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Dr. Joshua Weaver
Dr. Joshua Weaver

Q: How Do You Diagnose Peripheral Neuropathy?

A: Neuropathy means a disorder of the nerves. Peripheral nerves are found all over the body and down through the arms and legs. When something affects the peripheral nervous system, there could be hundreds of causes.

The most common cause of peripheral neuropathy is diabetes.

Nerves have tiny blood vessels wrapped around them. These vessels supply the nerves with blood. Diabetes can damage these blood vessels. When the vessels are damaged, the nerves don’t get as much blood as they need, causing a variety of symptoms.

These symptoms may include numbness (lack of sensation) or tingling (often called “pins and needles), pain (often a burning sensation) or weakness in the muscles.” These symptoms occur most often in the hands and feet.

When we diagnose peripheral neuropathy, we use a lot of tools. Sometimes, the diagnosis is obvious. Sometimes, the diagnosis is more complicated.

We start by getting the patient’s medical history. Then we complete a physical exam. We check their sensation to touch and temperature. We check muscle strength and evaluate reflexes. These are all ways the nerves send messages to the brain.

When we think someone has peripheral neuropathy we use electromyography (electrical stimulation) to look at how the nerves are working. This way we can see if nerves are damaged, and if so, what parts of the nerves and how badly the nerves are damaged.

Once we have a better idea of what kind of neuropathy is going on, then we often do blood tests. That is when we check for diabetes, thyroid problems, kidney issues, vitamin levels and other tests. We do blood tests to see if there is anything we can treat right away.

The Weill Cornell Medicine Center for Comprehensive Spine Care has experts from many different specialties. We work together to diagnose and treat many disorders of the spine and nerves.

Dr. Joshua Weaver, neurologist and co-director of the WCM Center for Comprehensive Spine Care

This question was answered during the episode of Spine Time called “Neuropathy: Diagnosing and Managing Nerve Pain.” A recording of this webinar held on January 26, 2022, is available on YouTube. To sign up for future episodes of Spine Time, where you can ask questions of our spine specialists, subscribe here.

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