What Are the Four Stages of Peripheral Neuropathy?

Rina Caprarella

April 13, 2023

Rina Caprarella

Peripheral neuropathy is a disorder of the nerves that control sensation, movement, and muscle strength. It is caused by a number of factors, including diabetes, traumatic injuries, infections, metabolic disorders, and inherited causes.

Once diagnosed, a doctor will order tests to find out what’s causing the nerve damage. These may include blood tests to detect diabetes, liver or kidney problems, and other metabolic disorders, as well as body fluid tests to look for hidden infections or vitamin deficiencies.

Stage 1: Sporadic Pain and Numbness

There are many different symptoms of peripheral neuropathy, including numbness (also known as ‘pins and needles’) and pain in the hands and feet. These can be accompanied by weakness or paralysis in your muscles or other problems such as trouble walking and balancing.

Peripheral neuropathy can develop instantly or slowly over weeks, months, or even years. This is because it depends on how the nerves have been damaged as well as whether they are functioning normally and in the right places in your body.

Unlike other parts of your body, nerve cells are not easily repaired or replaced once they have been badly damaged. Damage to nerves can happen from a number of causes, including trauma or surgery or even circulation-related issues, such as a lack of blood flow.

If you’ve been living with numbness, tingling, or weakness in your hands or feet for longer than you like, it’s time to talk to a board-certified neurologist. Luay Shayya, MD, at Neurology Consultants of Arizona in Scottsdale, specializes in diagnosing all types of neuropathy and providing customized treatment solutions that help you manage the symptoms and get long-lasting relief.

Stage 2: Persistent pain and numbness

Damage to peripheral nerves can lead to a wide range of symptoms. They can affect a person’s ability to feel pain and temperature sensations, numbness in their hands and feet, weakness, and paralysis.

Some of the most common symptoms are pain and numbness, which may feel worse at night. It can be painful when a touch or pressure that generally isn’t painful triggers an extreme reaction (allodynia) or when it feels more intense than normal (hyperalgesia).

Weakness and paralysis are also possible because peripheral neuropathy weakens the nerves that carry motor signals to muscles. It can cause clumsiness and balance problems, especially in the dark, and even lead to falls.

Peripheral neuropathy can develop from traumatic injuries, infections, metabolic problems, exposure to toxins, and inherited causes. In addition, it can happen if you have unmanaged type 2 diabetes or an alcohol use disorder.

Stage 3: Difficulty Carrying Out Daily Tasks

People suffering from stage three often feel they can’t carry out specific tasks easily. This is usually the result of a combination of factors, including pain and numbness.

It can also be challenging to get motivated for tasks that were previously a pleasure, like doing the dishes or scrubbing the kitchen floor. Some people I work with find it helpful to break a big task into smaller, easier-to-manage steps.

The first step is getting medical advice to diagnose and treat any underlying causes of peripheral neuropathy. Your GP will ask questions about your symptoms and arrange tests to determine what’s causing your condition.

Treatments for peripheral neuropathy vary, depending on the cause. Some treatments can limit the effects of the condition, while others are designed to minimize its impact on your life.

Stage 4: Paralysis

Peripheral nerves send messages between your central nervous system (the brain and spinal cord) and the rest of your body. These signals carry information about pain, temperature, and other senses.

A nerve can be damaged by many different causes. Some of the most common causes are exposure to toxins and chemicals and infections such as HIV or Lyme disease.

Other causes include genetic conditions such as familial amyloidosis or Fabry disease. Some forms of neuropathy are idiopathic, meaning they have no known cause.

These types of neuropathies typically develop slowly over time. They usually start in your feet but may affect your hands and arms too.

In stage 4, the nerves are so damaged that they’re not able to send any more messages to your brain. This means you’ll have numbness all over your legs and feet, as well as problems walking, balancing, and coordinating.