Tong’s Podiatry Clinic, we evaluate patients with numbness, tingling, burning foot pain, and balance problems to determine the cause of their symptoms and develop an individualized treatment plan.

What Is Peripheral Neuropathy?

Peripheral neuropathy is damage or dysfunction of the peripheral nervous system—the network of nerves that carries information between your brain, spinal cord, muscles, skin, and internal organs.

When these nerves are damaged, they may send abnormal signals or fail to send signals at all.

This can affect:

Sensation
Muscle strength
Balance
Coordination
Temperature perception
Pain perception

Peripheral neuropathy usually begins in the toes and gradually progresses upward, a pattern often called a “stocking distribution.”

How Common Is Peripheral Neuropathy?

Peripheral neuropathy affects millions of Americans, with the risk increasing with age.

While diabetes is the most common cause, many people develop neuropathy from other medical conditions, medications, injuries, or nutritional deficiencies.

In some cases, the cause cannot be identified.

What Causes Peripheral Neuropathy?

Many different conditions can damage peripheral nerves.

Common causes include:

Diabetes

Diabetes is the leading cause of peripheral neuropathy. High blood sugar over time can damage the small nerves in the feet and legs.

Prediabetes

Even mildly elevated blood sugar may contribute to nerve damage before diabetes is officially diagnosed.

Vitamin Deficiencies

Low levels of certain vitamins—particularly Vitamin B12—can affect nerve function.

Alcohol Use

Long-term excessive alcohol use may contribute to nerve damage and nutritional deficiencies.

Chemotherapy

Some chemotherapy medications can cause peripheral neuropathy as a side effect.

Autoimmune Diseases

Conditions such as rheumatoid arthritis and lupus may affect the peripheral nerves.

Kidney Disease

Poor kidney function can allow toxins to accumulate in the bloodstream, potentially affecting nerves.

Infections

Certain viral and bacterial infections may contribute to nerve damage.

Trauma

Foot, ankle, or leg injuries can damage individual nerves.

Idiopathic Neuropathy

Sometimes no specific cause is found despite thorough evaluation.

What Are the Symptoms?

Symptoms often begin gradually.

Common symptoms include:

Numbness in the toes or feet
Tingling (“pins and needles”)
Burning pain
Sharp or stabbing sensations
Electric shock-like pain
Increased sensitivity to touch
Reduced ability to feel temperature
Difficulty sensing pressure
Muscle weakness
Balance problems
Frequent tripping
Feeling like you’re walking on cotton or pebbles

Symptoms may affect one foot or both.

Early Warning Signs

Many people overlook the earliest symptoms.

You should seek evaluation if you notice:

Socks feel bunched up when they are not
Burning feet at night
Tingling while resting
Loss of sensation when walking barefoot
Difficulty feeling small objects beneath your feet
Unexplained balance problems

Early diagnosis offers the greatest opportunity to identify and address underlying causes.

Why Is Peripheral Neuropathy Dangerous?

Loss of sensation means you may not notice:

Cuts
Blisters
Burns
Splinters
Pressure injuries
Developing infections

Without protective sensation, small injuries can become serious problems before they are noticed.

For patients with diabetes, this significantly increases the risk of:

Foot ulcers
Infection
Delayed wound healing
Hospitalization
Amputation

Regular foot examinations are essential.

How Is Peripheral Neuropathy Diagnosed?

A podiatric evaluation includes a thorough assessment of your symptoms and foot health.

Your evaluation may include:

Medical History

Your podiatrist may ask about:

Diabetes
Medications
Alcohol use
Family history
Previous injuries
Medical conditions
Symptom progression

Physical Examination

The feet are examined for:

Skin changes
Calluses
Ulcers
Muscle weakness
Foot deformities
Circulation
Balance

Neurological Examination

Your podiatrist may evaluate:

Protective sensation
Light touch
Vibration sensation
Temperature sensation
Reflexes
Muscle strength

Additional Testing

Depending on your symptoms, additional testing or referral to another healthcare provider may be recommended to identify the underlying cause.

Treatment Options

Treatment depends on the underlying cause and your individual symptoms.

Your care plan may include one or more of the following.

Managing the Underlying Cause

Treating diabetes, correcting vitamin deficiencies, or addressing other medical conditions may help slow the progression of neuropathy.

Foot Care

Daily foot care helps reduce complications.

Recommendations include:

Daily foot inspections
Moisturizing dry skin (avoiding between the toes)
Wearing properly fitted shoes
Avoiding barefoot walking
Routine podiatric care

Pain Management

Depending on your symptoms, your healthcare provider may recommend medications or other therapies to help manage nerve pain.

Balance and Strength Training

Exercises may improve:

Balance
Walking stability
Lower extremity strength
Fall prevention

Custom Orthotics

For some patients, custom orthotics may improve foot mechanics, redistribute pressure, and enhance comfort while walking.

Can Peripheral Neuropathy Be Reversed?

Whether neuropathy can be reversed depends on its cause.

Some forms of neuropathy may improve if the underlying condition is identified and treated early, such as vitamin deficiencies or certain medication-related neuropathies.

Other forms, including long-standing diabetic neuropathy, may not be reversible, but symptoms and progression can often be managed with appropriate medical care and preventive strategies.

Protecting Your Feet

Patients with neuropathy should:

Check feet every day
Wear shoes indoors and outdoors
Avoid walking barefoot
Inspect inside shoes before wearing them
Trim nails carefully
Report new wounds immediately
Schedule regular podiatry visits

These simple habits can help reduce the risk of serious complications.

When Should You See a Podiatrist?

Schedule an appointment if you experience:

Numbness in your feet
Burning foot pain
Tingling sensations
Loss of balance
Difficulty feeling your feet
Frequent falls
Foot wounds that are slow to heal
Diabetes with any changes in foot sensation

Prompt evaluation can help identify the cause of your symptoms and reduce the risk of future complications.

Frequently Asked Questions

Is peripheral neuropathy the same as diabetic neuropathy?

No. Diabetic neuropathy is one type of peripheral neuropathy. Many other medical conditions can also damage peripheral nerves.

Does peripheral neuropathy always cause pain?

No. Some people experience pain, while others mainly notice numbness, tingling, or loss of sensation.

Can peripheral neuropathy affect only one foot?

Yes. Some types of nerve injuries affect a single nerve, while generalized peripheral neuropathy usually affects both feet.

Is numbness in the feet normal with aging?

No. Although neuropathy becomes more common with age, persistent numbness should always be evaluated.

Can exercise help?

For many patients, regular physical activity and balance exercises may improve strength, stability, and overall function. Your healthcare provider can recommend an exercise program appropriate for your condition.

Why Choose Dr. Tong’s Podiatry Clinic?

Dr. Tong provides comprehensive evaluation and ongoing care for patients with peripheral neuropathy by:

Identifying early signs of nerve damage
Performing neurological foot examinations
Assessing circulation and foot health
Monitoring for ulcers and pressure injuries
Providing diabetic foot care
Recommending custom orthotics when appropriate
Educating patients on strategies to reduce complications

Our goal is to help patients maintain healthy, active feet while minimizing the risks associated with peripheral neuropathy.

Schedule a Peripheral Neuropathy Evaluation

If you’re experiencing numbness, tingling, burning pain, or weakness in your feet, don’t ignore these symptoms. Early evaluation may help identify the underlying cause and reduce your risk of complications.

Schedule a consultation with Dr. Tong today to receive a comprehensive foot and nerve evaluation.

Diabetic Foot Care
Neuropathic Foot Pain: Causes and Treatment
Signs You May Have Peripheral Neuropathy
Burning Feet at Night: What Does It Mean?
Custom Orthotics
Foot Health Tips
Why Annual Diabetic Foot Exams Matter
Balance Problems and Foot Health

What Is Peripheral Neuropathy? Causes, Symptoms, Diagnosis & Treatment