What is peripheral neuropathy?
Peripheral neuropathy means the nerves connecting the brain and spinal cord to the rest of the body are damaged or not working properly. It most often affects the longest nerves first, producing numbness, tingling or burning pain in the feet that may spread up the legs and into the hands. Diabetes is the most common cause in the UK; others include vitamin B12 deficiency, alcohol, thyroid disease, certain medicines including chemotherapy, and inflammatory or inherited conditions.
It becomes more common with age, affecting roughly 1 in 10 people over 55. Diagnosis involves a neurological examination, blood tests to look for treatable causes, and often nerve conduction studies, which measure how well electrical signals travel along the nerves and clarify the pattern and severity of damage.
Common symptoms
- Numbness or reduced sensation in the feet or hands
- Tingling or 'pins and needles'
- Burning, stabbing or shooting pain
- Feeling of walking on cotton wool
- Balance problems, especially in the dark
- Muscle weakness or foot drop
- Oversensitivity to touch
How long will you wait?
Routine NHS neurology referrals typically take four to eight months in many areas, often with an additional wait of weeks to months for nerve conduction studies.
Privately, you can typically see a consultant neurologist within 3–7 days, with nerve conduction studies usually arranged within 1–2 weeks.
NHS England median referral-to-treatment wait: 12.4 weeks, with 2.5 million people waiting over 18 weeks (May 2026). Individual waits vary by trust and urgency.
Treatment options
- Treating the underlying cause. Optimising diabetes control, correcting B12 deficiency, reducing alcohol or adjusting causative medicines.
- Neuropathic pain medication. Drugs such as amitriptyline, duloxetine, gabapentin or pregabalin, which target nerve pain specifically.
- Topical treatments. Capsaicin cream or lidocaine patches for localised burning pain.
- Physiotherapy and foot care. Balance training, appropriate footwear and regular podiatry to prevent falls and foot complications.
What does private treatment cost?
As a guide, a private neurology consultation costs around £250–£350, and nerve conduction studies with EMG around £400–£800 depending on the extent of testing.
Does health insurance cover peripheral neuropathy?
Private medical insurance typically covers investigation of new neuropathy symptoms — consultations, blood tests and nerve conduction studies — to establish a cause. If the neuropathy stems from a chronic condition such as diabetes, ongoing management is usually excluded under chronic condition rules, and a pre-existing diabetes diagnosis may limit cover for related complications. Acute, treatable causes are more likely to be covered throughout.
Frequently asked questions
What causes peripheral neuropathy?
Diabetes is the most common cause in the UK, but the list is long: vitamin B12 deficiency, excess alcohol, underactive thyroid, kidney disease, some chemotherapy drugs and inflammatory conditions such as CIDP can all be responsible. In up to a quarter of cases no cause is found despite thorough testing — this 'idiopathic' neuropathy is usually slowly progressive and benign.
Are nerve conduction studies painful?
They are uncomfortable rather than painful for most people. Small electrical pulses are applied to the skin to measure how fast your nerves conduct signals, which feels like brief tapping or tingling. If needle EMG is added, a fine needle records muscle activity, which can be briefly sore. The whole test usually takes 30–60 minutes and needs no recovery time.
Can nerve damage be reversed?
It depends on the cause. Neuropathy from B12 deficiency, thyroid disease or medication often improves substantially once the cause is corrected, and good diabetes control can halt progression. Long-standing damage may not fully recover because nerves regrow slowly, which is a strong argument for early diagnosis. Even where damage persists, pain and balance can usually be improved considerably.