Early warning signs of neuropathy you should not ignore

Short answer: the most common early signs of neuropathy are burning feet at night, tingling or pins and needles, numbness, a feeling like your socks are bunched up or you are walking on pebbles, balance problems, and sometimes sharp shooting pain. Pain is not always part of it. Dr. Mohamed Karim, D.C., says many people have no pain at all at first, and many assume the rest is just aging.

What neuropathy actually is

Neuropathy means damage to, or dysfunction of, the nerves. Most people think of it as foot pain, but it reaches further: circulation, balance, sleep, energy and the simple confidence to walk across a parking lot. It is often why people move from a cane to a walker to a wheelchair.

Early signs to watch for

• Burning feet, especially at night or by the end of the day
• Tingling or pins and needles
• Numbness
• The feeling of socks bunched under your feet, or of walking on rocks or something in your shoe
• Balance problems or new stumbles
• Sharp, shooting pain, for some people

Why symptoms get worse at night

During the day you are moving and distracted. At night the body quiets down, there is less movement and fewer distractions, and the discomfort becomes more noticeable. That is when people report feet that feel on fire, pain that keeps them awake, or legs that twitch restlessly for no clear reason.

What causes it

Dr. Karim uses a rough three-way split:

• About a third is linked to type 2 diabetes, and he counts prediabetes here too.
• About a third is idiopathic, meaning no cause is found.
• About a third comes from other known conditions: autoimmune disease, chemotherapy, Lyme disease, poor circulation, long-standing lower back problems or sciatica, B vitamin deficiencies and chronic inflammation.

A frustrating number of people are told their tests look normal while their symptoms keep getting worse.

Can neuropathy improve?

In many cases, yes, especially when it is caught early, according to Dr. Karim. The work is finding the root cause and improving nerve health along with circulation and inflammation. The two biggest mistakes he sees are waiting two or three years after the numbness starts, and relying only on medication to mask symptoms while the damage continues.

Wanda: a severe case

Wanda, who lets the clinic share her story, is the example he returns to. When she first came in she used a walker and had to rest between the parking lot and the door. Testing showed about 98% nerve loss on the soles of her feet and 91% on the tops. She could not tell carpet from tile. She had symptoms in her hands too.

Dr. Karim told her honestly that her hands would likely respond but her feet might be too far gone. She wanted to try anyway. Her reasons were concrete: her grandkids’ events, staying out of a nursing home, avoiding a wheelchair, and traveling with her family again after years of feeling like a burden on vacation.

She had already seen neurosurgeons, neuropathy specialists and general doctors, and had been on a high dose of gabapentin for years among more than 20 medications. By the clinic’s measurements she improved about 32% in three months and about 72% by nine months. She moved from walker to cane to no aid, went back to family events and took a couple of vacations with them, and by nine months was down to three medications.

Not every case goes that way, and he says so. But it is why he tests before he promises anything.

Watch the episode

Noticing a few of these? Book a free consultation for a nerve test, or read how neuropathy treatment in North Liberty works. Related: is it neuropathy or just aging? and three neuropathy myths.

This article summarizes a podcast episode and is general information, not medical advice. Individual results vary. Any medication changes should be made with your prescribing doctor. See our medical disclaimer.