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Peripheral neuropathy — numbness, tingling and nerve pain in hands and feet — Empire Minimally Invasive Spine and Pain

Peripheral Neuropathy: Why Your Hands and Feet Feel Numb or Tingly

Numbness, tingling, or a burning feeling in your hands or feet can be unsettling — and it’s one of the most common reasons people come in worried about their nerves. Often the cause is peripheral neuropathy. This guide explains what it is, what’s behind it, and the treatments that can calm the symptoms and protect the nerves.

Key takeaways
  • Peripheral neuropathy is damage to the nerves outside the brain and spinal cord.
  • It often starts in the feet and hands as numbness, tingling, or burning.
  • Diabetes is the single most common cause, but there are many others.
  • Finding and treating the underlying cause is the most important step.
  • Medications, therapy, and nerve stimulation can meaningfully reduce the pain.

What is peripheral neuropathy?

Peripheral neuropathy is damage to the peripheral nerves — the network that carries signals between your brain and spinal cord and the rest of your body. When those nerves are damaged, the messages get scrambled, which is why neuropathy can cause odd sensations, pain, weakness, or numbness, most often in the hands and feet.

Cleveland Clinic explains that “peripheral neuropathy can disrupt your body’s control of automatic processes, as well as your sense of touch and muscle control” (Cleveland Clinic).
Where neuropathy often starts Often Starts in the Hands & Feet Hands Feet Tingling, numbness, burning
Neuropathy symptoms often begin in the feet and hands. Illustration for patient education.

What does neuropathy feel like?

Peripheral neuropathy usually feels like numbness, tingling, or a burning or “pins-and-needles” sensation, often starting in the feet and later the hands. Some people describe sharp, electric-shock-like pain; others notice weakness, poor balance, or a loss of feeling that makes it hard to sense temperature or a small injury. Symptoms often come on gradually and can be worse at night. Common signs include:

  • Numbness or reduced feeling in the feet or hands
  • Tingling or a “pins-and-needles” sensation
  • Burning or sharp, shooting pain
  • Muscle weakness or trouble with balance

What causes peripheral neuropathy?

Peripheral neuropathy has many possible causes, and finding the right one is central to treating it. By far the most common is diabetes, but nerves can also be damaged by pressure or injury, certain medications, and other health conditions. Frequent causes include:

  • Diabetes — the leading cause of peripheral neuropathy
  • Nerve compression or injury
  • Chemotherapy and some other medications
  • Heavy alcohol use
  • Vitamin deficiencies (such as B12)
  • Autoimmune conditions and certain infections

How is peripheral neuropathy diagnosed?

Peripheral neuropathy is diagnosed with a physical and neurological exam, plus tests to find the cause. Your physician checks your sensation, reflexes, strength, and balance, and may order blood tests (for example, to check for diabetes or a vitamin deficiency) and nerve studies such as electromyography. Pinpointing the cause is what makes treatment effective, which is how care is approached at Empire Minimally Invasive Spine and Pain.

How is peripheral neuropathy treated?

Peripheral neuropathy is treated by addressing the underlying cause and calming the nerve pain, and Empire follows a step-and-ladder approach.

Treat the cause

Because so many cases are driven by an underlying condition, managing that condition — for example, controlling blood sugar in diabetes or correcting a vitamin deficiency — is the foundation of treatment and can keep the neuropathy from progressing.

Medication and therapy

Specific medications can quiet nerve pain, and physical therapy helps with strength, balance, and staying safe on your feet.

Neuromodulation

When nerve pain is chronic and hasn’t responded to other treatments, gentle electrical stimulation can help mask the pain signals. A spinal cord stimulator or a peripheral nerve stimulator can reduce pain for the right candidates — and both let you test the device first (our guide to the pros and cons of a spinal cord stimulator explains how). When a compressed nerve is the culprit, relieving that pressure can help directly.

Cleveland Clinic notes that while some neuropathy can be reversed if caught and treated early, “treatment can help relieve symptoms” even when the nerve damage is lasting (Cleveland Clinic). You can learn more on our peripheral nerve pain page.

When should you see a doctor?

See a doctor if you have ongoing numbness, tingling, burning, or weakness in your hands or feet — especially if you have diabetes. Early evaluation matters because some causes are reversible when caught early, and treating the underlying condition can stop the damage from spreading. Reduced feeling in the feet also raises the risk of unnoticed injuries, so it’s worth getting checked.

Seek prompt care if you have:
  • Sudden numbness, weakness, or paralysis
  • Rapidly spreading symptoms or trouble walking
  • A foot sore or wound that isn’t healing (especially with diabetes)
These need prompt evaluation rather than waiting.
Numbness, tingling, or burning in your hands or feet?

Empire Minimally Invasive Spine and Pain can help find the cause of your neuropathy and build a plan to calm the nerve pain. Serving Long Island and New Jersey.

Request a consultation Or call our New York office at 516-229-1443.

Frequently asked questions

What is the most common cause of peripheral neuropathy?

Diabetes is the single most common cause. Persistently high blood sugar damages the small nerves over time, which is why good blood-sugar control is central to preventing and slowing diabetic neuropathy.

Can peripheral neuropathy be reversed?

Sometimes. Cleveland Clinic notes some neuropathies can be reversed if the cause is found and treated early, while others are lasting. Even when the damage is permanent, treatment can still relieve the symptoms.

Why are my hands and feet numb and tingling?

Numbness and tingling in the hands and feet is a classic sign of peripheral neuropathy, often from diabetes, a pinched nerve, a vitamin deficiency, or another cause. Because the reasons differ, it’s worth having it evaluated to find yours.

What helps nerve pain from neuropathy?

Treating the underlying cause comes first, along with specific nerve-pain medications and physical therapy. For chronic pain that doesn’t respond, nerve stimulation (a spinal cord or peripheral nerve stimulator) can help reduce it.

Is neuropathy the same as a pinched nerve?

Not exactly. A pinched nerve is one specific nerve compressed at one spot (like sciatica), while peripheral neuropathy usually affects many small nerves, often symmetrically in both feet or hands. A specialist can tell which you have.

About the author

Dr. John Akhnoukh, M.D. is the founder of Empire Minimally Invasive Spine and Pain and is board-certified in Anesthesiology and Pain Medicine by the American Board of Anesthesiology. He completed his interventional pain fellowship through the Weill Cornell tri-institutional program (NewYork-Presbyterian, Memorial Sloan Kettering, and Hospital for Special Surgery) and focuses on image-guided, minimally invasive treatments for spine and nerve pain, including neuromodulation for chronic nerve pain.

This article is for general education and is not a substitute for medical advice. Talk with a qualified clinician about your specific symptoms.

Dr. John Akhnoukh
Dr. John Akhnoukh

Dr. John Akhnoukh is a board-certified anesthesiologist and board-certified interventional pain management physician. He completed a pain medicine fellowship across New York-Presbyterian Hospital, Memorial Sloan Kettering, and the Hospital for Special Surgery, and his anesthesiology residency at Mount Sinai St. Luke's West. He earned his M.D. at SUNY Downstate Medical Center. Dr. Akhnoukh invented the Akhnoukh Cervical Ultrasound Technique (A.C.U.T.), which uses ultrasonography to map cervical anatomy and reduce the risk of cervical spine procedures. He is a member of the World Academy of Pain Medicine Ultrasonography and the North American Neuromodulation Society, and has performed thousands of pain management procedures.

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