Have you been diagnosed with lower limb neuropathy?
It’s likely you hadn’t heard of it before this diagnosis.
Here, I answer all the most frequently asked questions from my patients diagnosed with peripheral nerve damage in the lower limbs. Drawing on my experience as a physical therapist and scientific studies on the topic (links at the end of the article).
Happy reading 🙂!
Last update: 4 June 2024
Disclaimer: no Affiliate links. Complete disclosure in legal notices.
Written by Nelly Darbois, physical therapist and scientific writer
Summary
What is lower limb neuropathy?
Lower limb neuropathy literally means: “neurological disease of the lower limbs,” “neurological impairment of the lower limbs.”
In simpler terms, it means you have a problem with the nerves in your legs.
This type of nerve is part of the peripheral nervous system, as opposed to the central nervous system.
The central nervous system consists of the brain and spinal cord.
The peripheral nervous system includes nerves throughout the body that branch out from the spinal cord.
There are many subcategories within lower limb neuropathies, also known as “polyneuropathy of the lower limbs.” This term encompasses them all.
In this table, I summarize the types and forms of lower limb neuropathy that people most frequently inquire about. Some of these terms actually refer to the same types of neuropathy.
| Type of Neuropathy | Explanations |
|---|---|
| Degenerative Neuropathy of the Lower Limbs | Nerves located in the legs and feet deteriorate over time. This deterioration can be caused by various conditions such as hereditary disorders, autoimmune diseases, infections, trauma, or other environmental factors (such as alcohol consumption). |
| Sensory Axonal Neuropathy of the Lower Limbs | This means that a specific area of your nerves is affected: the axons of sensory nerves, responsible for sensitivity in the legs. |
| Sensory-Motor Axonal Polyneuropathy of the Lower Limbs | In this case, it’s also the axons of your nerves that are affected. However, both sensory nerves (responsible for sensitivity) and motor nerves (responsible for movement) are involved. |
🚨 Typically, polyneuropathy means that multiple nerves are affected, while neuropathy can encompass either multiple or single nerves. However, the two terms are sometimes used interchangeably.
Here are names of different types of lower limb polyneuropathy:
- Diabetic neuropathy
- Alcoholic neuropathy
- Small fiber neuropathy of the lower limbs
- Chronic inflammatory demyelinating polyneuropathy with lower limb involvement
- Tarsal tunnel syndrome (similar to carpal tunnel syndrome but at the ankle), etc.
What are the causes of lower limb polyneuropathy?
Many factors (or combinations of factors) can trigger nerve disorders in the lower limbs:
- Genetic predisposition without identifiable cause
- Hereditary diseases such as Charcot-Marie-Tooth disease
- Alcoholism: up to 7 out of 10 people who chronically consume alcohol develop lower limb neuropathy [Sadowski 2022]
- Infection
- Physical trauma, either acute or repetitive
- Medication intake: certain chemotherapy agents, HIV medications, antiepileptic drugs, and antibiotics
- Autoimmune diseases
- Vascular disorders: poor blood circulation in the legs
This is why you often undergo many tests when neuropathy is suspected or diagnosed.
Can Lower Limb Neuropathy Be Cured?
Yes, some forms of lower limb neuropathy can be cured.
In certain cases, peripheral nerves can regenerate and repair themselves, especially if the damage was temporary.
For example, in the case of neuropathy caused by nerve compression due to a fracture, the nerve can regrow and recover after the pressure on the nerve is relieved and the injury has healed.
What is the progression of this type of neuropathy?
It is difficult to provide specific information on the progression without knowing the exact type of lower limb neuropathy you have.
Here are some examples of progression for common types of neuropathy.
☑️ When a nerve has been damaged along with an ankle fracture:
You may experience reduced sensitivity and mobility for several weeks. However, in some cases, sensitivity and mobility can return, often after several months.
☑️ In the case of small fiber neuropathy:
(Additional details would follow as needed.)
The disease progresses slowly. It reaches a plateau and then no longer progresses for most people.
☑️ In the case of diabetic neuropathy:
The progression depends heavily on whether your diabetes is well controlled or not.
✅ If your diabetes is well controlled, the symptoms can stabilize, and the pain can be limited.
❌ If your diabetes is not controlled, the risk of complications is higher: skin lesions, ulcers, infections, and sometimes amputations.
☑️ In the case of alcohol-related neuropathy:
If alcohol consumption continues, sensory and motor disorders worsen over time.
If alcohol is stopped, sensory and motor disorders decrease in some people.
What are the treatments for lower limb neuropathy?
There are two main types of treatments for neuropathies:
- Treatments for the causes of the neuropathy: for example, stopping alcohol consumption or an antibiotic for an infection.
- Treatments for the symptoms of the neuropathy: for example, medications for pain or physical therapy to improve balance.
Depending on the type of neuropathy, your symptoms, and its cause, treatments will vary greatly!
There are no medical or other treatments that can regrow nerves or accelerate their healing.
However, in the case of traumatic nerve injury, electrotherapy can be used to maintain muscle trophicity while waiting for nerve regrowth.
Is physical therapy useful for lower limb neuropathy?
Here is a summary of what physical therapy can potentially offer:
🤝 Maximize your autonomy and quality of life.
🏋️♂️ Strengthen weakened muscles to improve stability and motor function.
🦶 Improve the mobility of your lower limbs to facilitate daily activities.
🧠 Enhance proprioception and coordination to help reduce the risk of falls.
💊 Relieve pain associated with neuropathy.
Again, it is important to look at each case individually, depending on the type of neuropathy you have and the treatment modalities your physical therapist offers.
***
Here’s what I wanted to tell you about this! I wish you a very good recovery! Do you have any comments or questions? Your comments are welcome 🙂 !
You may also like:
📚 SOURCES
Bodman MA, Varacallo M. Peripheral Diabetic Neuropathy. 2023 Sep 4. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan–. PMID: 28723038.
Flossdorf P, Haupt WF, Brunn A, Deckert M, Fink GR, Lehmann HC, Wunderlich G. Long-Time Course of Idiopathic Small Fiber Neuropathy. Eur Neurol. 2018;79(3-4):161-165. doi: 10.1159/000487717. Epub 2018 Mar 8. PMID: 29518780.
Bodman MA, Varacallo M. Peripheral Diabetic Neuropathy. [Updated 2023 Sep 4]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK442009/
Sadowski A, Houck RC. Alcoholic Neuropathy. [Updated 2022 Dec 30]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK499856/
Written by Nelly Darbois
I enjoy writing articles that answer your questions, drawing on my experience as a physiotherapist and scientific writer, as well as extensive research in international scientific literature.
I live in the French Alps☀️🏔️, where I enjoy the simple pleasures of life (+ I’m a Wikipedia consultant and the founder of Wikiconsult).