Peripheral neuropathy often presents as burning, tingling, stabbing, or a “pins and needles” sensation in the hands or feet. Typically, this sensation will begin in the fingers or toes, but it may spread to affect the hands, wrists, arms, feet, ankles and even lower parts of the legs. The pain usually presents in a symmetrical pattern, meaning both hands or both feet are affected equally. Use of the hands for activities such as gripping or lifting objects may worsen the pain. Standing or walking may worsen the pain in the lower limbs. As the condition progresses, loss of touch, pain, and temperature sensations may occur.
Peripheral neuropathy may occur due to a variety of underlying medical conditions, such as uncontrolled diabetes, HIV, peripheral vascular disease, Sjogren’s syndrome, Guillain-Barré syndrome or Lyme disease. But it can also be caused by chemotherapy, vitamin deficiencies, alcohol abuse, contact with toxic substances or other traumas. It is important to remember that an underlying cause cannot always be found.
Affected areas must be monitored since cuts, bruises, ulcers and other injuries to the hands and feet may not present as pain. Nerve conduction tests may be helpful in confirming a diagnosis.
If the underlying cause of peripheral neuralgia is identified, treatment should focus on that condition. Better diabetic control or correction of vitamin deficiencies may result in improvement. Conditions may also be treated with oral medications and topical ointments.