There are billions of nerves in your body. Most of them, your peripheral nerves, are like branches of a tree that spread out all over and transmit messages back to the trunk—your brain and spinal cord. When everything goes smoothly, your brain gets the info it needs so that you can move your muscles, recognize pain, and keep your internal organs working properly.
But when peripheral nerves get damaged, it’s another story: Walking could become challenging, you might experience unrelenting pain, or you could end up with a serious injury because you had no idea how hot that stove was.
An estimated 20 million Americans suffer from peripheral nerve damage, a.k.a. neuropathy, according to the National Institute of Neurological Disorders and Stroke. “Diabetes is the number one cause. Bad luck [meaning you inherited an anatomical defect] is number two. Repetitive motion and Lyme disease follow,” says Andrew Elkwood, M.D., a surgeon who specializes in nerve reconstruction at The Institute for Advanced Reconstruction in New York and New Jersey.
Other causes include sudden trauma (like a car accident), aging, vitamin deficiencies, heavy exposure to toxins (including alcohol, cancer medications, lead, mercury, and arsenic), and infections and autoimmune disorders like hepatitis C, diphtheria, HIV, Epstein-Barr, rheumatoid arthritis, and Guillain-Barré Syndrome. In some cases, there’s no known cause.
The good news is that nerve damage generally develops slowly, says Isha Gupta, M.D., an assistant professor of neurology at Mount Sinai’s Icahn School of Medicine. That means you might be able to treat it before it worsens—but getting the right diagnosis isn’t always easy. Your best shot? See a doctor right away if you have any of the following symptoms.
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1You feel numbness, tingling, or burning.
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This sensation is an early sign of nerve damage, and may radiate from your hands or feet into your arms or legs, per the U.S. National Library of Medicine. “Compression of sensory nerves (often while sleeping) is relatively common, and symptoms such as numbness or tingling can be temporary,” says Dr. Gupta. But if the pins-and-needles feeling doesn’t go away, get it checked out.
2So you may get injured because you didn’t feel something you should have.
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Sensory nerves are supposed to tell your brain that a surface is dangerous in some way, and if they’re not doing their job properly you could seem more accident-prone. If you have burns, cuts, or other trauma because you didn’t realize that you were touching something hot, sharp, or otherwise uncomfortable, see your doc, says R. Glenn Smith, M.D., Ph.D., a neurologist at Houston Methodist.
3It’s difficult or impossible to move part of your body.
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If motor nerves are affected, then muscle weakness or even paralysis may occur, says Dr. Smith. These same symptoms could also indicate that there’s an underlying issue that needs urgent attention, so it’s best to head to the ER.
For instance, if this weakness or numbness comes on suddenly (particularly on one side of the body)—and you also experience sudden confusion, trouble walking or seeing, and a severe headache—you may be having a stroke, and you’ll need medical attention ASAP.
4There is pain running down just one leg.
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A constant sharp pain, burning, or tingling that starts in the lower back and travels down the back of your leg could mean that you have sciatica. This happens when the sciatic nerve—which runs from your lower back, to your hips, and down your legs—becomes compressed or damaged, either by a herniated disk in your spine or by a disease such as diabetes.
5You’re way clumsier than usual.
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Suddenly stumbling and falling a lot? “If large nerves affecting sensation are damaged, then lack of coordination and failure to sense the position of the body can lead to falls,” says Dr. Smith. For instance, numbness in your feet can make it difficult to tell where you’re walking, leading to a stumble.
In certain cases, if you also experience a tremor, rigid muscles, and speech changes, it might turn out that you have a condition like Parkinson’s disease, in which the nerve cells in your brain have become damaged.
6...or you’re running to the bathroom all the time.
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Damaged nerves can send your bladder faulty messages, so you feel like you have to pee a lot or have trouble making it to the restroom in time. (You have a higher than average risk of this problem if you gave birth to a child vaginally or have diabetes.) On the flip side, you may also have issues emptying your bladder or being able to tell when your bladder is full.
7You get brief, intense headaches that feel like electric shocks.
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You may have something called occipital neuralgia, a condition that can occur when a nerve in your neck gets pinched. You may need a nerve block—an injection that temporarily blocks the troublesome nerve from transmitting pain signals.
8You’re sweating too much or too little.
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It might be a sign that the nerves carrying info from your brain to your sweat glands have become compromised, so your body temperature may fluctuate more frequently. Your doctor might order tests to measure your sweating and heart rate.
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