At Well Heeled Podiatry, I’ve seen how peripheral neuropathy can creep into people’s lives – sometimes gradually, other times like a freight train. A tradie who can no longer feel his tools properly, a retired nurse who says her feet feel like they’re “full of ants”, or a mum who’s lost confidence in walking the dog around the block. This kind of nerve pain isn’t just annoying – it’s exhausting, dangerous, and frustrating.
But here’s the good news: you’re not stuck with it. There are ways to manage peripheral neuropathy effectively – and the earlier you get on top of it, the better.
What Is Peripheral Neuropathy?
Peripheral neuropathy is when the nerves outside your brain and spinal cord stop working properly. These are the nerves that help you feel, move, and react. So when they go haywire, the symptoms can range from mild tingling to full-blown loss of sensation or stabbing pain.
You might notice:
- Numbness or pins and needles (especially in the feet and hands)
- A burning or electric shock-type pain
- Trouble keeping your balance or buttoning a shirt
- Feet feeling ice-cold or unbearably sensitive, even in summer
Common Types
Depending on which nerves are affected, you might hear your doctor use one of these terms:
| Type | What it Means |
| Mononeuropathy | One single nerve is affected (e.g. carpal tunnel syndrome) |
| Polyneuropathy | Multiple nerves on both sides of the body – often the feet and legs |
| Multiple Mononeuropathy | Two or more separate nerves affected in different areas |
Most of the patients I see with neuropathy have polyneuropathy, often due to diabetes or B12 deficiency – but we always dig deeper.
What Causes It?
There’s no single cause. Here are the most common culprits we see in clinic:
- Poorly controlled diabetes – hands down the most common in Australia
- Long-term alcohol use
- Vitamin B deficiencies – often missed on a basic blood test
- Autoimmune conditions like lupus or coeliac disease
- Infections such as shingles or Lyme disease (rare but possible)
- Chemotherapy or other medications toxic to nerves
We even see cases linked to workplace chemical exposure – especially in older tradies and mechanics.
Symptoms to Watch Out For
Everyone feels nerve damage a bit differently, but there’s a few red flags you should never ignore:
- Tingling or burning that won’t go away
- Weakness in your legs or hands
- Struggling with balance, especially on uneven ground
- Feet that feel numb or hypersensitive
If left untreated, neuropathy can lead to foot ulcers, infections, falls, and even amputations. It’s not just a “nuisance” – it’s something to take seriously.
Monique’s Tip:
If you’re over 50 and diabetic, your feet should be checked at least twice a year by a podiatrist. Don’t wait until there’s a wound or infection – by then, it’s already too late.
How We Diagnose Peripheral Neuropathy – And Why Guesswork Isn’t Good Enough
I’ve lost count of the number of patients who’ve walked into our clinic with neuropathy symptoms and said, “I thought it was just old age” or “My GP said it might be my circulation.” The truth is, peripheral neuropathy is often misdiagnosed or brushed off – especially in its early stages.
But the earlier we find the cause, the better chance we have at calming things down and avoiding long-term nerve damage.
We start with the basics, but that doesn’t mean we stop there.
1. Medical History & Symptom Timeline
We’ll ask things like:
- When did the symptoms start?
- Is it worse at night?
- Any recent illnesses, surgeries or medication changes?
- How’s your blood sugar control (even if you’re not diabetic)?
Sometimes people don’t realise how relevant their past health is. One patient of mine – a keen bushwalker – had mild tingling for years. Turns out, he’d had gastric surgery ages ago and was chronically low in B12.
2. Clinical Foot & Nerve Check
During your podiatry visit, we’ll test:
- Light touch using monofilaments
- Vibration sense with a tuning fork
- Sharp/dull distinction using neuro tips
- Proprioception – your awareness of where your foot is in space
We also check your foot pulses, skin health and muscle tone. All this gives us a sense of how your nerves are behaving – and how much risk you’re at for things like ulcers or falls.
3. Blood Tests & Imaging
Your GP or specialist might order:
- Full blood count
- B12 and folate levels
- HbA1c (for diabetes)
- Thyroid and liver function
- Inflammatory markers
- Occasionally, an MRI if we suspect nerve compression or spinal causes
We work closely with your doctor to make sure no stone is left unturned.
4. Nerve Conduction Studies
These tests sound scary, but they’re just a fancy way of checking how fast (or slow) your nerves are sending messages. They can help pinpoint whether it’s your peripheral nerves or something further up the chain, like the spine or brain.
Real Patient Story: Grace, 67
Grace came to see us with “tingly toes” that had been getting worse for over a year. She thought it was her shoes – or maybe ageing. After a thorough assessment, we picked up decreased sensation, delayed reflexes and some muscle wasting. Blood tests showed low B12 and borderline diabetes (which had never been diagnosed!). She’s now on supplements, a new diet plan and gets podiatry care every 6 weeks.
She told me last month, “I wish I hadn’t waited so long. I just thought it was something I had to live with.”
Monique’s Tip:
If you’ve had bariatric surgery, take B12 seriously. Even years later, deficiencies can pop up and mimic neuropathy.
Quick Checklist: Do I Need a Neuropathy Assessment?
- Numbness, tingling or burning in hands or feet
- Poor balance or coordination
- History of diabetes, alcohol use or chemo
- Loss of feeling in toes or soles
- Muscle weakness or twitching
If you ticked two or more, book a check-up. Don’t wait.
Over-the-Counter Help for Neuropathy: What Works, What Doesn’t
When your feet are burning at 2am or feel like they’re full of crushed ice, you’ll try just about anything for relief. I’ve had patients come in with bags of creams, pills, sprays – half-used and half-understood. Some work. Some don’t. Some might even make things worse.
So, let’s break it down.
Topical Creams and Patches
These can be a great place to start – especially if you prefer to avoid tablets.
| Type | How it Works | What to Expect |
| Capsicum Cream | Made from chilli – depletes pain neurotransmitters | Can sting at first. Use with gloves. Works best over weeks. |
| Lidocaine Patches | Local anaesthetic – numbs the area | Great for focused pain. Often used on the tops or soles of feet. |
| Menthol Creams | Cooling effect – distracts from nerve pain | Short-term relief. Smells a bit minty but feels good! |
Always patch test first – especially if you have thin or fragile skin (common in older adults or people with diabetes).
Oral Options from the Chemist
While not a cure, these can take the edge off – particularly during flare-ups.
- Ibuprofen or Naproxen (NSAIDs): Good if inflammation’s involved. Avoid long-term use without medical advice.
- Paracetamol: Mild but useful, especially if combined with other strategies.
- Magnesium or Calcium: These can help calm twitchy muscles or cramping, but don’t expect overnight miracles.
Supplements That Actually Do Something
We don’t push pills for the sake of it – but some nutrients really matter for nerves.
| Supplement | Why It Helps |
| B1, B6, B12 | Critical for healthy nerve function. Low levels can cause or worsen neuropathy. |
| Alpha-Lipoic Acid | Antioxidant that’s shown promise, especially in diabetic neuropathy. |
| Magnesium | Helps with muscle relaxation and nerve signal transmission. |
Important: Don’t overload on B6 – too much can actually cause nerve damage. That’s why professional guidance matters.
Be Wary of “Miracle” Products
If someone online promises to cure your nerve pain in 7 days with a spray made from moon dust and seaweed – run. Neuropathy is complex. There’s no silver bullet.
What we recommend is a combination approach:
- Topical relief
- Targeted supplementation (based on blood tests)
- Exercise and circulation support
- Regular check-ins
Real Scenario: Tom, 58 – Office Worker
Tom came in complaining of “cold feet that burn at night.” He’d been using three different creams but applying them too often and too thick. We worked out he had mild diabetic neuropathy, got him onto a proper B12 regimen, taught him how to use capsicum cream once daily, and changed his socks to a moisture-wicking blend. Two weeks later, he said, “It’s the first time I’ve slept through the night without kicking my feet out of the sheets.”
Getting Back on Your Feet: How Movement Helps Peripheral Neuropathy
When your feet feel like they’ve got pins and needles or you’re scared you’ll trip over a crack in the pavement, exercise can feel like the last thing you want to do. But here’s the kicker — it’s one of the best things you can do for neuropathy.
Movement gets blood pumping, improves balance, builds muscle, and helps manage blood sugar — all essential if you want to reduce symptoms or prevent them getting worse.
Why Exercise Helps Nerve Pain
From a podiatrist’s perspective, here’s what regular movement can do:
- Improves circulation: Fresh blood = oxygen and nutrients delivered to damaged nerves
- Builds muscle strength: Especially important if you’ve had muscle wasting
- Enhances balance and coordination: Reduces your fall risk — a biggie with neuropathy
- Helps with fluid retention: Many people with poor circulation get swollen feet or ankles
- Controls blood sugar: Critical if you’ve got diabetic neuropathy
What Kind of Exercise is Safe?
You don’t need to hit a bootcamp or run laps around the Tan. The goal is consistent, low-impact movement that gets you mobile without straining fragile nerves.
Best Exercises for Neuropathy:
| Type | Examples | Why It Works |
| Aerobic | Walking, swimming, aqua aerobics, cycling | Boosts blood flow and cardiovascular health |
| Strength | Light resistance bands, body weight (e.g. sit-to-stand) | Supports joint stability and muscle preservation |
| Balance | Standing on one leg, heel-to-toe walking, Tai Chi | Improves coordination and reduces fall risk |
| Flexibility | Stretching, yoga, Pilates | Keeps joints moving freely and prevents stiffness |
Monique’s Tip:
Start with 10 minutes a day and work up. If walking hurts, try water-based options — many local pools run classes that are brilliant for neuropathy and arthritis.
Setting Up a Weekly Routine
Here’s a realistic plan I often give patients just starting out:
Beginner Neuropathy Exercise Plan:
| Day | Activity |
| Monday | 15 min walk + 5 min foot stretch |
| Tuesday | Rest or gentle yoga |
| Wednesday | Aqua aerobics class or home stretches |
| Thursday | Strength training (resistance band + balance work) |
| Friday | 20 min walk |
| Saturday | Optional – light gardening, Tai Chi, or Pilates |
| Sunday | Rest or walk with family |
Real Case: Kevin, 73 – Former Bowls Player
Kevin used to play bowls three times a week but stopped after developing painful, tingly feet and losing balance. He said, “I felt like I was walking on cardboard.” We started him on basic balance drills using a chair, short daily walks in his yard, and gentle foot mobilisation. Within a month, he was back at bowls once a week with a walking stick for support — and smiling again.
Don’t Wait for Trouble: How Regular Checks Keep You Moving
One thing I’ve learnt in clinic is this: the smallest change in your feet can cause the biggest dramas if it’s ignored. Peripheral neuropathy makes it tricky because the warning signs – pain, heat, injury – often aren’t felt properly. By the time people notice a blister or cut, it’s already infected.
This is why regular foot checks – both at home and with your podiatrist – aren’t optional. They’re essential.
Why Foot Checks Matter
If you’ve got reduced sensation, your risk of foot ulcers, infections, nail trauma, and wound breakdown goes through the roof.
Here’s what I often explain to patients with diabetic or alcohol-related neuropathy:
- That “tiny pebble” in your shoe could wear a hole in your skin before you even feel it.
- Dry skin and cracks between the toes become gateways for bacteria.
- Nail edges digging into numb toes can cause major problems — including cellulitis
How to Check Your Feet at Home (Daily Checklist)
I recommend checking your feet every night before bed – takes 2 minutes.
Foot Self-Check List
| What to Look For | Why It Matters |
| Redness or swelling | Sign of infection or pressure point |
| Cuts, blisters or cracks | Especially dangerous if you can’t feel them |
| Changes in nail shape or colour | Could signal fungal infection or trauma |
| Cold or discoloured toes | May indicate circulation issues |
| New calluses or pressure areas | Often show up before ulcers do |
Use a mirror if you need help seeing your soles — or ask your partner, carer or even grandkids. (I’ve had one lovely lady teach her grandson to “do Nanna’s nightly foot patrol!”)
How Often Should You See a Podiatrist?
| Risk Level | Recommended Check-up Frequency |
| Low (good sensation, no diabetes) | Every 12 months |
| Moderate (mild neuropathy or diabetes) | Every 3–6 months |
| High (known neuropathy, past ulcer/infection) | Every 6–8 weeks |
At Well Heeled Podiatry, we use nerve and circulation testing tools to track changes over time. We also offer nail care, callus removal, orthotic support, and offloading strategies if we see trouble brewing.
Partnering With Your GP or Endocrinologist
Neuropathy doesn’t work in isolation. Whether it’s linked to diabetes, autoimmune issues, chemo, or post-viral complications, we work closely with your broader healthcare team.
- Got diabetes? We’ll help track your foot risk level and pass that info on.
- Just finished chemo? We’ll support you with gentle care and nerve recovery advice.
- Suspect B12 issues? We’ll recommend pathology testing or refer you back to your GP.
Real Case: Janine, 61 – On Her Feet All Day
Janine’s a hairdresser and hadn’t felt her pinky toes in months. She assumed it was from “standing all day”. Turns out, she had undiagnosed pre-diabetes and early neuropathy. With a few changes to her footwear, a B12 supplement, and 2-monthly podiatry visits, she’s now back in comfy runners and says her balance is “ten times better”.
Monique’s Tip:
In summer, watch for sunburn or cracked heels, especially if you walk barefoot or wear thongs. Neuropathy means you might not feel it – but your skin still suffers.
Living With Neuropathy: Your Plan for Staying One Step Ahead
If you’re dealing with peripheral neuropathy, don’t wait for things to get worse before taking action. You don’t have to live in fear of losing your balance, tripping on kerbs, or waking up at night with burning feet. With the right care, the right advice — and a bit of persistence — it’s possible to feel safer, stronger, and more in control.
Over the years, I’ve seen patients go from hobbling in with numb, painful feet to walking their dogs again or getting back on the bowling green. It’s never too late to start.
Your Neuropathy Management Checklist
Here’s a simple plan you can follow to take back control:
Get a Proper Diagnosis
- Book a full nerve and circulation assessment (ask your GP or podiatrist)
- Request blood tests for B12, diabetes, thyroid, and inflammatory markers
- Get a referral for nerve conduction studies if needed
Use What Works (Not What’s Trending)
- Try topical relief (capsicum, lidocaine or menthol)
- Supplement only if clinically low in B12 or other key nutrients
- Avoid “miracle” cures — stick with evidence-backed options
Move Every Day
- Aim for 15–30 minutes of low-impact exercise (walking, swimming, yoga)
- Include basic strength and balance drills a few times per week
- Build it into your routine — even 10 minutes makes a difference
Check Your Feet
- Look at your feet daily for signs of trouble
- Moisturise your heels and between the toes (but not too much!)
- Wear well-fitted shoes with cushioning and toe room
- Avoid walking barefoot, especially outdoors or on hot surfaces
Book Regular Podiatry Visits
- Stick to a schedule based on your risk level (every 6–12 weeks if high risk)
- Ask about custom orthotics or pressure offloading if needed
- Keep your toenails short, smooth, and infection-free
Peripheral neuropathy is common — but that doesn’t mean you should just put up with it. If you’re living with pain, numbness, or foot issues that don’t seem right, please don’t ignore it. Early action can mean the difference between managing it — and losing function.
At Well Heeled Podiatry, we take a hands-on, practical approach that goes beyond orthotics. Whether you’re managing diabetes, post-chemo symptoms, or just feeling unsure what’s going on with your feet, we’re here to help you move better and live confidently.
Give us a call or book online here to schedule your Neuropathy Assessment Appointment.
Let’s get you back on your feet — pain-free, safely, and confidently.
