Ask the doctors: Neuropathy has many causes beyond diabetes

Q: I often read about neuropathy in the feet, and it is always linked to diabetes. I've had pain, tingling, burning and partial numbness in my feet for years but do not have diabetes.

Why is neuropathy not talked about separately from diabetes? Can I do anything for my symptoms?

A: Neuropathy is a condition in which the nerves in the body no longer function properly. It can occur due to physical damage to the nerve itself. It can also be from metabolic causes such as diabetes, autoimmune or inflammatory conditions and infection.

Certain medical treatments, including chemotherapy, can cause neuropathy. It can also arise due to poor nutrition, alcohol abuse and exposure to environmental toxins such as heavy metals. There can also be a genetic component to neuropathy.

Risk of the condition may increase with age. As with many diseases and conditions, the cause is often not clear. This is known as idiopathic neuropathy.

Your symptoms suggest the most common form of the condition, peripheral neuropathy. It usually affects the feet and, less often, the hands. It features the tingling, burning, numbness and pain that you described.

Peripheral neuropathy in the feet can mute the ability to feel sensory changes, such as temperature, vibration, touch and even foot position. The condition can cause muscle weakness, cramping or twitching. It can interfere with balance and the ability to walk. It can also cause dry or cracked skin, affect nails, and slow the healing of cuts or sores. This is especially true in diabetic neuropathy.

And that brings us to part of your question. Diabetes is a leading cause of this condition. So it makes sense that it's often part of discussions about peripheral neuropathy. Over time, the metabolic effects of high blood sugar can damage the nerves of the feet and hands, as well as the tiny blood vessels that nourish them. Idiopathic neuropathy, where a direct cause is not clear, is the next most common diagnosis.

Unfortunately, the nerve damage of neuropathy is often long-lasting. When an underlying cause is identified early and successfully treated, improvement can occur. Vitamin deficiency or toxin exposure are examples of such causes. If you have not consulted a medical professional, it would be wise to do so.

Treatment focuses on managing symptoms. This includes lifestyle changes and preventing further damage. It may also involve medications that target nerve pain, such as gabapentin. Nutrition is important in nerve health, particularly vitamin B12. You can address low levels of B12 with diet and, if needed, B12 injections.

Foods rich in B12 include salmon, sardines, tuna, clams, oysters, mussels, beef, liver and eggs. Many prepared and packaged foods are fortified with this essential vitamin.

A daily gentle massage of the feet, ankles and calves may help ease symptoms. Foot exercises can also help. Exercises may include ankle flexes and circles, toe spreads and curls, heel raises, and pointing and flexing the feet.

It is important to approach all of this gently and gradually and not overdo it. With consistent care, it can be possible for you to improve comfort, strength and foot health.

• Dr. Eve Glazier is an internist and associate professor of medicine at UCLA Health. Dr. Elizabeth Ko is an internist and assistant professor of medicine at UCLA Health. Send your questions to askthedoctors@mednet.ucla.edu.

© 2026 UCLA Health. Distributed by Andrews McMeel Syndication