Peripheral Neuropathy

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Peripheral neuropathy can involve changes in function, pain, and sensation due to nerve damage from previous surgeries, injuries, and, sometimes, systemic diseases.

UT Southwestern Medical Center surgeons are among a handful of specialists in the U.S. who are fellowship trained in evaluating and treating conditions that affect peripheral nerves.

What Is Peripheral Neuropathy?

This condition involves damage to the peripheral nerves, which span from head to toe, connecting the brain and spinal cord with the rest of the body. These nerves are critical for transmitting signals related to sensation, movement, and involuntary functions throughout the body.

Hundreds of disorders and injuries can affect the peripheral nervous system. Peripheral neuropathy can result from systemic diseases, previous surgeries, injuries, or exposure to toxins, leading to a wide range of symptoms.

Peripheral Neuropathy pain in elderly on hand, fingers, sensory nerves with numb, muscle weakness

What Are the Types of Peripheral Neuropathy?

Some of the peripheral nerve disorders UT Southwestern surgeons and care teams treat include:

Brachial plexus injuries, damage to nerves controlling the shoulder, arm, and hand
Carpal tunnel syndrome, nerve compression in the wrist
Cubital tunnel syndrome, nerve compression in the elbow
Facial paralysis
Migraine headaches
Nerve compression injuries of the leg and arm
Nerve reconstruction
Nerve-related pain (numbness, tingling, shooting pain)
Peroneal neuropathy, nerve damage that causes foot drop and lower leg weakness
Tarsal tunnel syndrome, nerve compression in the ankle
Peripheral neuropathy caused by diabetes, autoimmune diseases, and other health concerns

Why Choose UT Southwestern for Peripheral Neuropathy Care?

With broad and deep clinical experience, backed by research and investigation conducted at UT Southwestern, we are defining a wider range of effective nonsurgical and surgical treatment options for patients. Our faculty members publish their work in high-impact scientific journals and present their work worldwide.

In treating peripheral neuropathy, we perform surgery only if absolutely necessary. When surgery is needed, our experienced specialists use the latest, most effective techniques.

We offer a team approach to care. A patient’s care team includes a peripheral nerve specialist as well as doctors and medical professionals in plastic surgery, neurosurgery, neurology, internal medicine, pain management, occupational therapy, physical therapy, and rehabilitation, as needed.

Our peripheral nerve experts are fellowship-trained specialists who:

Have extensive experience in a broad range of clinical conditions
Participate in groundbreaking clinical trials
Evaluate products and technology before they are widely available to the public
Adhere to a strict code of ethics
Teach future surgeons
Lead continuing education for practicing physicians

What Causes Peripheral Neuropathy?

Peripheral neuropathy can be caused by a variety of conditions that damage the nerves outside the brain and spinal cord. One of the most common causes is diabetes, particularly when blood sugar levels are not well-controlled.

Autoimmune diseases such as lupus, rheumatoid arthritis, and Guillain-Barré syndrome can also trigger peripheral neuropathy by causing the immune system to mistakenly attack the body's own nerves.

Other known causes include:

Infections such as Lyme disease, shingles, and human immunodeficiency virus (HIV)
Nutritional deficiencies, especially in vitamins B1, B6, B12, and E, as well as copper
Exposure to toxins such as heavy metals and certain chemicals
Excessive alcohol use
Certain medications, such as some chemotherapy drugs
Genetic conditions such as Charcot-Marie-Tooth disease
Physical injuries
Tumors pressing on nerves
Vascular disorders affecting blood flow

What Are Common Symptoms of Peripheral Neuropathy?

Symptoms vary depending on whether sensory, motor, or autonomic nerves are affected.

Sensory Symptoms of Peripheral Neuropathy

Sensory nerve damage often leads to:

Numbness, tingling, or a burning sensation in the hands and feet, which may spread upward into the arms and legs
Heightened sensitivity to touch or pain from stimuli that are not usually painful

Motor Symptoms of Peripheral Neuropathy

Damage to motor nerves can cause:

Muscle weakness, cramps, or even paralysis, affecting coordination and mobility
Difficulty walking
Balance issues
Difficulty performing tasks that require fine motor skills
Muscle wasting or atrophy (from prolonged weakness)

Autonomic Symptoms of Peripheral Neuropathy

Autonomic nerve damage affects involuntary bodily functions, leading to symptoms such as:

Excessive or reduced sweating
Digestive problems
Abnormal blood pressure or heart rate
Issues with bladder or bowel control

testing for loss of sensation in a patient's feet.

How Is Peripheral Neuropathy Diagnosed?

At UT Southwestern, patients receive a comprehensive evaluation to determine the extent and cause of the nerve damage.

We begin with a detailed medical history and physical examination, focusing on symptoms, lifestyle factors, and underlying medical conditions (such as diabetes).
A neurological exam is performed to assess reflexes, muscle strength, sensory perception, and coordination.

Based on the evaluation, the surgeon will decide whether additional specialists need to be involved and whether further testing is needed, such as:

Blood tests to detect vitamin deficiencies, metabolic disorders, or signs of autoimmune activity
Imaging studies, such as a computed tomography (CT) scan or magnetic resonance imaging (MRI), to help identify structural issues or tumors
Nerve function tests, including electromyography (EMG) and nerve conduction studies, to measure electrical activity in muscles and nerves to evaluate their function
Nerve or skin biopsy to provide detailed information about nerve fiber health

How Is Peripheral Neuropathy Treated?

Our surgeons develop care plans personalized to each patient’s diagnosis and overall medical needs. UT Southwestern offers a full range of treatment options for peripheral neuropathy, including:

Therapies for facial paralysis
Advanced minimally invasive nerve compression surgery for carpal tunnel syndrome and migraines
Minimally invasive nerve release surgery in the leg and foot for patients with diabetes and other conditions
Innovative microsurgical techniques to improve painful conditions involving the wrist, elbow, shoulder, chest, knee, and ankle, as well as to address pain after pelvic and inguinal hernia procedures
Groundbreaking nerve reconstruction, such as nerve transfers and grafts to achieve better functional recovery over a shorter period of time
Surgery to move or disconnect sensory nerves that cause pain
Surgery to reconstruct nerves that have been severed as a result of trauma, tumor removal, or birth-related brachial palsy

If surgery is part of a patient’s treatment strategy, the surgeon will thoroughly explain what to expect during recovery and discuss whether physical therapy will be needed after surgery.

“Over the past decade, we have become one of the leading centers in the U.S. in treating very difficult problems in patients with facial paralysis. Our team has been able to contribute to the advancement of the field.”

Shai Rozen, M.D.
Professor of Plastic and Reconstructive Surgery, Director of Microsurgery and the Facial Palsy Program