Peripheral Neuropathy: How Diagnosis and Treatment Can Help Protect Your Nerve Health

Peripheral neuropathy occurs when nerves outside the brain and spinal cord become damaged or irritated. These nerves help control sensation, movement, balance, and certain automatic body functions. When they are not working properly, symptoms can range from mild numbness to severe burning pain.

At Palm Beach Pain Institute in Delray Beach, Florida, Marcie A. Merson, MD, evaluates nerve-related pain and helps patients explore treatment options for peripheral neuropathy.

What peripheral neuropathy feels like

Peripheral neuropathy often begins gradually. Some people first notice numbness in their toes. Others describe pins-and-needles, burning, stabbing, crawling, or electric sensations. Symptoms may be worse at night or after standing and walking.

Common signs of peripheral neuropathy include:

• Numbness or reduced sensation
• Tingling or pins-and-needles feelings
• Burning pain
• Sharp, shooting, or electric pain
• Sensitivity to touch
• Muscle weakness
• Cramping
• Balance problems
• Feeling like you are wearing socks when you are not

Peripheral neuropathy often affects the feet and legs first, but it can also involve the hands and arms.

What causes peripheral neuropathy?

Neuropathy is not one single condition. It is a symptom pattern that can have many possible causes. Identifying the cause is one of the most important parts of treatment.

Common causes include diabetes, nerve compression, herniated discs, spinal stenosis, vitamin deficiencies, thyroid problems, autoimmune conditions, infections, kidney or liver disease, alcohol use, certain medications, chemotherapy, prior surgery, and traumatic injuries.

Sometimes, no clear cause is found. This is called idiopathic neuropathy. Even then, treatment may still reduce symptoms and help protect function.

How peripheral neuropathy is diagnosed

A thorough evaluation is essential because neuropathy symptoms can overlap with other conditions, including sciatica, vascular problems, arthritis, pinched nerves, and spine-related pain.

During your visit, Dr. Merson reviews your symptoms, medical history, medications, past injuries, and any conditions that may affect nerve health. She may ask when symptoms started, whether they are worsening, whether they affect one side or both sides, and what makes them better or worse.

Your exam may include sensation testing, reflex checks, strength testing, balance assessment, and evaluation of your spine, legs, or arms depending on your symptoms. Additional testing may be recommended when needed, such as blood work, imaging, nerve studies, or coordination with another specialist.

The goal is to determine whether your symptoms are truly coming from peripheral nerves, where the nerve problem may be located, and what is contributing to it.

Treatment options for peripheral neuropathy

Treatment depends on the cause, severity, and pattern of your symptoms. For example, neuropathy related to diabetes may require blood sugar management, while neuropathy from nerve compression may require spine-focused treatment.

A personalized plan may include:

Medication management

Certain medications can help calm overactive nerve signals and reduce burning, tingling, or shooting pain. Topical treatments, anti-inflammatory medications, nerve pain medications, or other prescriptions may be considered depending on your symptoms and medical history.

Physical therapy

Physical therapy can help improve strength, balance, flexibility, circulation, and walking confidence. It may also reduce fall risk, which is especially important when neuropathy affects sensation in the feet.

Osteopathic manual therapy

If nerve symptoms are related to musculoskeletal tension, posture, joint restriction, or spine mechanics, osteopathic manual therapy may help reduce stress on irritated nerves and support better movement.

TENS therapy

Transcutaneous electrical nerve stimulation, or TENS, uses gentle electrical impulses to interfere with pain signals. It may be used as part of a broader neuropathy pain management plan.

Interventional pain treatments

When neuropathy symptoms are connected to a pinched nerve, spinal stenosis, herniated disc, or another spine-related problem, targeted injections or other minimally invasive treatments may be appropriate.

Why follow-up matters

Peripheral neuropathy can change over time. Regular follow-up helps track whether symptoms are improving, stable, or worsening. It also allows Dr. Merson to adjust medication, therapy, or treatment recommendations based on your response.

During follow-up visits, it is helpful to discuss pain levels, sleep quality, walking tolerance, balance, medication side effects, and any changes in numbness or weakness.

When to seek care

Schedule an evaluation if numbness, tingling, burning, or nerve pain is persistent, spreading, or affecting your daily life. You should seek prompt medical attention if you develop sudden weakness, loss of bladder or bowel control, rapidly worsening numbness, or symptoms after a serious injury.

Find relief from nerve pain

Peripheral neuropathy can make simple daily activities uncomfortable, but treatment can help. With the right diagnosis and a customized care plan, many patients can reduce nerve pain, improve function, and feel more confident moving through the day.

To schedule a peripheral neuropathy evaluation at Palm Beach Pain Institute in Delray Beach, Florida, call 561-499-7020 or book an appointment online today.