Brain, Nerve & Chronic
Neuropathy & Nerve Pain
From diabetic neuropathy to nerve compression — modern treatment.
Peripheral neuropathy is damage to the nerves outside the brain and spinal cord, causing pain, numbness, tingling, or weakness — most often in the hands and feet. Causes range from diabetes (most common) to nerve compression to chemotherapy side effects. Treatment depends on the underlying cause and the predominant symptom (pain vs. numbness vs. weakness). Our pain management and neurosurgical teams collaborate to address neuropathy at the right level.
Understanding the Condition
What is Neuropathy & Nerve Pain?
Peripheral neuropathy can affect sensory nerves (numbness, tingling, burning), motor nerves (weakness, atrophy), or autonomic nerves (sweating changes, blood pressure regulation, GI issues). Most cases are length-dependent — the longest nerves are affected first, which is why symptoms usually start in the toes and feet and gradually move up the legs.
Diabetic neuropathy is by far the most common cause in the US. Other major causes include chemotherapy, B12 deficiency, alcohol, autoimmune conditions, and idiopathic small-fiber neuropathy. Compression neuropathies (carpal tunnel, ulnar nerve at the elbow) are a separate category that may be surgically correctable.
Common Causes
- Diabetes (most common — affects ~50% of diabetics over time)
- Chemotherapy
- B12 deficiency
- Alcohol use
- Autoimmune conditions (Guillain-Barré, CIDP, vasculitis)
- Toxin exposure
- Compression neuropathy (carpal tunnel, ulnar nerve at elbow)
- Idiopathic (cause unknown after workup)
Common Symptoms
- Numbness, tingling, or 'pins and needles' (most common — usually starts in toes/feet)
- Burning or shooting pain
- Increased sensitivity to touch (allodynia)
- Weakness, especially in the feet (foot drop)
- Balance problems and falls
- Compression neuropathies: localized to one nerve distribution
When to Seek Care
When Should You See a Specialist?
See a specialist for persistent numbness or burning, weakness affecting walking or grip, neuropathic pain unresponsive to over-the-counter measures, or any sudden-onset neuropathic symptoms (which can indicate a more serious cause). Ascending weakness — calls for urgent evaluation (could be Guillain-Barré).
Treatment Options
How We Treat Neuropathy & Nerve Pain
We always begin with the least invasive treatment that's likely to work for you. Surgery is reserved for cases where conservative care has been given a fair trial — or when the situation truly requires it.
Conservative (Non-Surgical) Care
- Underlying cause treatment (diabetes control, B12 replacement, alcohol cessation)
- Neuropathic pain medications (gabapentin, pregabalin, duloxetine, amitriptyline)
- Topical agents (capsaicin, lidocaine patches)
- Physical therapy with balance training
- Image-guided peripheral nerve blocks
- Spinal cord stimulation (for refractory neuropathic pain)
Surgical Options
- Nerve decompression for compression neuropathies (carpal tunnel, cubital tunnel)
- Spinal cord stimulator implantation for refractory diffuse neuropathic pain
- Peripheral nerve stimulator implantation for focal neuropathic pain
Recovery & Outlook
What to Expect After Treatment
Highly variable by cause. Diabetic neuropathy: stabilizes or improves with tight glucose control but rarely fully reverses. B12-deficiency neuropathy: often partially reversible with replacement. Compression neuropathies: usually improve significantly with surgical decompression. Idiopathic neuropathy: focus on symptom management and slowing progression.
Meet Your Team
Specialists Who Treat Neuropathy & Nerve Pain
Related Treatments
Services That Address Neuropathy & Nerve Pain
Neuropathy & Nerve Pain — Frequently Asked Questions
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Sciatica
Pain radiating along the sciatic nerve from the lower back through the hips and down each leg.
Carpal Tunnel Syndrome
Compression of the median nerve in the wrist causing numbness, tingling, and weakness.
Chronic Pain
Persistent pain lasting more than 3 months that requires specialized management approaches.
Get Expert Help for Neuropathy & Nerve Pain
Our specialists can diagnose your condition and design a personalized treatment plan that gets you back to the life you love.