Diabetes is the most common cause of peripheral neuropathy in the UK.
Neuropathy can also be caused by other health conditions and certain medications. In some cases, no cause can be identified and this is termed idiopathic neuropathy.
Peripheral neuropathy caused by either type 1 diabetes or type 2 diabetes is called diabetic polyneuropathy. It's probably caused by high levels of glucose in your blood damaging the tiny blood vessels that supply your nerves.
Peripheral neuropathy becomes more likely the longer you've had diabetes. Up to one in every four people with the condition experience some pain caused by nerve damage.
If you have diabetes, your risk of polyneuropathy is higher if your blood sugar is poorly controlled or you:
- regularly consume large amounts of alcohol
- are over 40 years old
If you have diabetes, you should examine your own feet regularly to check for ulcers (open wounds or sores) or chilblains.
As well as diabetes, there are many other possible causes of peripheral neuropathy.
Some of the health conditions that can cause peripheral neuropathy include:
- excessive alcohol drinking for years
- low levels of vitamin B12 or other vitamins
- physical damage to the nerves – such as from an injury or during surgery
- an underactive thyroid gland (hypothyroidism)
- certain infections – such as shingles, Lyme disease, diphtheria, botulism and HIV
- inflammation of the blood vessels (vasculitis)
- chronic liver disease or chronic kidney disease
- monoclonal gammopathy of undetermined significance (MGUS) – the presence of an abnormal protein in the blood
- certain types of cancer, such as lymphoma (a cancer of the lymphatic system) and multiple myeloma (a type of bone marrow cancer)
- Charcot-Marie-Tooth (CMT) disease and other types of hereditary motor sensory neuropathy – genetic conditions that cause nerve damage, particularly in the feet
- having high levels of toxins in your body, such as arsenic, lead or mercury
- Guillain-Barré syndrome – a rare condition that causes rapid onset of paralysis within days
- amyloidosis – a group of rare but serious conditions caused by deposits of abnormal protein called amyloid in tissues and organs throughout the body
- conditions caused by overactivity of the immune system – such as rheumatoid arthritis, lupus or Sjogren's syndrome
A few medications may sometimes cause peripheral neuropathy as a side effect in some people. These include:
- some types of chemotherapy for cancer – especially for bowel cancer, lymphoma or myeloma
- some antibiotics, if taken for months – such as metronidazole or nitrofurantoin
- phenytoin – used to treat epilepsy – if taken for a long time
- amiodarone and thalidomide