Peripheral Neuropathy

The peripheral nervous system consists of the nerves that run from the central nervous system to the rest of the body. There are three types of nerves that make up this system: motor nerves, sensory nerves, and autonomic nerves. Each one plays an important role in how the body functions. The motor nerves are responsible for movement, the sensory nerves carry sensory information, and the autonomic nerves control involuntary responses.

When one or more of the nerves that make up the peripheral nervous system are damaged or destroyed, peripheral neuropathy occurs.

What Is Peripheral Neuropathy?

Peripheral neuropathy affects the nerves in the hands, feet, legs, and arms. It is the change of nerve function to give less accurate sensory information, motor function, and/or autonomic nerve function.

Symptoms of peripheral neuropathy include multiple variations and combinations of discomfort in the arms or legs, such as:

  • Aching pain
  • Altered sensations
  • Balance problems
  • Burning
  • Interference with sleep due to various symptoms
  • Numbness
  • Restless leg problems
  • Stabbing pain
  • Tingling or jerking
  • Weakness

How Is It Diagnosed?

The history of symptoms leads to the diagnosis with the use of zonal tests, such as EMG, to stimulate the nerves, showing loss of function to varying degrees. Sensory testing can give an idea of the areas of sensory changes. The more precise Pressure-Specified Sensory Device™ (PSSD) provides a way to stage the degree of the problem as well as the sensory changes. 

Those with mild changes from normal may see the improvement of system function with the use of topical and oral medications or other treatments. Moderate changes show more damage and less chance to self-correct. Severe changes have more extensive damage and minimal to no self-recovery chances. 

Due to the duration of the problem and onset pattern, it is sometimes difficult for a person to identify which stage of the problem they are currently in.

What Is the Treatment Process?

Prior to treatment, PSSD testing will be done to stage the degree (mild, moderate, or severe) of the problem. Sensory reeducation practice will begin, allowing time to address any general systemic problems as well as for them to recover and stabilize. Once this process is satisfactory, a mutual decision by the patient and their doctor will be made as to the timing of any interventions.  

For surgical interventions, an outpatient procedure that involves relieving local tight pressure points around the nerves at multiple levels in an arm or leg will take place. It lasts anywhere from 30 minutes to 150 minutes, depending on the number of areas being addressed. Please note that only one extremity at a time is addressed to allow recovery time as well as to avoid overwhelming the patient with the new sensations to be expected with recovery.


The initial protective padded dressing as well as the tag sutures will be removed between 10 and 14 days post-op. Sensory reeducation that was practiced preoperatively will also begin at this stage. Close monitoring of this sensory recovery process will determine the timing of addressing any additional or other extremity issues. 

The postoperative routine is to retest using PSSD between 3 and 6 months and then again at 12 months. This provides a way to monitor recovery during the sensory reeducation process. By 12 months, the majority of sensory reeducation has occurred, depending on the diligence each person uses during their recovery. 

Symptom relief can occur within the first few weeks or longer depending on the degree of the initial problem as well as the type of problem. Improved sensation will allow patients to self-protect from minor injuries becoming major problems as well as to improve muscle function and activity level.  

Patient-Centered Care for Peripheral Neuropathy Begins Here

At OrthoAlabama Spine & Sports, our peripheral neuropathy specialist, Dr. Steven Roberts, is a dedicated expert committed to providing exceptional care focused on you and your needs. 

Dr. Roberts specializes in assessing, diagnosing, and treating peripheral neuropathy and is the only doctor in Alabama that utilizes PSSD testing. He is highly skilled at performing multiple nerve releases for chronic sensory neuropathy of the upper and lower extremities and uses his vast experience and knowledge to provide each patient with the best possible outcome.

Request an Appointment

To schedule an appointment with our peripheral neuropathy expert, please call (205) 228-7600 or request an appointment online.