Neuropathy: Types, Symptoms, Causes, and Treatment

Neuropathy refers to damage or dysfunction of the nerves that transmit signals between the brain, spinal cord, and the rest of the body. These nerves control sensation, movement, and many automatic body functions, and common nerve damage symptoms may include numbness, tingling, burning pain, or muscle weakness. 

Because neuropathy can stem from many different causes—including diabetes, spine conditions, autoimmune diseases, chemotherapy, infections, kidney disease, thyroid disorders, or inherited conditions—evaluation may involve multiple medical specialties.

At CLS Health in Houston, physicians across several specialties collaborate to identify the underlying cause of neuropathy and guide patients toward the most appropriate treatment plan. Early evaluation may identify a treatable cause, help manage symptoms, and reduce the risk of further complications.

What Is Neuropathy? 

Neuropathy most commonly refers to peripheral neuropathy, a condition affecting nerves outside the brain and spinal cord. 

Peripheral nerves carry three main types of signals: 

1. Sensory nerves 
   Transmit sensations such as touch, temperature, and pain. 
2. Motor nerves 
   Control muscle movement and coordination. 
3. Autonomic nerves 
   Regulate involuntary functions like heart rate, blood pressure, digestion, and sweating. 

When these nerve pathways become damaged, communication between the nervous system and the body becomes disrupted. This can cause numbness, burning pain, weakness, or changes in automatic functions such as digestion, blood pressure, or sweating.

Is Neuropathy the Same as Nerve Pain? 

Not always. Neuropathy is when nerves are damaged or not working properly, while neuropathic pain is the pain that results from that damage. 

Some individuals experience: 

• Numbness without pain 
• Muscle weakness 
• Tingling sensations 

Others develop more intense nerve pain described as: 

• Burning 
• Electric shock sensations 
• Sharp or shooting pain 

In some cases, symptoms may resemble spine-related nerve compression, such as radiculopathy or sciatica. These conditions involve pressure on spinal nerves rather than widespread nerve dysfunction. 

Accurate diagnosis helps determine the most effective treatment approach. 

Common Symptoms of Neuropathy 

Symptoms vary depending on which nerves are affected. 

Sensory Symptoms 

• Burning sensations 
• Tingling (“pins and needles”) 
• Numbness 
• Electric shock–like pain 
• Increased sensitivity to touch 
• Reduced ability to feel temperature 

Motor Symptoms 

• Muscle weakness 
• Muscle cramps or twitching 
• Difficulty walking 
• Balance problems 
• Reduced coordination 

Autonomic Symptoms 

• Dizziness when standing 
• Digestive problems 
• Abnormal sweating 
• Blood pressure instability 
• Changes in heart rate 

Symptoms often begin gradually and may start in the feet or hands before spreading upward. Neuropathy can present in several forms depending on which nerves are affected. 

Types of Neuropathy 

Neuropathy is not a single disease. It describes many different nerve disorders with different causes. 

1. Peripheral Neuropathy 

The most common type. It often begins in the feet and toes, gradually progressing up the legs and sometimes affecting the hands. 

2. Diabetic Neuropathy 

A complication of long-term diabetes, caused by chronic high blood sugar damaging nerves. It most commonly affects the feet. 

3. Small Fiber Neuropathy 

This type primarily affects small sensory nerve fibers responsible for pain and temperature sensation. Symptoms often include intense burning pain or temperature sensitivity. 

4. Autonomic Neuropathy 

This form affects nerves that control automatic body functions, including heart rate, blood pressure, digestion, and bladder function. It is frequently associated with diabetes or autoimmune conditions. Symptoms may include dizziness when standing (orthostatic hypotension) 

6. Radiculopathy (Spine-Related Nerve Compression) 

Radiculopathy occurs when spinal nerves become compressed, often due to conditions such as herniated discs or spinal stenosis. Radiculopathy is technically a form of nerve root compression rather than peripheral neuropathy, but it can cause similar symptoms. Symptoms may include pain, numbness, or weakness along a nerve pathway. 

7. Chemotherapy-Induced Neuropathy 

Certain cancer treatments can damage nerves, leading to persistent tingling, numbness, or burning sensations in the hands and feet. 

8. Idiopathic Neuropathy 

In some cases, a clear cause cannot be identified even after a comprehensive evaluation. Published estimates vary, but approximately 25% to 46% of peripheral neuropathy cases may be classified as idiopathic.

Neuropathy includes several different conditions with distinct causes and treatment approaches. Understanding the specific type of neuropathy is an important step in choosing the right care plan. 

Central Neuropathic Pain After a Stroke

Central neuropathic pain is different from peripheral neuropathy. It results from damage to the brain or spinal cord rather than nerves outside the central nervous system.

Post-stroke central neuropathy can sometimes cause ongoing burning, tingling, numbness, or heightened sensitivity. Treatment may involve neurology, pain management, physical medicine and rehabilitation, and physical therapy.

What Causes Neuropathy? 

Many medical conditions, treatments, and exposures can damage peripheral nerves. Common causes include:

• Diabetes
• Vitamin deficiencies, particularly vitamin B12 deficiency
• Chronic kidney disease
• Hypothyroidism
• Autoimmune diseases
• Monoclonal gammopathies, which involve abnormal proteins in the blood
• Hereditary neuropathies, such as Charcot-Marie-Tooth disease
• Chemotherapy and certain other medications
• Alcohol misuse 
• Toxic exposures
• Infections
• Physical trauma

In some individuals, several factors may contribute to nerve damage at the same time.

Spine disorders such as herniated discs and spinal stenosis can compress spinal nerve roots and cause similar symptoms. This is called radiculopathy rather than peripheral neuropathy.

Acute vs Chronic Neuropathy 

Neuropathy may develop in different ways depending on its cause. 

• Acute neuropathy 
  Develops suddenly due to infection, injury, toxin exposure, or inflammatory disorders. 
• Chronic neuropathy 
  Develops gradually over months or years. This pattern is common with conditions such as diabetes, autoimmune disease, or metabolic disorders. 

Understanding how symptoms began helps physicians determine the most appropriate diagnostic tests and treatment strategy. 

Who Is at Higher Risk for Neuropathy? 

Certain factors increase the likelihood of developing neuropathy. 

Risk factors include: 

• Long-standing diabetes 
• Autoimmune diseases 
• Chemotherapy treatments 
• Alcohol use disorder 
• Family history of neuropathy 
• Vitamin deficiencies 
• Chronic kidney disease 

Patients with these risk factors should seek evaluation if they notice persistent numbness, tingling, or weakness. 

How Neuropathy Is Diagnosed 

Diagnosing neuropathy requires identifying both the nerve damage and its underlying cause. 

Evaluation may include: 

• Neurological examination 
  A physician evaluates reflexes, muscle strength, coordination, and sensation. 
• EMG and nerve conduction studies (EMG/NCS) 
  These tests measure electrical activity to evaluate how well the nerves and muscles are working together. 
• Blood tests 
  Used to detect diabetes, vitamin deficiencies, autoimmune disease, and other conditions. 
• Imaging tests 
  MRI scans may identify spinal nerve compression or structural problems. 
• Autonomic nervous system testing 
  In certain cases, testing evaluates how nerves control heart rate, blood pressure, and sweating. 

Because neuropathy has many potential causes, diagnosis often involves collaboration between multiple specialists. 

Which Specialist Treats Neuropathy? 

The right specialist depends on the cause of the nerve damage, the symptoms involved, and the testing or treatment needed. Care may focus on treating the underlying condition, managing nerve pain, and improving strength, balance, and daily function. Because these needs can overlap, some patients benefit from coordinated care involving more than one specialty.

Treating the Underlying Cause

• Blood sugar management for diabetic neuropathy
• Vitamin replacement for nutritional deficiencies
• Treatment of thyroid, kidney, autoimmune, or infectious conditions
• Medication review when a drug may be contributing

Managing Nerve Pain

• Medications specifically used for neuropathic pain
• Topical treatments
• Nerve blocks in selected cases
• Spinal cord or peripheral nerve stimulation for persistent symptoms

Opioids are generally not recommended as a first-line or long-term treatment for neuropathic pain because their potential risks often outweigh their limited benefit. Your provider can recommend treatment based on the cause, severity, and impact of your symptoms.

Improving Function and Safety

• Physical therapy
• Balance and gait training
• Assistive devices when needed
• Foot care for patients with reduced sensation

At CLS Health, physicians across multiple specialties collaborate to identify the cause of neuropathy and connect patients with the most appropriate treatment pathway.

When to Seek Medical Evaluation 

You should seek medical evaluation if you experience: 

• Progressive weakness 
• Difficulty walking 
• Frequent falls 
• Persistent numbness 
• Burning pain in the feet or hands 
• Open sores on the feet 
• Rapidly worsening symptoms 
• Dizziness or fainting related to blood pressure changes 

Early evaluation can help prevent complications and reduce the risk of permanent nerve damage. 

Call 911 for sudden one-sided numbness or weakness, facial drooping, difficulty speaking, severe dizziness, or other possible signs of a stroke. Seek urgent care for rapidly progressing weakness or new loss of bladder or bowel control.

Neuropathy Care Across Greater Houston 

CLS Health provides neuropathy-related evaluation and treatment across Greater Houston. Depending on the cause and effects of your symptoms, care may involve neurology, pain management, endocrinology, physical medicine and rehabilitation, or rheumatology.

Neurology

Neurologists diagnose nerve disorders and may use EMG and nerve conduction studies to determine which nerves are affected. Neurology care is available in Sugar Land, Webster–Clear Lake, and Cypress.

Pain Management

Pain management specialists treat persistent neuropathic pain using options such as medication management, nerve blocks, spinal cord stimulation, and peripheral nerve stimulation. Locations include Sugar Land, Webster–Clear Lake, Katy, Cinco Ranch, Pasadena, and the Pearland area.

Endocrinology

Endocrinologists help patients with diabetic neuropathy manage blood sugar and reduce the risk of additional nerve damage. Endocrinology care is available in Webster–Clear Lake, Memorial City, and the Houston Galleria area.

Physical Medicine and Rehabilitation

Physical medicine and rehabilitation specialists help address weakness, mobility limitations, balance problems, and changes in walking caused by nerve damage. PM&R care is available in Sugar Land.

Rheumatology

Rheumatologists evaluate and treat autoimmune conditions that may contribute to neuropathy, including lupus, Sjögren’s disease, and vasculitis. Rheumatology care is available in Webster–Clear Lake, the Houston Galleria area, Pasadena, and Conroe–The Woodlands.

Schedule a Neuropathy Evaluation in Houston 

If numbness, burning, tingling, or weakness persists or worsens, a comprehensive evaluation can help identify the cause and guide you to the appropriate specialist.

Schedule an appointment with CLS Health for coordinated neuropathy care across Greater Houston.