Peripheral Neuropathy
Numbness, tingling and burning have several possible causes, many of them metabolic or systemic. Establishing which applies matters more than assuming.
Neuropathy Has Several Possible Causes
Peripheral neuropathy is a description of what the nerves are doing, not a diagnosis of why. Diabetes is the single most common cause. Others include vitamin B12 deficiency, thyroid disease, kidney disease, alcohol use, chemotherapy and other medications, autoimmune conditions and infections — and in a meaningful proportion of cases no cause is identified at all. Working out which of these applies is a medical evaluation, and it usually involves blood work.
This matters because the causes are not interchangeable. A B12 deficiency or an undiagnosed thyroid problem is treatable, and treating it is what changes the symptoms. If your numbness has not been investigated, that investigation is the priority, and we will say so and refer rather than begin care.
Where a Structural Contribution May Be Relevant
Separately from these systemic causes, nerve roots and peripheral nerves can be irritated or compressed along their course — at the nerve root in the spine, or at entrapment sites such as the carpal tunnel or cubital tunnel. That produces symptoms in the distribution of the affected nerve, which is usually distinguishable on examination from the symmetrical, stocking-and-glove pattern typical of a metabolic neuropathy.
Where examination points to a compressive or mechanical contribution, that is something structural care may be able to address. Where it points to a metabolic or systemic cause, structural care is not the answer and we will say so. Both can also be present at once, particularly in patients with diabetes.
How We Approach It
Our aim is to establish whether a structural contribution is plausible, and to be honest when it is not.
- •Detailed Examination: We check for spinal misalignments that correlate with your specific neuropathy symptoms.
- •Structural care where indicated: Where a compressive or mechanical contribution is identified, correction and traction address that finding. This does not treat a metabolic neuropathy.
- •Lifestyle Factors: We also discuss the general health factors known to matter for nerve health, and coordinate with your physician where the cause is metabolic rather than structural.