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Peripheral Neuropathy Treatment
Diabetic & Non-Diabetic Nerve Care
Burning, tingling, or numbness in your feet could be peripheral neuropathy. Our board-certified Michigan podiatrists provide comprehensive evaluation and evidence-based treatment to reduce pain, prevent complications, and slow progression.
️ Does This Describe You?
- Tingling, burning, or electric shock sensations in your feet or toes
- Numbness or reduced feeling in your feet that affects your balance
- Foot pain that is noticeably worse at night
- Sensitivity to touch — even a light bedsheet causes discomfort
- Weakness in your feet or difficulty sensing the ground beneath you
Neuropathy Treatment in Michigan — Balance Foot & Ankle
Peripheral neuropathy affects over 20 million Americans, with the feet and legs being the most commonly affected areas. At Balance Foot & Ankle in Howell and Bloomfield Township, Michigan, our board-certified podiatrists — Dr. Tom Biernacki, Dr. Carl Jay, and Dr. Daria Gutkin — specialize in diagnosing and treating peripheral neuropathy to protect your feet and improve your quality of life.
What Is Peripheral Neuropathy?
Peripheral neuropathy occurs when the nerves outside the brain and spinal cord (peripheral nerves) are damaged. In the feet, this damage disrupts the signals between your brain and extremities, causing numbness, tingling, burning pain, or weakness. The condition can affect sensory nerves (feeling), motor nerves (movement), or autonomic nerves (sweating and skin health).
Common Causes of Neuropathy
Diabetic Neuropathy
Diabetes is the leading cause of peripheral neuropathy, affecting up to 50% of people with diabetes over their lifetime. High blood sugar damages small blood vessels that supply the nerves, particularly in the feet. Good blood sugar control is the single most important factor in preventing progression. Learn more about our diabetic foot care program.
Watch: Neuropathy Explained by Dr. Biernacki
Dr. Tom Biernacki, DPM — Board-Certified Podiatrist | Balance Foot & Ankle, Michigan
Other Causes
- Vitamin deficiencies — B12, B6, folate, and vitamin D deficiency can all cause or worsen neuropathy
- Alcohol use — chronic alcohol consumption is toxic to peripheral nerves
- Chemotherapy — many cancer treatments cause neuropathy as a side effect
- Autoimmune conditions — lupus, rheumatoid arthritis, Guillain-Barré syndrome
- Infections — shingles, Lyme disease, HIV
- Kidney disease — toxin buildup from impaired kidney function
- Idiopathic — in up to 30% of cases, no specific cause is identified
Symptoms of Peripheral Neuropathy
Neuropathy symptoms typically begin in the toes and gradually progress upward. Common symptoms include:
- Numbness or reduced sensation — inability to feel temperature, pain, or touch in the feet
- Tingling or “pins and needles” — often worse at night
- Burning or shooting pain — can be severe and disrupt sleep
- Sensitivity to touch — even light contact (like bedsheets) causes discomfort
- Muscle weakness — difficulty lifting the front of the foot (foot drop)
- Balance problems — loss of proprioception increases fall risk
- Dry, cracked skin — autonomic nerve damage reduces sweating
Why Neuropathy Is Dangerous for Your Feet
Loss of sensation in the feet creates a serious safety risk. Patients with neuropathy may not feel cuts, blisters, burns, or pressure sores — allowing minor injuries to become infected or develop into ulcers. Diabetic foot ulcers are the leading cause of non-traumatic amputations in the United States. Early detection and proactive foot care can prevent these devastating complications.
How We Diagnose Neuropathy
- Comprehensive neurological exam — monofilament testing, vibration perception, reflex assessment, and muscle strength testing
- Nerve conduction studies (NCS/EMG) — measures the speed and strength of electrical signals in your nerves
- Blood work — checking glucose, HbA1c, vitamin B12, thyroid function, kidney function, and other markers
- Vascular assessment — evaluating blood flow to the feet since neuropathy and peripheral arterial disease often coexist
- Skin biopsy — in select cases, to assess small fiber nerve density
Treatment Options
While nerve damage often cannot be fully reversed, treatment focuses on slowing progression, managing symptoms, and protecting your feet from complications.
Treating the Underlying Cause
- Blood sugar optimization — the most important step for diabetic neuropathy
- Vitamin supplementation — B12, B-complex, vitamin D, and alpha-lipoic acid based on lab results
- Medication adjustment — identifying and addressing drug-induced neuropathy
Pain Management
- Prescription medications — gabapentin, pregabalin, duloxetine, and other nerve pain medications
- Topical treatments — prescription-strength capsaicin, lidocaine patches, and compounded creams
- MLS laser therapy — non-invasive dual-wavelength laser that reduces nerve pain and promotes healing
- Nerve decompression — surgical release of compressed nerves in select candidates
Protective Foot Care
- Regular podiatric examinations — comprehensive foot checks every 3–6 months
- Custom diabetic orthotics — accommodate foot deformities and redistribute pressure
- Therapeutic footwear — extra-depth diabetic shoes that reduce pressure on vulnerable areas
- Daily foot inspection education — we teach patients how to check their feet for injuries they may not feel
- Wound care — immediate treatment of any cuts, blisters, or ulcers to prevent infection
Living with Neuropathy: Tips from Our Podiatrists
- Check your feet every day — look for cuts, blisters, redness, swelling, or sores
- Never walk barefoot, even at home
- Test bath water temperature with your hand or elbow before stepping in
- Keep feet moisturized to prevent cracks (but not between the toes)
- Trim toenails carefully or have them trimmed by a podiatrist
- Wear well-fitting, seamless socks and avoid going sockless in shoes
- Stay active — regular walking and balance exercises slow neuropathy progression
Book Your Neuropathy Evaluation
If you’re experiencing numbness, tingling, or burning in your feet, early evaluation and treatment can make a significant difference. Our podiatrists perform thorough neuropathy assessments and create personalized care plans.
Book an Appointment Online or call (810) 206-1402.
We serve patients throughout Southeast Michigan at our Howell and Bloomfield Township offices.
Frequently Asked Questions: Neuropathy
Can neuropathy in the feet be reversed?
In some cases, yes — particularly when caused by vitamin deficiencies or early-stage diabetes with good blood sugar control. However, long-standing nerve damage is often permanent. Treatment focuses on slowing progression, managing pain, and preventing complications like ulcers and infections.
What does neuropathy in the feet feel like?
Neuropathy symptoms vary but commonly include numbness, tingling (pins and needles), burning pain, sharp or shooting pain, and sensitivity to touch. Some patients describe a “walking on cotton” sensation or feeling like they’re wearing socks when they’re not.
How often should someone with neuropathy see a podiatrist?
Patients with peripheral neuropathy should see a podiatrist every 3–6 months for a comprehensive foot examination, or more frequently if they have diabetes, poor circulation, or a history of foot ulcers. Regular visits catch problems early before they become serious.
Does Medicare cover neuropathy treatment?
Medicare covers podiatric care for peripheral neuropathy, including diabetic foot exams, therapeutic shoes and inserts (under the Diabetic Shoe Bill), and treatment for neuropathy-related complications. Balance Foot & Ankle accepts Medicare and most insurance plans.
Related Conditions
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Howell Office
3980 E Grand River Ave, Suite 140
Howell, MI 48843
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Bloomfield Hills Office
43700 Woodward Ave, Suite 207
Bloomfield Hills, MI 48302
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Howell · (810) 206-1402 Bloomfield · (248) 335-0322Frequently Asked Questions
Can peripheral neuropathy be reversed?
Reversal depends on the cause. Diabetic neuropathy rarely reverses completely, but excellent blood sugar control can prevent progression and sometimes improve symptoms. B12 deficiency neuropathy often improves significantly with supplementation. Compression neuropathies (tarsal tunnel) can be surgically corrected with excellent outcomes.
What are the early signs of neuropathy in the feet?
Early signs include tingling, burning, or pins-and-needles sensations starting in the toes. You may notice numbness spreading up the foot, unusual sensitivity to touch, pain when walking, or difficulty feeling temperature changes in your feet. Early diagnosis is critical for preventing complications.
How is neuropathy treated by a podiatrist?
Treatment depends on the cause and severity. Options include: blood sugar optimization (for diabetic neuropathy), prescription medications (gabapentin, pregabalin, duloxetine), MLS laser therapy to reduce nerve inflammation, custom orthotics for pressure relief, topical compounded creams, and vitamin supplementation. Surgical decompression for tarsal tunnel neuropathy can provide dramatic relief.
Common Questions: Neuropathy Treatment
What is the best vitamin for peripheral neuropathy?
B vitamins are essential for nerve health. B12 deficiency is a direct cause of neuropathy that responds dramatically to supplementation. B1 (thiamine), B6, and B9 (folate) are also important. R-Alpha Lipoic Acid (R-ALA) has the strongest research backing for reducing neuropathy pain and improving nerve conduction. Always consult your podiatrist before starting supplements.
Does peripheral neuropathy get worse over time?
Without treatment, diabetic neuropathy typically progresses slowly over years. With excellent blood sugar control, many patients stabilize their neuropathy. Some B12 deficiency cases improve significantly with supplementation. Compression neuropathies (tarsal tunnel) can worsen without intervention. Early treatment is critical for the best long-term outcome.
What is the fastest way to reduce neuropathy pain?
Prescription gabapentin or pregabalin work within days for most patients. Topical compounded creams provide targeted relief without systemic side effects. MLS laser therapy gives rapid pain reduction through direct nerve effects. Long-term, addressing underlying causes (blood sugar, B12, compression) provides lasting improvement.
Does walking help neuropathy in feet?
Moderate walking benefits peripheral neuropathy — it improves circulation, maintains muscle strength, and releases endorphins. Patients with sensory loss must inspect feet before and after walking, wear proper footwear, and avoid going barefoot. Start with short walks and use support if balance is affected.
Medical References & Resources
- Diabetic foot health and neuropathy — American Diabetes Association (ADA)
- Peripheral neuropathy clinical information — National Institute of Neurological Disorders (NINDS)
Watch: Dr. Tom on Neuropathy in Feet
Dr. Tom Biernacki, DPM — 950K+ YouTube subscribers · 156M+ video views · Michigan’s most-watched podiatrist.
Essential Products for Neuropathy
Neuropathy makes you lose sensation — which means proper shoes, socks, and daily inspection are non-negotiable. Here are the essentials.
Best Shoes for Diabetic Neuropathy
Medicare A5500-eligible shoes that prevent pressure wounds.
Best Compression Socks
Graduated compression for edema, neuropathy, and long days.
Diabetic Foot Care Kit
4 essentials: mirror, urea cream, diabetic socks, antibacterial wipes.
Watch Dr. Tom on Peripheral Neuropathy
Dr. Tom’s evidence-based home protocol for neuropathy — the supplements, shoes, and habits that slow nerve damage and reduce symptoms.
Neuropathy Home Management Kit
Neuropathy management is 80% habits, 20% products. These four evidence-supported tools form our standard home protocol for diabetic and idiopathic neuropathy:
Capsaicin Pain Relief Cream (0.075%)
Topical capsaicin depletes substance P — clinically proven to reduce burning neuropathic pain. Apply 3x daily for 6+ weeks for full effect.
Check Amazon Price →MediPeds Diabetic Crew Socks
Non-binding, moisture-wicking — prevents the skin breakdown that complicates neuropathy. Essential daily wear for anyone with foot numbness.
Check Amazon Price →Vive Long-Handle Foot Inspection Mirror
Daily foot check is the #1 habit that prevents neuropathic ulcers — if you can’t feel it, you have to see it.
Check Amazon Price →Eucerin Advanced Repair Foot Cream
Ceramide + urea keeps neuropathic skin supple — cracks are the entry point for the infections that cause amputations.
Check Amazon Price →Affiliate disclosure: Amazon links are affiliate links — we earn a small commission if you buy through them, at no cost to you. We only recommend products we actually prescribe to patients at Balance Foot & Ankle.