Clinical Fact Sheet:
Peripheral Neuropathy
DEFINITION
Altered nerve function in lower
extremities may involve diminished
or absent sensation to touch, pain, or
temperature, absence of sweating, foot
deformities, and altered gait/weight
bearing.
Patient education (see
RISK FACTORS
Diabetes
Smoking
Advanced age
Hansens Disease
Spinal cord lesion
TYPICAL ASSESMENT
History
Diabetes (duration, extent of
control)
Smoking (amount and duration)
Presence of Hansens Disease
Relief of pain with ambulation
Paresthesia of extremities
Physical Exam
Peripheral pulses palpable
Temperature of skin warm
Color of skin normal
Capillary refill normal (less than
3 seconds)
Motor neuropathy
o Diminished reflexes
o Orthopedic deformities
(hammer toes, hallux
deformity)
o Altered gait
Sensory neuropathy
o Diminished sensitivity to
touch
o Reduced sensitivity to pin
prick/monofilament testing
Autonomic neuropathy
o Xerosis (fissures common)
o Pathogenic fractures
TREATMENT
Control underlying medical and
nutritional disorders
prevention)
Stop smoking
Well-controlled diabetes
Non-weight bearing on affected
area
PREVENTION
Patient Education
No smoking
Compliance with medications
Control diabetes
Avoidance to cold, friction and
moisture between toes, going
barefoot
Routine professional foot care for
toenails and callouses
Use of well-fitting footwear
(leather is best)
Pressure reduction for heels and
other bony prominences
Avoidances of external use of
heat
Avoidance of temperature
extremes
Follow up with a healthcare
provider
QUESTIONS TO ASK YOUR
PHYSICIAN
What is causing my symptoms?
Are there certain types of tests
to determine their cause?
 Will my insurance cover these
tests?
Are there any specific
preparations for these tests
Is the condition temporary or
permanent?
Are there treatments available
for my condition?
Are there any side effects to
these treatments?
What if the medication/treatment
does not work?
Would physical therapy help?
Do I need to restrict any
activities?