What is neuropathy?

Neuropathy is when nerve damage leads to pain, weakness, numbness or tingling in one or more parts of your body.

The nerve damage may be because of:

• disease
• infection
• injury
• medicines
• long-term alcohol abuse

Sometimes, no cause is found.

What are the different types of neuropathies?

There are many different types of neuropathies. Neuropathies are usually named according to:

• the body part or area affected
• the cause of nerve damage
• the number of nerves affected

Autonomic neuropathy occurs when there is damage to the nerves that control your body's automatic functions, such as digestion, blood pressure and bladder function.

Diabetic neuropathy is caused by diabetes. It most commonly affects the nerves of your hands and feet. It can also affect the nerves controlling the automatic functions of your body (autonomic neuropathy). It sometimes affects the nerves in your hips and thighs.

Peripheral neuropathy affects the nerves in the outer (peripheral) parts of your body such as your feet, legs, hands and arms.

Focal or mononeuropathy affects only one nerve. Examples include carpal tunnel syndrome and Bell's palsy.

Polyneuropathy affects several nerves. Most people with neuropathy have polyneuropathy.

What are the symptoms of neuropathy?

Your symptoms will depend on the nerves involved.

Neuropathy can cause abnormal sensations in the affected body area, such as:

• pain, which is often worse at night
• numbness
• tingling, or ‘pins and needles'
• a burning sensation
• electric shock-like sensations

Neuropathy can also cause:

• muscle weakness
• a loss of movement or function
• problems with balance

Autonomic neuropathy can cause problems with:

• digestion (for example, feeling full faster when eating)
• bowel function (including diarrhoea or constipation)
• bladder function
• sexual response (for example, erectile dysfunction)
• sweating
• feeling lightheaded

What causes neuropathy?

There are many known causes of neuropathy, including:

• diabetes
• thyroid problems
• long-term alcohol abuse
• vitamin deficiencies
• some medicines and chemicals
• pressure on a nerve

Other causes can include:

• tumours or cancers
• chemotherapy or radiotherapy
• Guillain-Barre syndrome
• certain infections, including HIV infection and AIDS
• genetic conditions, such as Charcot-Marie-Tooth disease
• problems with your immune system or blood vessels

Sometimes, a cause can't be found.

When should I see my doctor?

See your doctor if you have symptoms of:

• numbness
• a tingling or prickling feeling in your skin
• a feeling of extra sensitivity to light touch
• weakness
• trouble with your co-ordination
• pain that feels like burning or electric shock-like sensations

When to seek urgent help

Seek urgent medical help if any of the above symptoms come on suddenly and are getting worse quickly.

Call triple zero (000) for an ambulance or go to the nearest hospital emergency department if you have trouble:

• breathing
• speaking
• swallowing

How is neuropathy diagnosed?

Your doctor will ask you questions about your symptoms, and whether anything makes them worse or better. They will want to know how long you have had symptoms.

They will also ask about:

• other conditions you have
• any medicines or other therapies you are taking
• your family history
• your diet and lifestyle

They will examine you to work out if there is a problem with one or several nerves. They will also look for the cause of the nerve problem.

You might be asked to have tests called nerve conduction studies. This type of test can measure the electrical activity in your nerves.

Your doctor may also recommend blood tests to help find the cause of the neuropathy.

Sometimes, imaging tests such as an MRI scan or ultrasound scan may be done.

Your doctor may refer you to a neurologist (specialist doctor) for further tests and treatment.

How is neuropathy treated?

Treatment for neuropathy depends on the cause. If the cause is a medicine you are taking, you may need to change your medicine.

You may need to take medicines to treat nerve pain.

Treatment for neuropathy can include treatment from allied health professionals such as:

• an occupational therapist
• a physiotherapist
• a podiatrist

What are the complications of neuropathy?

If you have a loss of sensation in your feet due to neuropathy, you are at risk of foot problems. These can include:

• foot or leg ulcers
• skin changes or infections
• bone and joint problems in your ankles and feet

You may also have balance problems and a higher risk of falls.

Your doctor will likely suggest regular foot care to prevent these complications.

Serious complications can develop from autonomic neuropathy and other conditions where the nerves that control your breathing, blood pressure and heart are involved.

Can neuropathy be prevented?

Some types of neuropathies may be prevented, such as neuropathy associated with alcohol abuse or very restrictive diets.

You can reduce your risk of developing neuropathy associated with diabetes by keeping your blood glucose levels well controlled.

Resources and support

Diabetes Australia has information about neuropathies related to diabetes.

The Cancer Council has information on peripheral neuropathy related to cancer.

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with 24 hours a day, 7 days a week.