Polyneuropathy of the Lower Limbs: What It Is and How It Manifests

The feet go numb as if they were covered with a thick fabric, and a burning or shooting sensation runs through the toes. This is not imagination or fatigue — this is how polyneuropathy of the lower limbs can manifest. We will explain what can cause these sensations and at what point they should not be ignored.

What polyneuropathy of the lower limbs is

Peripheral nerves are the network outside the brain and spinal cord: sensory nerves transmit pain and touch, motor nerves control muscles, and autonomic nerves regulate blood pressure and bladder function. Polyneuropathy is multiple damage to peripheral nerves, usually symmetrical, with predominant involvement of the distal parts of the limbs. Polyneuropathy is the most common type of nerve damage. It starts with the longest nerves, so symptoms first appear in the feet and over time seem to spread upward and later affect the hands.

Main causes of nerve damage in the legs

Diabetes mellitus is considered the most common cause of polyneuropathy: high sugar levels over time damage the nerves, and this damage is called diabetic polyneuropathy. Nerves can be affected by physical trauma, a viral infection such as shingles, side effects of certain medications, or excessive alcohol consumption. Other causes include kidney and liver disease, autoimmune diseases, vitamin B12 deficiency, exposure to toxins, and hereditary conditions. Sometimes the cause cannot be identified.

Symptoms of polyneuropathy of the legs

The main manifestations are numbness and tingling in the feet, burning, stabbing, or shooting pain, loss of balance and coordination, and muscle weakness, especially in the feet. These sensations are usually constant but may come and go. When motor nerves are damaged, there may be weakness and muscle pain, cramps, twitching, and muscle wasting; when sensory nerves are affected, there may be an inability to feel heat, cold, or pain, such as a cut on the foot. Symptoms may develop over days or slowly, over months and years.

What types exist and how the course progresses

Polyneuropathy may affect one nerve, several nerves, or all nerves in the body. By the nature of the course, acute forms (up to 4 weeks), subacute forms (from 4 to 8 weeks), and chronic forms (longer than 8 weeks) are distinguished. The prognosis varies: with treatment of the underlying cause, some cases improve, but in some people the damage remains persistent or gradually increases.

How polyneuropathy is diagnosed

The doctor asks about symptoms, past illnesses, and family history, performs an examination, and may order tests: blood tests, genetic tests, studies of the electrical activity of nerves and muscles, assessment of autonomic nerve function, nerve or skin biopsy, CT or MRI to see whether something is compressing a nerve. If damage to the nervous system is suspected, the person may be referred to a neurologist. The earlier the diagnosis is made, the higher the chance of limiting the damage.

Possible complications and when to see a doctor

If the cause is not treated, serious complications are possible — for example, a foot ulcer that becomes infected; without treatment this can lead to gangrene and, in severe cases, amputation. You should see a doctor for pain, tingling, or loss of sensation in the feet, impaired balance or weakness, and also for a cut or ulcer on the foot that does not heal. People at high risk, especially those with diabetes, are advised to have regular check-ups.

• numbness and tingling in the feet
• burning, stabbing, or shooting pain
• loss of balance and coordination
• muscle weakness, especially in the feet
• a non-healing ulcer or cut on the foot

Polyneuropathy itself is not a reason to call an ambulance; 103 or 112 — for signs of stroke or heart attack.

This material is for reference and does not replace a doctor's consultation: only a specialist, after examination and tests, can say what exactly is happening with your nerves.

This content is for reference and does not replace a doctor's consultation. Medical disclaimer