When patients experience numbness, tingling, or burning sensations in their feet, the most common assumption is that diabetes is to blame. While diabetic neuropathy is indeed a leading cause of nerve damage in the feet, it’s far from the only explanation.

At Foot & Ankle Associates of Southern NH, we see many patients with non-diabetic peripheral neuropathy—a condition that can be both confusing and frustrating when the cause isn’t immediately clear. Let’s explore some of the lesser-known culprits behind this often debilitating condition.

What Is Peripheral Neuropathy?

Peripheral neuropathy is a condition involving damage to the peripheral nerves—the network responsible for transmitting signals between your brain, spinal cord, and the rest of your body. In the feet, this often presents as:

• Burning or tingling sensations

• Numbness or loss of sensation

• Sharp or shooting pain

• Muscle weakness or imbalance

1. Idiopathic Neuropathy: When There's No Clear Cause

“Idiopathic” means “of unknown origin,” and unfortunately, that applies to a fair number of neuropathy cases. Especially in older adults, peripheral nerve symptoms may develop without an identifiable trigger.

Although frustrating for patients, idiopathic neuropathy can still be managed. Our focus is on symptom control, maintaining balance and strength, and monitoring for progression over time. Treatment may include topical creams, oral medications, physical therapy, and custom orthotics to improve stability and prevent falls.

2. Alcohol-Induced Neuropathy: More Common Than You Think

Chronic alcohol consumption can damage nerve tissue, leading to what's known as alcoholic neuropathy. This occurs due to both the toxic effects of alcohol itself and the nutritional deficiencies that often accompany long-term alcohol use—particularly in B vitamins that support nerve health.

Symptoms may be subtle at first but can become progressively worse if not addressed. Treatment involves lifestyle modifications, including alcohol cessation, nutritional supplementation, and regular monitoring to prevent worsening nerve damage.

3. Vitamin Deficiencies: Small Imbalances, Big Impact

Certain vitamins are critical to nerve function, and a lack of these nutrients can lead to neuropathy:

• Vitamin B12: Deficiency can lead to demyelination of nerves, causing numbness, balance issues, and cognitive symptoms.

• Vitamin B6: Both too little and too much can be harmful.

• Vitamin E and folate: Also important for nerve health and repair.

Older adults, vegetarians, individuals with gastrointestinal disorders (like Crohn’s or celiac disease), and patients taking long-term antacid medications are especially at risk. Fortunately, identifying and correcting these deficiencies can sometimes reverse or improve neuropathic symptoms.

4. Chemotherapy-Induced Neuropathy: A Tough Side Effect

For cancer survivors, chemotherapy-induced peripheral neuropathy (CIPN) is a common and often long-lasting side effect. Drugs like paclitaxel, vincristine, and cisplatin can damage peripheral nerves, leading to pain, tingling, or numbness—especially in the hands and feet.

At our clinic, we work with patients undergoing or recovering from cancer treatment to provide supportive care aimed at reducing discomfort, improving mobility, and enhancing quality of life during a challenging time.

When to See a Podiatrist

If you’re experiencing ongoing numbness, tingling, or foot pain—whether or not you have diabetes—it’s worth a visit. Identifying the cause early allows for more effective management and may prevent complications like falls, ulcers, or permanent nerve damage.

At Foot & Ankle Associates of Southern NH, we take a comprehensive, empathetic approach to neuropathy care. Our goal is to help you get answers, feel understood, and find real relief.

Take the First Step Toward Relief

If you or a loved one is dealing with symptoms of peripheral neuropathy, don’t wait. Book an appointment today and let’s get to the root of your symptoms—together.