Peripheral neuropathy occurs when nerves in the body become injured or inflamed, disrupting the normal flow of signals between the body and the brain. In the feet and legs, that usually shows up as burning pain, tingling, or numbness. Because the longest nerves in the body run to the feet, neuropathy symptoms typically start there first and can gradually move upward if the underlying cause isn't addressed.
Neuropathy can be uncomfortable and, left unmanaged, can raise the risk of unnoticed cuts, sores, and infections — especially for people with diabetes. The good news is that a combination of medical treatment and daily foot care can meaningfully reduce symptoms and lower your risk of complications. Here's what our podiatrists want you to know.
What is peripheral neuropathy?
Peripheral neuropathy is damage or dysfunction of the peripheral nerves — the nerves outside the brain and spinal cord that carry sensation and movement signals throughout the body. When these nerves are injured or inflamed, they can misfire, sending pain signals when nothing is actually wrong, or failing to transmit sensation at all.
Because the nerves that reach the feet are the longest in the body, they're often the first affected and the most vulnerable to damage. That's why neuropathy symptoms so frequently begin in the feet before potentially progressing toward the ankles and lower legs.
What causes neuropathy in the feet and legs?
Diabetes is the most common cause of peripheral neuropathy, since prolonged high blood sugar can damage nerves over time. But diabetes isn't the only cause. Other common contributors include:
- Vitamin deficiencies, particularly B12
- Autoimmune diseases
- Chronic alcohol use
- Chemotherapy and certain other medications
- Infections
- Physical trauma or nerve compression
Patients with diabetes should be especially attentive to early neuropathy symptoms, since reduced sensation can mask injuries that would otherwise be obvious.
What are the symptoms of neuropathy?
Early symptoms are often subtle and can be easy to write off before they become more disruptive. Common signs include:
- Numbness or reduced sensation in the feet
- Tingling or a "pins and needles" feeling
- Burning or electric-shock-like pain, which may worsen at rest or at night
- Muscle weakness as the condition progresses
- Balance difficulties or increased risk of falls
If you notice these symptoms, especially if you have diabetes or another risk factor, it's worth having your feet evaluated rather than waiting for them to worsen.
How is neuropathy managed?
There's no single treatment that works for everyone, so management typically combines medication, supportive care, and daily habits tailored to your symptoms and their underlying cause.
Medical treatment
- Medications such as gabapentin, pregabalin, and certain antidepressants, which can help reduce nerve pain
- Topical treatments like lidocaine patches or capsaicin cream for localized relief
- Physical therapy to strengthen muscles and improve balance
- Custom orthotics to redistribute pressure and improve foot function — see our custom orthotics options
- Advanced therapies, including TENS units, neuromodulation, and acupuncture, for patients who need additional relief
Daily foot care
Because reduced sensation can hide developing problems, daily foot care is essential for anyone managing neuropathy:
- Inspect your feet every day for cuts, blisters, redness, or swelling
- Keep feet clean and moisturized to prevent cracking
- Remove hazards from your path at home to reduce fall risk
- Check bathwater temperature carefully, since reduced sensation can mask water that's too hot
- Wear supportive, well-fitting shoes at all times
When should you see a podiatrist?
See a podiatrist if you notice new or worsening numbness, tingling, or burning pain in your feet or legs — particularly if you have diabetes, since early evaluation can help protect against complications like unnoticed wounds or infections. Nerve-related symptoms tend to be more manageable the earlier they're addressed, so don't wait for them to interfere with daily life. You can request an appointment at either of our Northern Utah offices.
Medically reviewed by the physicians at Wasatch Foot & Ankle Institute. Our board-certified, fellowship-trained podiatrists provide foot and ankle care in Farmington and South Ogden, Utah. This article is for general education and is not a substitute for an in-person evaluation.