Conditions / Systemic & Complex
Peripheral Neuropathy
Numbness, tingling or burning in the feet can have many causes — diabetes being the most common, but far from the only one. We assess sensation, identify your risk level, and help protect your feet from unnoticed injury.
Peripheral neuropathy refers to damage or dysfunction of the peripheral nerves — the nerves that carry signals between the brain, spinal cord and the rest of the body. It commonly affects the feet first, since peripheral nerves are longest here and particularly vulnerable to damage.
Symptoms typically begin in the toes and feet and can gradually progress up the legs in a "stocking" distribution. Because reduced sensation means injuries can go unnoticed, peripheral neuropathy in the feet carries a real risk of unrecognised wounds, infection and, in severe or poorly managed cases, more serious complications — making regular podiatric foot checks an important part of management.
Diabetes is the most common cause seen in podiatry, but peripheral neuropathy has many possible underlying causes — identifying the specific cause matters for treatment and prognosis.
Diabetes
The most common cause of peripheral neuropathy. Prolonged high blood glucose damages small nerve fibres, typically starting in the feet.
Vitamin Deficiency
Particularly B12 deficiency — can cause nerve damage that is potentially reversible if identified and treated early.
Alcohol-Related
Chronic excessive alcohol use is directly toxic to peripheral nerves and a recognised cause of neuropathy.
Medication Side Effects
Certain chemotherapy drugs and other medications can cause peripheral nerve damage as a side effect.
Autoimmune & Inflammatory
Conditions such as rheumatoid arthritis and certain autoimmune disorders can involve peripheral nerve inflammation.
Idiopathic
In some cases no clear cause is identified despite thorough investigation — still requires the same protective foot care approach.
Numbness or reduced sensation in the toes and feet
Tingling or "pins and needles" sensation
Burning pain, often worse at night
Sensitivity to touch that wasn't previously painful
Balance difficulties or unsteadiness on uneven ground
Not noticing cuts, blisters or injuries to the feet
We carry out a thorough neurological foot assessment including monofilament testing (a standardised test for protective sensation), vibration perception testing, and reflex assessment. This allows us to quantify your level of sensory loss and classify your foot risk level.
Where the cause of neuropathy is not already established, we will refer you to your GP for investigation of underlying causes — including blood tests for diabetes, vitamin B12 and other relevant markers.
Treating the underlying cause is the priority and is managed medically. Our role in podiatry is focused on protecting the foot from the consequences of reduced sensation and helping manage symptoms.
01
Check your feet every day — use a mirror for the soles if needed, or ask someone to help
02
Never walk barefoot — even indoors — as you may not feel an injury
03
Check bath and shower water temperature with your elbow or a thermometer, not your feet
04
Wear well-fitted, protective footwear and check inside shoes before putting them on
If you have new numbness, tingling or burning in your feet, it's worth having this properly assessed and the underlying cause investigated — some causes, like vitamin B12 deficiency, are treatable and potentially reversible if caught early.
If you have known peripheral neuropathy and notice a wound, cut or area of redness on your foot, don't wait for a routine appointment — reduced sensation means these can progress without pain to warn you. Contact us promptly.
Is peripheral neuropathy always caused by diabetes?
No — diabetes is the most common cause but far from the only one. Vitamin deficiencies, alcohol use, certain medications, autoimmune conditions and other factors can all cause peripheral neuropathy. Identifying the cause matters, as some are treatable.
Can peripheral neuropathy be reversed?
This depends on the cause. Neuropathy from vitamin B12 deficiency can improve significantly with supplementation if caught early. Diabetic neuropathy is generally managed rather than reversed, with good blood glucose control slowing progression. We can help identify whether investigation of the underlying cause would be worthwhile.
Why do I need regular foot checks if my feet don't hurt?
This is the key risk with neuropathy — reduced sensation means you may not feel an injury developing. Regular professional screening catches problems before they become serious, even when your feet feel fine.
Is this covered by health insurance?
Podiatry consultations and foot screenings are typically covered by most major insurers. We work with Bupa, Aviva, WPA and others. See our
Insurance page for full details.
Ready to book your assessment?
We'll assess your sensation, identify your risk level, and help protect your feet going forward.
