Diabetic Neuropathy

Know Everything From Causes, Symptoms, To Treatment

Jump to

Symptoms
Causes
Treatment
Our Providers

Diabetes is a common chronic condition affecting over 8 million people in the U.S^[1]. If you’re living with diabetes, you know how much it can impact daily life, from monitoring blood sugar levels to managing diet and medications. Over time, high blood sugar can affect more than just energy levels—it can lead to a condition called diabetic neuropathy.

Nearly 50% of people with diabetes^[2] develop some form of neuropathy. It causes more than just discomfort; it can make walking difficult, increase the risk of injuries, and affect digestion and circulation. Understanding how it develops and learning about treatment options can help you manage symptoms and maintain your quality of life.

What You Need To Know About Diabetic Neuropathy

Diabetic neuropathy is a condition in which prolonged high blood sugar levels cause nerve damage. When blood sugar stays too high for too long, it affects the way nerves function, leading to pain, tingling, numbness, and weakness—most often in the feet, legs, and hands.

To understand why this happens, it helps to know how glucose affects the body. Glucose is the main source of energy for your body’s cells, but when levels remain too high, it can become harmful. Excess glucose interferes with nerve function in several ways:

Inflammation and oxidative stress: High blood sugar triggers inflammation and produces harmful molecules called free radicals, which damage nerve cells over time.
Reduced blood flow: Excess glucose can damage the blood vessels that supply oxygen and nutrients to your nerves, leading to poor circulation and nerve deterioration.
Disrupted nerve signals: High glucose levels can interfere with how nerves communicate, causing them to send faulty signals (leading to pain) or stop working altogether (causing numbness).

How Nerve Damage Influences Overall Well-Being

The nervous system controls everything from movement to digestion, and when nerve damage occurs, it can disrupt essential functions. Nerves act like electrical wires, sending signals between the brain and the rest of the body. When high blood sugar damages these nerves, the signals become weak, delayed, or even completely blocked. This can lead to:

Loss of sensation: Damaged nerves may stop sending pain or temperature signals, making it harder to notice injuries, burns, or pressure sores.

Chronic pain: Some nerves misfire, sending pain signals even when there’s no injury, causing burning, tingling, or sharp, stabbing sensations.

Muscle weakness: Weakened nerve signals to muscles can make it harder to walk, grip objects, or maintain balance.

Autonomic nervous system issues: If nerve damage affects automatic body functions, it can lead to dizziness, digestive problems, bladder issues, or irregular heart rate.

Diabetic neuropathy usually starts in the feet and legs, then progresses to the hands and arms. This pattern, called glove and stocking neuropathy, is due to the way nerves extend from the spine. Over time, symptoms can worsen, leading to difficulty walking, reduced reflexes, and increased risk of injuries.

Symptoms That Point To Nerve-Related Problems

Diabetic neuropathy symptoms vary depending on which nerves are affected. Some people experience tingling and numbness, while others struggle with muscle weakness or problems with automatic body functions like digestion or bladder control. Identifying these symptoms early can help prevent complications and improve symptom management.

Joint Discomfort

Joint discomfort may stem from inflammation, wear, or injury, causing stiffness and limited mobility.

Radiating Nerve Pain

Radiating nerve pain from compression or damage may cause tingling, weakness, or numbness in the limbs.

Pain With Movement

Pain with movement may stem from joint, nerve, or muscle issues, making activity more difficult.

Localized Pain

Localized pain in one area may result from injury, inflammation, or nerve issues, impacting movement.

Chronic Leg Pain

Chronic leg pain may result from nerve, circulation, or joint issues, often affecting comfort and mobility.

Swelling

Swelling may result from inflammation or joint issues, often leading to stiffness and limited movement.

Tingling And Numbness

Restricted range of motion may result from stiffness, inflammation, or damage, making movement difficult.

Muscle Weakness

Muscle weakness may stem from nerve, muscle, or joint issues, making movement and activity more difficult.

Muscle Spasms

Muscle spasms are sudden contractions from nerve issues, dehydration, or fatigue, causing pain and stiffness.

Joint Stiffness

Reduced flexibility in joints due to nerve irritation or inflammation.

Warmth And Hyperpigmentation

Warmth and skin hyperpigmentation may signal inflammation, poor circulation or underlying joint conditions and is often seen with swelling or pain.

Changes in Color

Changes in skin color may indicate circulation, inflammation, or nerve issues often seen as redness or discoloration.

Difficulty Standing Or Walking

Difficulty standing or walking may result from muscle, joint, or nerve issues, affecting daily mobility.

Foot Drop

Foot drop is a symptom where lifting the front of the foot becomes difficult due to nerve or muscle dysfunction, leading to an altered gait.

Restricted Range Of Motion

Difficulty moving the neck, back, or affected limbs due to pain or stiffness.

Difficulty With Fine Motor Skills

Difficulty with fine motor skills may result from nerve, muscle, or joint issues, affecting daily tasks.

Loss Of Balance

Loss of balance may stem from nerve, muscle, or vestibular issues, raising fall risk and affecting mobility.

Common Causes Of Diabetic Neuropathy

Diabetic neuropathy develops when prolonged high blood sugar damages nerves, leading to pain, numbness, and weakness. While glucose-related nerve damage is the primary cause, other factors can increase the risk or worsen symptoms.

Blood Sugar Imbalance

When glucose levels remain elevated for long periods, it damages nerves by triggering inflammation, oxidative stress, and poor circulation. This leads to weakened nerve signals, reduced sensation, and chronic pain.

Frequent blood sugar spikes can also worsen symptoms, as nerves struggle to function correctly without consistent glucose regulation. Over time, nerve fibers deteriorate, making it harder for your body to detect injuries, control muscle movement, or regulate automatic functions like digestion.

Smoking

Smoking can lead to diabetic neuropathy because it restricts blood flow to the nerves. Tobacco use damages blood vessels, reducing oxygen and nutrient delivery to nerve cells. This can result in faster nerve degeneration, increased pain, and slower healing from injuries.

Smoking also worsens inflammation and oxidative stress, both of which contribute to nerve damage. For people with diabetes, this can accelerate the progression of neuropathy and increase the risk of serious complications like foot ulcers and infections.

Kidney Disease

When the kidneys don’t function properly, toxins and waste build up in the blood, causing nerve inflammation and increased oxidative stress. This can make diabetic neuropathy symptoms more severe.

Additionally, kidney disease often causes electrolyte imbalances, which are essential for proper nerve function. Low levels of key minerals like potassium and magnesium can lead to muscle weakness, cramps, and worsening nerve pain.

The Influence Of Genetics

While high blood sugar is the primary cause of diabetic neuropathy, genetics can also play a role in how nerves respond to damage. Some people may be more genetically predisposed to nerve dysfunction, making them more vulnerable to developing neuropathy even with controlled blood sugar levels.

Genetic factors can affect the way your body processes glucose, manages inflammation, and repairs nerve damage. If neuropathy runs in your family, you may be at a higher risk of developing symptoms earlier or experiencing more severe nerve-related complications.

Long-Term Diabetes And Nerve Health

The longer diabetes is present, the higher the risk of developing diabetic neuropathy. Over time, prolonged high blood sugar damages nerves and weakens their ability to send signals, leading to numbness, pain, and muscle weakness.

Long-term diabetes also affects blood circulation, reducing oxygen and nutrient supply to nerves. This makes it harder for the body to repair damaged nerve fibers, allowing neuropathy to progress.

Blood Flow Issues And Nerve Damage

Healthy nerves rely on steady blood flow to receive oxygen and nutrients. When diabetes affects circulation, nerves become deprived of essential support, leading to weakness, numbness, and pain.

High blood sugar can cause your blood vessels to narrow, reducing circulation and making it harder for nerves to function properly. Poor blood flow also slows healing, increasing the risk of infections, ulcers, and further nerve damage—especially in the feet and legs.

How Physicians Diagnose This Condition

Diagnosing diabetic neuropathy^[3] involves evaluating symptoms, reviewing medical history, and performing tests to assess nerve function. Since nerve damage can progress gradually, early detection is key to preventing complications. Physicians typically use a combination of physical exams and diagnostic tests to confirm neuropathy and rule out other conditions.

Physical exam: A physician checks for changes in sensation, reflexes, muscle strength, and balance.
Nerve conduction studies: These tests measure how quickly electrical signals travel through nerves to detect damage. They include:
- Electromyography (EMG): Evaluates muscle response and identifies nerve dysfunction.
- Nerve conduction velocity (NCV): Measures the speed of nerve signals and detects slowed or blocked transmissions.
Blood tests: Blood tests help determine underlying causes of nerve damage and assess overall metabolic health. They can include:
- Blood sugar levels: Checks for prolonged high glucose levels, which contribute to nerve damage.
- A1C test: Measures average blood sugar over the past 2–3 months.
- Kidney and thyroid function tests: Evaluate conditions that may worsen neuropathy.

What Happens If Diabetic Neuropathy Is Left Untreated

Without proper management, diabetic neuropathy can worsen over time, leading to severe complications that impact mobility, organ function, and overall quality of life. Nerve damage doesn’t just cause discomfort—it can increase the risk of serious health issues.

However, timely treatment can slow progression, reduce symptoms, and prevent severe complications. Addressing diabetic neuropathy early can help maintain nerve function and overall well-being. If left untreated, potential complications include:

Increased risk of infections: Numbness in the feet and hands makes it harder to detect blisters, sores, or cuts, increasing the risk of infections and slow-healing wounds.
Muscle weakness: Damaged nerves can reduce muscle strength, making walking, gripping objects, and maintaining balance more difficult.
Digestive issues and malnutrition: Nerve damage in the digestive system can cause bloating, constipation, or nausea, leading to poor nutrient absorption and unintended weight loss.
Cardiovascular problems: Autonomic nerve damage can affect blood pressure and heart rate, leading to dizziness, fainting, or an increased risk of heart disease.
Sexual dysfunction: Nerve damage can impair blood flow and sensation, leading to erectile dysfunction in men and reduced arousal or discomfort in women.
Permanent nerve damage: If left untreated, nerve deterioration may become irreversible, leading to chronic pain, loss of sensation, and long-term mobility challenges.

We Provide Evidence-Based Treatments for Diabetic Neuropathy

Managing diabetic neuropathy requires more than just symptom relief—it calls for a personalized, comprehensive approach to protect nerve health and improve daily function. At Compass Pain and Wellness, we take a multidisciplinary approach to treating diabetic neuropathy and other chronic nerve conditions. Our team combines evidence-based conventional treatments with advanced therapies to help manage symptoms, restore function, and enhance quality of life.

By focusing on nerve protection, pain management, and functional recovery, we help you regain mobility, reduce discomfort, and improve your overall well-being. Early intervention and the right treatment strategy can slow nerve damage, prevent complications, and support long-term health.

If you’re experiencing nerve pain, numbness, or mobility issues, Compass Pain and Wellness is here to help. Schedule a consultation today to explore personalized options for managing diabetic neuropathy and taking control of your health.

Conventional treatments aim to reduce pain, improve mobility, and slow the progression of nerve damage. These are often used alongside Compass Pain and Wellness’s advanced therapies, which offer additional relief and long-term benefits. Some key conventional treatments include:

Mindfulness and Meditation

Mindfulness and meditation help manage chronic pain by reducing stress and promoting emotional resilience.

Acupuncture

Acupuncture stimulates targeted points on the body to reduce pain, support healing, and restore energy balance.

Physical Therapy

Physical therapy improves strength, flexibility, and mobility while addressing pain from injury or chronic conditions.

Medication Therapy

Medication therapy uses tailored prescriptions to reduce chronic pain and improve daily function and comfort.

Spinal Cord Stimulation

Spinal cord stimulation delivers electrical pulses to block nerve pain and reduce discomfort in the back or limbs.

Our Providers

Meet our experienced and compassionate team of doctors who specialize in helping you manage your condition. With a patient-centered approach, our doctors work to understand your unique needs and provide compassionate, personalized care. Trust our providers to guide you on your journey to better health and improved well-being.

Dr. Kristi Reed, MD

Dr. Randolph Cribbs, MD

Dr. Carl Balog, MD

References

Reach out to Compass Pain today and learn how we help you manage diabetic neuropathy and get your life back on track!

Get Started