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How to Diagnose Neuropathy: A Comprehensive Guide


An illustration of a doctor consulting with a patient, likely discussing symptoms related to neuropathy or nerve-related conditions.

If you suspect you may have neuropathy, getting an accurate diagnosis is the critical first step in finding relief and preventing further nerve damage. Neuropathy occurs when the peripheral nerves become damaged or diseased, leading to symptoms like numbness, tingling, weakness, and pain in the hands and feet. In this comprehensive guide, we’ll walk you through everything you need to know about how to diagnose neuropathy so you can get the treatment you need.

Key Takeaways

  • Neuropathy is diagnosed through a combination of your medical history, physical exam, neurological exam, and diagnostic tests
  • Blood tests can check for underlying conditions like diabetes, vitamin deficiencies, infections, and autoimmune disorders that may be causing your neuropathy
  • Nerve conduction studies and electromyography (EMG) measure the electrical activity in your nerves and muscles to assess nerve damage
  • Skin biopsies and nerve biopsies may be done to examine nerve fibers under a microscope for signs of neuropathy
  • Getting an early and accurate diagnosis is key to preventing permanent nerve damage and finding the most effective treatment options for your specific type of neuropathy

Medical History and Physical Exam

The first steps in diagnosing neuropathy involve your doctor gathering information about your symptoms, medical history, and performing a physical exam.

Detailed Symptom History

Your doctor will ask you to describe your symptoms in detail, including: – What symptoms you’re experiencing (numbness, tingling, burning pain, weakness, sensitivity to touch, etc.) – Where you’re feeling symptoms (toes, feet, fingers, hands, legs, etc.) – When your symptoms started – If symptoms came on gradually or suddenly – What makes symptoms worse or better – If symptoms are constant or come and go – How symptoms impact your daily activities and quality of life

This information helps your doctor determine the pattern and severity of your symptoms to guide the diagnostic process. For example, peripheral neuropathy often starts with symptoms in the toes and feet before progressing up the legs.

Medical History

Your doctor will also take a thorough medical history to identify any risk factors or underlying conditions that may be contributing to your neuropathy. This includes asking about: – Other medical conditions you have (diabetes, autoimmune disorders, kidney disease, etc.) – Medications and supplements you take – Exposure to toxins (alcohol abuse, chemotherapy drugs, heavy metals, etc.) – Family history of neuropathy – Lifestyle factors (smoking, diet, physical activity, occupation, etc.)

Certain conditions like diabetes, vitamin deficiencies, and autoimmune disorders are common causes of peripheral neuropathy. Identifying and treating the underlying cause is key to managing neuropathy symptoms.

Physical and Neurological Exam

Your doctor will perform a comprehensive physical exam to look for signs of neuropathy and assess your overall health. This includes: – Checking your reflexes – Testing your muscle strength and tone – Examining your skin for ulcers, infections, or changes in color or texture – Assessing your balance and coordination – Testing your ability to feel light touch, pinpricks, vibration, and temperature

During the neurological exam, your doctor will focus on evaluating your nervous system function. They may use tools like a 128-Hz tuning fork to test your vibration perception or a thin fiber to test your sensitivity to light touch.

Diagnostic Tests

While the medical history and physical exam provide important clues, diagnosing neuropathy often requires additional testing to confirm nerve damage and identify the underlying cause. Some common diagnostic tests for neuropathy include:

Blood Tests

Blood work is usually the first step in diagnosing neuropathy. Your doctor may order various blood tests to check for: – Diabetes (fasting blood sugar, hemoglobin A1C) – Vitamin deficiencies (B12, folate, vitamin E) – Thyroid disorders – Liver and kidney function – Toxic substances and heavy metals – Vasculitis and inflammation – Abnormal immune system proteins – Infections (Lyme disease, HIV, hepatitis C)

These tests can help identify or rule out potential causes of your neuropathy. For example, a vitamin B12 deficiency can lead to neuropathy symptoms that are reversible with B12 supplementation.

Nerve Conduction Studies

Nerve conduction studies are tests that measure how fast electrical signals travel through your peripheral nerves. This test can show if you have nerve damage and how severe it is.

During the test, electrodes are placed on your skin that deliver small electrical pulses to stimulate the nerve. The speed and strength of the nerve’s response are measured. Slow or weak responses can indicate damage to the nerve or myelin sheath that insulates and protects the nerve.

Nerve conduction studies are often used to diagnose common types of peripheral neuropathy like: РDiabetic neuropathy РChronic inflammatory demyelinating polyneuropathy (CIDP) РCarpal tunnel syndrome РGuillain-Barré syndrome

Electromyography (EMG)

Electromyography (EMG) is often done along with nerve conduction studies to diagnose peripheral neuropathy. While nerve conduction studies measure the speed of electrical signals in your nerves, EMG measures the electrical activity in your muscles.

During an EMG, a thin needle electrode is inserted into the muscle to record electrical activity. The electrode may be moved to different areas of the muscle to get a complete picture. Your doctor will be able to see and hear the electrical activity on a monitor.

EMG can help determine if your symptoms are due to nerve damage or a muscle disorder. It can also show which muscles and nerves are affected.

Other Diagnostic Tests

Depending on your specific symptoms and risk factors, your doctor may recommend additional tests to diagnose neuropathy:

Test Description
Skin biopsy A small sample of skin is removed to examine the nerve fibers under a microscope. This test can diagnose small fiber neuropathy.
Nerve biopsy A small piece of nerve tissue is surgically removed for examination. This test is not as commonly done anymore.
Lumbar puncture (spinal tap) A sample of cerebrospinal fluid is removed from your spinal canal to check for infections, inflammation, and abnormal proteins.
Imaging tests (CT, MRI) Scans that show detailed images of the brain, spinal cord, and nerves to look for tumors, herniated disks, or other abnormalities compressing nerves.

Diagnosing the Type of Neuropathy

Once diagnostic testing confirms you have neuropathy, the next step is to determine the specific type of neuropathy. There are over 100 known types of peripheral neuropathy, each with its own symptoms and causes.

The three main types of peripheral neuropathy are:

  1. Sensory neuropathy: Affects the nerves that control sensation, causing symptoms like numbness, tingling, and pain. This is the most common type.
  2. Motor neuropathy: Affects the nerves that control muscle movement, causing symptoms like weakness, cramps, and muscle atrophy.
  3. Autonomic neuropathy: Affects the nerves that control involuntary functions like blood pressure, digestion, bladder function, and sweating.

Some people have a combination of types, known as sensorimotor neuropathy. The type of neuropathy you have will guide your treatment plan.

When to See a Neuropathy Specialist

If you’ve been diagnosed with neuropathy, it’s important to see a specialist who has experience treating this complex condition. A neuropathy specialist can help: – Identify the cause of your neuropathy – Determine the type and severity of neuropathy – Recommend the most effective treatment options – Monitor your condition and adjust treatment as needed – Provide lifestyle recommendations to manage symptoms and prevent progression

At Asuta Health, our neuropathy specialists use the latest diagnostic tools and treatment methods to help you find relief from neuropathy pain and other symptoms. We offer state-of-the-art therapies like: – Electrical nerve stimulation – Infrared therapy – Vibration therapy – Manual therapy techniques – Custom orthotics – Nutritional support

Our comprehensive treatment plans are tailored to your unique needs and designed to give you the best possible results. If you’re struggling with neuropathy, don’t wait to get help. The earlier neuropathy is diagnosed and treated, the better the chances of preventing permanent nerve damage.


Diagnosing neuropathy involves a combination of understanding your medical history, physical examination, neurological testing, and sometimes additional tests to determine the underlying cause. An accurate diagnosis is essential for getting the right treatment and managing your symptoms effectively.

If you suspect you may have neuropathy, don’t hesitate to talk to your doctor. And if you’ve been diagnosed with neuropathy, seeking care from a specialist can make all the difference in your quality of life. With the right diagnosis and treatment plan, it is possible to find relief from neuropathy symptoms and prevent further nerve damage.

At Asuta Health, we’re here to help you every step of the way. Contact us today to schedule a consultation with one of our experienced neuropathy specialists and take the first step towards feeling like yourself again.

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