Peripheral Neuropathy

Peripheral neuropathy results from damage to the peripheral nerves — the vast communication network that sends signals between your brain, spinal cord, and the rest of your body. Symptoms usually begin in the feet and hands (a "stocking-glove" pattern) and can include tingling, numbness, burning pain, sensitivity to touch, and muscle weakness. Over 100 types of peripheral neuropathy exist, with diabetes being the most common cause. Other causes include vitamin deficiencies (especially B12), autoimmune diseases, infections, kidney disease, alcoholism, toxin exposure, and certain medications. Some cases are idiopathic, meaning no clear cause is found.

Accurate diagnosis of peripheral neuropathy requires identifying both the type and the underlying cause. Dr. Zhou performs a detailed neurological exam testing sensation (light touch, pinprick, vibration, temperature), reflexes, and muscle strength. EMG and nerve conduction studies are central to the workup — they determine whether the neuropathy affects sensory nerves, motor nerves, or both, and whether it involves the nerve fiber (axonal) or the insulation around the nerve (demyelinating). This distinction is clinically important because it narrows down the possible causes. Blood work is typically ordered to check for diabetes, vitamin deficiencies, thyroid disorders, and other systemic causes.

Treatment of peripheral neuropathy focuses on addressing the underlying cause and managing symptoms. If diabetes is the cause, optimizing blood sugar control can slow or halt progression. Vitamin supplementation corrects deficiency-related neuropathies. Dr. Zhou creates comprehensive pain management plans that may include medications specifically effective for nerve pain, topical treatments, and physical therapy to maintain strength and balance. Regenerative medicine therapies may help promote nerve healing in certain cases. For patients with neuropathy affecting balance and coordination, Dr. Zhou designs rehabilitation programs focused on fall prevention and functional improvement.