Top 5 Causes of Peripheral Neuropathy & Warning Signs

That tingling, burning, or numbing sensation in your hands or feet? It’s not always just poor circulation or a pinched nerve.

For many, it’s a sign of something deeper: peripheral neuropathy, a condition where the nerves outside the brain and spinal cord (aka the “peripheral” nerves) start to misfire or break down.

And while the symptoms can vary from mild irritation to life-altering pain or weakness, knowing what are the causes of peripheral neuropathy can help you identify triggers early and take steps to protect your nerve health.

So let’s break down the five most common culprits, how they affect the nervous system, and what you can do to stay ahead of them.

1. Diabetes: The #1 Cause Worldwide

Let’s start with the elephant in the room.

Diabetes, specifically, long-term uncontrolled blood sugar, is the leading cause of peripheral neuropathy across the globe. It’s estimated that over half of people with diabetes will develop diabetic peripheral neuropathy.

Why? Because chronically high blood sugar damages small blood vessels that nourish your nerves. Without enough oxygen and nutrients, nerves can start to deteriorate, especially in your legs and feet.

If you’ve been diagnosed with type 1 or type 2 diabetes, you’ve probably already been warned to watch for signs like:

• Numbness or burning in the feet

• Loss of balance

• Sharp or shooting pain

The good news? Early control of blood sugar, combined with a solid care plan, can prevent or slow nerve damage from progressing.

2. Chemotherapy and Toxic Exposure

Life-saving treatments sometimes come with a steep price. Many chemotherapy drugs used to fight cancer can also harm healthy nerves in the process.

This is known as chemotherapy-induced peripheral neuropathy (CIPN), and for some, it can persist long after treatment ends.

Common signs include:

• Sensitivity to touch or temperature

• Weakness in the limbs

• Trouble with fine motor skills (like buttoning a shirt)

But it’s not just chemotherapy. Exposure to heavy metals (lead, mercury), industrial chemicals, or even excessive alcohol can have a similar effect. These toxins interfere with nerve signaling or kill nerve cells outright, especially with long-term exposure.

If you work in high-risk environments or have undergone chemo, it's worth talking to your doctor about routine nerve checks.

3. Physical Trauma or Repetitive Stress

Sometimes, the nerves don’t die off quietly; they get damaged from the outside in. Physical trauma from car accidents, falls, or sports injuries can crush or sever peripheral nerves directly.

But it doesn’t always have to be dramatic. Repetitive stress, like typing, using hand tools, or standing for long periods, can slowly damage nerves over time. Think carpal tunnel syndrome, sciatic nerve pain, or tarsal tunnel syndrome.

In these cases, early treatment (chiropractic care, bracing, physical therapy) can help restore function and reduce inflammation before permanent damage sets in.

4. Vitamin Deficiencies

Here’s something many people overlook: nutrition. Nerves need vitamins, especially B vitamins, to function properly. Without them, the protective coating around your nerves (called the myelin sheath) can start to break down.

The biggest troublemakers include:

• Vitamin B12 deficiency – Common in older adults, vegans, and people with digestive issues

• Vitamin B6 excess or deficiency – Too little or too much can be a problem

• Vitamin E and niacin deficiency – Rare, but possible with severe malnutrition or certain medical conditions

Symptoms tied to vitamin-related nerve damage often start subtly, tingling, balance issues, or brain fog, and get worse over time if left unchecked.

A simple blood test can help uncover any deficiencies, and in many cases, correcting the imbalance leads to improvement.

5. Autoimmune Disorders

When the immune system starts attacking the body’s own tissue, the nerves can get caught in the crossfire. Autoimmune conditions are a sneaky but serious trigger for peripheral neuropathy.

A few that are commonly associated include:

• Lupus

• Rheumatoid arthritis

• Guillain-Barré syndrome

• Sjogren’s syndrome

• Celiac disease

In these cases, nerve inflammation may come on gradually or hit hard and fast. Depending on the type of disorder, treatment usually involves calming the immune system through medications or other therapies.

The sooner these issues are identified, the better the chance of preserving nerve function and your quality of life.

Bonus: Other Potential Causes You Shouldn't Ignore

While these are the top five, the list doesn’t end there. Other notable causes of peripheral neuropathy include:

• Kidney or liver disease (which allows toxins to build up in the body)

• Thyroid dysfunction

• Infections like Lyme disease, shingles, or HIV

• Genetic disorders such as Charcot-Marie-Tooth disease

This is why an accurate diagnosis matters. Nerve symptoms can feel similar on the surface, but the underlying cause and the right treatment can vary widely.

Managing the Triggers: A Proactive Approach to Nerve Health

Knowing what are the causes of peripheral neuropathy gives you a powerful advantage: it allows you to make informed decisions and take steps to protect your nerve health.

Whether it’s managing blood sugar, correcting nutrient gaps, reducing toxic exposure, or working with a specialist on autoimmune care, every step you take can protect your nerve function moving forward.

And here’s something that often gets overlooked. Natural treatments and supportive care, such as chiropractic adjustments, massage therapy, and integrative rehabilitation, can go a long way toward improving circulation, reducing inflammation, and easing pain.

Sometimes, the best results come from combining traditional medicine with a holistic approach.

Your Nerve Health Matters, And So Does Your Support Team

Peripheral neuropathy doesn’t have to take over your life.

The key is getting ahead of it. Understanding the root causes, listening to your body, and getting the right care before small symptoms become big problems.

Oregon Medical Centers LLC is a medical clinic in Salem that specializes in personalized, non-invasive treatments for nerve-related pain and dysfunction.

With a focus on cutting-edge treatments, acoustic wave treatments, chiropractic care, rehabilitation therapy, and integrated medical therapy, we help patients manage their symptoms and restore their well-being from the ground up.

Chronic long-standing neuropathy can lead to amputations of a part of the lower limb. Don't ignore your symptoms; call us for a free consultation.

Unfortunately, every year in the United States, there are over 150,000 amputations due to peripheral neuropathy. Don't become a statistic. Give us a call for a no-charge consultation to see if you're a candidate for our cutting-edge treatment.

If you're ready to explore a proven, drug-free path to relief, contact Oregon Medical Centers today at 503-967-3708 or visit our neuropathy care page.