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What Are the Causes of Neuropathy in the Feet?

By M. DePietro
Updated Mar 03, 2024
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When there is damage to the nerves in the feet, neuropathy can develop. There are several causes of neuropathy in the feet, including metabolic disorders, hormonal problems, vitamin deficiencies, trauma, and alcoholism. Various types of blood disorders may also lead to neuropathy. Some people may also have hereditary neuropathy in the feet.

Symptoms of neuropathy in the feet include pain, tingling, burning, difficulty walking, and a loss of balance. Since sensation may decrease, people with foot neuropathy may not realize when they develop sores or blisters. Infections can develop and go unnoticed, which can prevent needed treatment.

One of the most common causes of neuropathy in the feet is diabetes. Over time, the nerves in the feet become damaged from the blood sugar in the body becoming too high. Blood vessels may also constrict easier in people with diabetes, leading to diabetic neuropathy.

Additional causes of neuropathy in the feet include a lack of certain vitamins. Vitamin B6, B12, and E are needed for proper nerve function in the body. When there is a deficiency in these vitamins, the nerves in the feet can be affected and symptoms of neuropathy in the feet can develop.

Alcoholism can also lead to foot neuropathy. People who have alcoholism may have poor nutrition, which leads to vitamin deficiencies. In addition, drinking excess alcohol in itself may cause damage to the nerves and subsequently neuropathy develops.

Entrapment neuropathy is neuropathy in the feet caused by compression of the nerves leading to the feet, such as the posterior tibial nerve. The nerves may become compressed due to trauma to the feet or conditions such as flat feet or arthritis. Both cancerous and benign tumors that press on the nerves to the feet can also lead to compression neuropathy. The damage to the nerve may also be caused by inflammation surrounding the nerve. This may occur with medical conditions that cause inflammation in the joints, such as arthritis.

Depending on the cause, once damage to the nerves in the feet has occurred, it may not be reversible. The goal may be treating the underlying cause and preventing the condition from becoming worse. In diabetics, blood sugar levels should be kept in control through diet, exercise, and insulin. Vitamins may be recommended for people with nutritional deficiencies.

Additional treatments may include surgery. In these procedures, constricted nerves are located and decompressed to improve blood flow. Surgery will not be an option in all cases of neuropathy.

What Can Be Done for Neuropathy in the Feet?

Foot or peripheral neuropathy has no cure. Therefore, the primary focus of treatments and therapies is to help patients manage the condition. The goal of these activities is to relieve symptoms and improve quality of life. The standard treatment for neuropathy is medication and possible therapy.

Medications 

Several potential medications can treat neuropathy symptoms, including over-the-counter pain medications and antidepressants. Pain relievers are common treatments for the condition because they can offer the quickest relief.

While OTC and nonsteroidal anti-inflammatory drugs are often used for mild instances of the condition, a doctor might prescribe opioids for more severe cases. However, the use of opioids is usually the last resort because of the addictive nature of the medication.

Anti-seizure meds have also shown promise in treating the symptoms of neuropathy because they can relieve nerve pain. Still, many patients do not like how the drugs make them feel. Common side effects include dizziness and drowsiness.

Antidepressants and topical treatments also show promise for relieving neuropathic pain. Antidepressants can interfere with the chemical processes that correspond to the feeling of pain. Unfortunately, there are also side effects, such as dizziness, drowsiness, dry mouth, nausea, weight gain, constipation, and changes in appetite.

Topical treatments like capsaicin cream or lidocaine patches might also reduce pain, but the side effects of the treatment can create discomfort. Capsaicin cream can cause irritation or minor burns to the skin, and lidocaine patches can result in numbness, drowsiness, and dizziness, like many other options.

Therapies 

As with medications, many therapies can ease the symptoms of neuropathy. From physical therapy to surgery, patients are not without options.

There has been some success with transcutaneous electrical nerve stimulation. TENS involves the placement of electrodes on specific areas of the skin. For 30 minutes daily over a month, a patient receives gentle currents at various electrical frequencies.

In some cases, a doctor might recommend plasma exchange and intravenous immune globulin. During the procedures, a patient’s blood is removed along with antibodies and other proteins before being cycled back into the body. Additionally, during immune globulin therapy, a patient receives proteins to work in place of antibodies. Each process can offer relief to certain inflammatory conditions.

Physical therapy is typically only necessary if your neuropathy is causing muscle weakness or stiffness. Additionally, surgery is often only necessary when neuropathy is a result of pressure from other bodies, like tumors.

What Are Home Remedies for Neuropathy in the Feet?

While some people might not believe it, there are many recommended home remedies for neuropathy. For example, eating a healthy and balanced diet is crucial to managing the condition because healthy eating ensures good nutrition. When you consume a balanced diet, you give yourself the best chance of obtaining all the essential nutrients, vitamins, and minerals. Therefore, ensure your diet is full of vegetables, fruits, lean proteins, and whole grains.

Exercise is another essential for managing neuropathy and related pain. Frequent exercise contributes to muscle strength and balance and helps control blood sugar levels. Your exercise routine does not even need to be anything particularly strenuous. For example, you can choose to walk three times per week or develop a yoga or tai chi habit. These gentle routines can benefit those with neuropathy.

Aside from healthy eating and exercise, you will want to avoid unhealthy lifestyle choices, such as smoking or excessive alcohol consumption. Smoking affects circulation, which increases the risks of foot problems and other neuropathy complications. Alcohol can also worsen peripheral neuropathy.

Additionally, if you have diabetes, you should focus on blood glucose levels and foot care. Maintaining appropriate glucose levels can help relieve neuropathy symptoms. You want to ensure you check your feet for blisters, calluses, and cuts regularly. Wearing loose, soft cotton socks and padded shoes can help.

How To Diagnose Neuropathy in the Feet

When diagnosing neuropathy in the foot, a doctor will need to perform several exams and tests. The primary examination is the neurological physical examination. During the exam, the doctor will perform a deep tendon reflex, sharp and dull touch, vibratory sensation, cold temperature testing, and proprioceptive exams.

A doctor will likely also want to perform several tests. These tests can include:

  • Imaging tests
  • Blood tests
  • Nerve biopsy
  • Nerve function tests
  • Skin biopsy 

The nerve function tests typically include MRI and CT scans. However, they can also include electromyography or EMG.

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Discussion Comments

By anon1006803 — On May 23, 2022

For those with neuropathy, quit sugar; eat healthy; make sure your organs (like your liver) are healthy; try taking Alpha Lipoic Acid supplements. The ALA works for me, reducing the burning and tingling in my feet. Keep it up. Also, there's good supplements for the liver: Curcumin, Choline, and Milk Thistle all are known to improve liver function. Do your own research. My neuropathy hasn't gone away, but it's really improved, where I can take these supplements intermittently.

By anon1002642 — On Jan 14, 2020

My left foot stays swollen all the time. It burns and I have tingling in my foot. What's the cause?

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