It often starts subtly. A faint burning sensation in the ball of your foot at the end of the day. A feeling like you're walking on pebbles that aren't there. Toes that tingle when you put on your shoes, or a patch of your heel that doesn’t feel sensation anymore. You might shrug it off at first.
But these are signs your feet are trying to tell you something important.
Peripheral neuropathy is damage to the nerves that carry signals between your feet, legs, and brain. Left unmanaged, it can lead to wounds that go unnoticed, infections that spread quickly, and complications that threaten your ability to stay active and independent. For patients living with diabetes or managing the side effects of chemotherapy, that risk is even greater.
At Neville Foot & Ankle Centers, we've spent nearly 40 years helping Greater Houston families take charge of their foot health. Our podiatrists understand that neuropathy isn't a problem you can simply wait out. It’s something that needs to be addressed. With the right care and the right partner, it's a condition you can manage well. If you're noticing changes in sensation, pain, or function in your feet, Neville Foot & Ankle Centers is the right place to start.
What Is Peripheral Neuropathy?
Peripheral neuropathy refers to damage or dysfunction of the peripheral nerves — the network of nerves outside the brain and spinal cord that carries sensory and motor signals to your feet and lower legs. When these nerves are damaged, the signals they send become distorted, delayed, or lost entirely.
The result can be a wide variety of symptoms, including:
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Burning or shooting pain. Many patients describe neuropathy pain as a sharp, electric, or fire-like sensation that comes on without warning, often at night.
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Tingling or "pins and needles." A persistent or intermittent prickling feeling in the toes, ball of the foot, or heel is among the most common early symptoms.
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Numbness or reduced sensation. When nerves lose their ability to transmit signals, areas of the foot may feel dull, deadened, or completely without feeling.
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Muscle weakness. Damage to motor nerves can cause weakness in the foot and lower leg, affecting your balance and the way you walk.
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Increased sensitivity. Some patients find that even light touch — the pressure of a sock or bed sheet — causes significant discomfort.
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Foot wounds that go unnoticed. Reduced sensation is particularly dangerous because it makes it harder to detect cuts, blisters, or pressure sores before they have a chance to become infected.
Symptoms can affect one foot or both, and they may come and go or remain constant. The pattern varies depending on which nerves are involved and what's causing the damage.
Common Causes of Foot and Ankle Neuropathy
Peripheral neuropathy has many possible causes, and identifying the underlying source is a critical part of developing an effective treatment plan. The most common causes our Greater Houston podiatrists see include:
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Diabetes. Diabetic peripheral neuropathy is one of the most prevalent complications of both type 1 and type 2 diabetes. Sustained high blood sugar levels damage the blood vessels that supply the peripheral nerves, impairing their function over time. It is estimated that roughly half of all people with diabetes will develop some degree of neuropathy during their lifetime.
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Chemotherapy-induced neuropathy. Certain chemotherapy drugs — particularly those used to treat breast cancer, ovarian cancer, and multiple myeloma — can damage peripheral nerves as a side effect of treatment. Symptoms may begin during treatment or develop in the months following their completion.
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Trauma or compression. Nerve damage can occur following a foot or ankle injury, surgery, or prolonged pressure on a nerve — such as from a poorly fitted shoe or a structural foot deformity.
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Autoimmune and inflammatory conditions. Diseases like rheumatoid arthritis, lupus, and Guillain-Barré syndrome can trigger nerve inflammation and damage.
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Vitamin deficiencies and other systemic causes. Deficiencies in B vitamins, thyroid disorders, kidney disease, and certain medications can all contribute to peripheral nerve dysfunction.
Because several of these causes share overlapping symptoms, accurate diagnosis — including a thorough patient history and, when appropriate, diagnostic imaging — is essential before treatment begins.
How We Treat Neuropathy at Neville Foot & Ankle Centers
There is no single treatment for peripheral neuropathy that works the same way for every patient. What works best depends on the type of neuropathy, how far it has progressed, your overall health, and your personal goals. That's why our podiatrists take a personalized approach — building a care plan around your specific situation rather than applying a one-size-fits-all protocol.
Treatment options at Neville Foot & Ankle Centers may include:
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MLS laser therapy. This non-invasive treatment uses targeted wavelengths of laser energy to reduce inflammation, stimulate nerve tissue, improve circulation, and ease neuropathy pain — without drugs or downtime.
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Custom orthotics. Prescription shoe inserts reduce pressure on sensitive areas of the foot, help redistribute weight, and protect against the skin breakdown that can occur when sensation is reduced.
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Protective footwear guidance. Choosing the right shoes is particularly important for patients with neuropathy. Our team provides detailed guidance on footwear that minimizes friction, pressure, and injury risk.
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Wound care and monitoring. For patients with reduced sensation, regular podiatric visits are a critical safety net. Our team checks for early signs of skin breakdown, ulceration, or infection and addresses problems before they escalate.
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Medications for symptom management. When appropriate, our podiatrists can coordinate with your primary care or specialist team regarding medications that help manage neuropathy pain.
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Physical therapy and rehabilitation. Targeted exercises help maintain muscle strength, improve balance, and reduce the fall risk that often accompanies neuropathy-related weakness and instability.
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Ongoing monitoring and care coordination. For diabetic patients, regular podiatric monitoring is one of the most important tools for preventing serious complications, including infection, ulceration, and amputation.
Throughout your care, we make it a priority to keep you informed. Dr. Neville and our team take the time to explain what's happening, what your options are, and what warning signs to watch for at home. We've found that our most engaged patients consistently achieve the best long-term outcomes.
Protecting Your Feet for the Long Term
One of the most important things to understand about neuropathy is that the goal of treatment isn't just to manage today's symptoms. The goal is to protect your feet for the years ahead. Neuropathy significantly raises the risk of foot ulcers, infections, and, in severe cases, amputation. The good news is that with attentive, consistent care, many of these outcomes can be prevented.
Routine podiatric visits are especially important for patients with diabetes or those undergoing chemotherapy. Even when symptoms seem mild or stable, regular check-ins allow our team to catch changes early, adjust your treatment plan as needed, and ensure your footwear and daily care habits are providing adequate protection.
At Neville Foot & Ankle Centers, we partner with you to protect your mobility, your independence, and your ability to keep doing the things that matter most to you.