Symptoms range widely depending on which nerves are affected and how severely. They often develop gradually, beginning in the hands and feet and potentially spreading further over time.

Common sensory symptoms include:

• Tingling or a "pins and needles" sensation, often in the hands and feet
• Burning pain, which can be persistent or come and go
• Numbness or reduced ability to feel touch, temperature, or pain
• Sharp, stabbing, or electric shock-like sensations
• Increased sensitivity to touch, where even light contact feels uncomfortable or painful

When motor nerves are affected, symptoms may include:

• Muscle weakness, making everyday tasks like climbing stairs or gripping objects more difficult
• Loss of coordination or balance, which can increase the risk of falls
• Muscle twitching or cramping
• Difficulty with fine motor tasks such as buttoning a shirt or writing

Peripheral neuropathy has many potential causes, and in some cases no clear cause is identified.

• Diabetes is one of the most common causes. Persistently elevated blood sugar can damage nerves throughout the body, particularly in the hands and feet. This is known as diabetic neuropathy.
• Spinal nerve compression from conditions such as a herniated disc, spinal stenosis, or bone spurs can compress nerve roots as they exit the spine, producing symptoms consistent with neuropathy in the affected nerve's territory.
• Physical injury or trauma can directly damage peripheral nerves. Fractures, dislocations, or repeated pressure on a nerve can disrupt normal signaling.
• Carpal tunnel syndrome is a form of peripheral neuropathy caused by compression of the median nerve at the wrist, producing numbness, tingling, and weakness in the hand.
• Vitamin deficiencies, particularly B12, B1, and B6, can impair nerve function over time, as these vitamins are essential for nerve cell health.
• Autoimmune conditions such as rheumatoid arthritis or lupus can trigger immune responses that damage nerve tissue.
• Alcohol use disorder is a recognized cause of peripheral neuropathy due to both direct nerve toxicity and associated nutritional deficiencies.
• Certain medications used in the management of other chronic conditions can have neuropathy as a side effect.

• People with diabetes are at significantly elevated risk, particularly those with long-standing or poorly controlled blood sugar.
• Older adults are more vulnerable as nerve function naturally changes with age and years of cumulative wear.
• People with autoimmune conditions have a heightened risk of immune-mediated nerve damage.
• Those with nutritional deficiencies, particularly people who follow restrictive diets, have absorption issues, or consume excessive alcohol, may not get adequate B vitamins for nerve health.
• People who perform repetitive physical tasks or experience sustained pressure on specific nerves may develop localized neuropathy at those sites.
• Individuals with spinal conditions such as degenerative disc disease or spinal stenosis may experience nerve compression that produces neuropathic symptoms in the arms or legs.

Tingling in my feet is just normal aging. While some changes in sensation occur with age, persistent tingling, burning, or numbness warrants professional evaluation. These sensations often have an identifiable cause.

Neuropathy always comes from diabetes. Diabetes is one of many causes. Many people with peripheral neuropathy do not have diabetes, and other causes are very common.

Neuropathy cannot be helped. While nerve damage can be slow to heal, many people experience meaningful improvement when the underlying cause is identified and addressed, particularly in cases involving compression or nutritional deficiency.

The symptoms will go away on their own. Some cases do resolve without intervention, but many do not, and untreated neuropathy can sometimes progress. Professional evaluation is important when symptoms persist or worsen.

Diagnosing peripheral neuropathy typically begins with a thorough health history and a neurological examination. Your healthcare provider will ask about the nature of your symptoms, when they began, and whether they have changed over time. They will also ask about your medical history, medications, lifestyle habits, and any relevant family history.

During the examination, the provider may test:

• Sensation by assessing your ability to feel vibration, light touch, and temperature changes
• Reflexes, which can be diminished in some forms of neuropathy
• Muscle strength and coordination
• Balance

Further testing may include blood work to check blood sugar, B vitamin levels, thyroid function, and other relevant markers. Nerve conduction studies and electromyography (EMG) can measure how well nerves and muscles are communicating. Imaging such as MRI may be used to evaluate the spine when nerve root compression is suspected as a contributing factor.

You should speak with a healthcare provider if you experience:

• Persistent tingling, numbness, or burning in the hands or feet
• Weakness affecting your ability to walk, grip, or perform everyday tasks
• Balance problems or an increased tendency to stumble or fall
• Symptoms that began suddenly or are worsening over time

Seek prompt care if you experience:

• Rapid onset of weakness in multiple limbs
• Difficulty breathing alongside limb weakness
• Sudden and severe loss of sensation

These symptoms can indicate a more serious neurological condition and require urgent evaluation.