Neuropathy: what it feels like and what you can do

Numbness, tingling, burning or stabbing pain in your hands or feet is not just an annoyance — it's often neuropathy, nerve damage that changes how you feel. Some people blame aging. Other times it's a medication, diabetes, or a vitamin gap. The good news: many causes are treatable, and small daily steps can slow damage and ease pain.

Common causes and quick clues

Neuropathy has many faces. Diabetes is the top cause for peripheral neuropathy — high blood sugar slowly injures small nerves in the feet. Other causes to watch for: certain medicines (some cholesterol drugs and chemotherapy agents), long-term alcohol use, low vitamin B12, autoimmune diseases, infections, and toxin exposure. If you recently started a new drug and your feet or hands change, mention it to your doctor.

Clues that point to neuropathy: symptoms start in the toes or fingertips and spread up, pain feels like pins-and-needles or burning, and you may lose balance or sense of temperature. Weakness or muscle wasting suggests larger nerve involvement and needs faster evaluation.

Practical treatments and day-to-day care

Treatment focuses on the cause plus symptom control. If blood sugar is high, improving glucose control is the single most effective step for diabetic neuropathy. If a medication is the culprit, your clinician may switch it. For autoimmune causes, short steroid courses (like prednisone) or immunosuppressants such as azathioprine are options — but those need close medical supervision.

For nerve pain itself, common choices include gabapentin or pregabalin, and the antidepressant duloxetine. Topical options like lidocaine patches or capsaicin cream help some people and have fewer side effects. If your doctor prescribes a statin or metformin, ask about B12 checks — low B12 can cause or worsen neuropathy, and replacing it often helps.

Non-drug steps matter a lot. Daily foot checks, proper shoes, and seeing a podiatrist cut the chance of ulcers and infections. Gentle strength and balance exercises reduce falls. Physical therapy can ease stiffness and improve gait.

Some supplements show promise for certain people: alpha-lipoic acid and B12 (if deficient) have trial support. Always tell your doctor what you take so supplements don’t clash with meds.

If pain is severe, progressive weakness appears, or you notice sudden loss of bowel or bladder control, seek urgent care. A neurologist can order tests like nerve conduction studies or blood work to pinpoint the cause and match the right treatment.

You don’t have to accept constant numbness or burning. Start with a clear checklist: check blood sugar and B12, review your medicines, protect your feet, and try simple pain-control options while working with a clinician to treat the root cause.