Lifestyle

5 Signs of Peripheral Neuropathy Most People Blame on Aging

By Erica Coleman · August 7, 2026

Your feet tingle. Your hands go numb. You assume it’s circulation, or sleeping wrong, or just age. It might be your nerves dying.

An estimated 20 million Americans have peripheral neuropathy — damage to the nerves outside the brain and spinal cord — and many don’t know it because the early symptoms mimic what most people expect aging to feel like. The condition progresses gradually, and by the time it’s diagnosed, significant nerve damage may already be permanent.

Tingling or “pins and needles” that doesn’t go away. Everyone’s foot falls asleep occasionally. But when the tingling persists after you move, recurs without an obvious trigger, or appears in both feet symmetrically, it’s not positional — it’s neurological. This “stocking-and-glove” pattern, where symptoms appear in the feet and hands first, is one of the hallmark early presentations.

Burning pain in your feet — especially at night. Unlike the dull ache of a sore muscle, neuropathic pain feels sharp, electric, or burning. It often worsens at night when you’re lying still, disrupting sleep and leading to fatigue that compounds the problem. Many people treat it with over-the-counter pain medication for months before connecting it to nerve damage.

You’re dropping things or losing grip strength. When the nerves that control fine motor function in your hands begin to deteriorate, you notice it in small ways first — fumbling with buttons, struggling to open jars, dropping your phone more often. It feels like clumsiness. It’s actually declining nerve signaling.

You’re losing your balance without a clear reason. Your nerves tell your brain where your feet are in relation to the ground. When those signals weaken, your proprioception — your body’s sense of its own position — declines. You may stumble on flat surfaces, feel unsteady on stairs, or notice that you need to hold railings you never used before. Falls in adults over 60 are frequently caused by undiagnosed neuropathy.

You can’t feel temperature changes in your feet. Stepping into a hot shower and not feeling the heat on your feet, or walking barefoot on a cold floor without noticing, means the sensory nerves are no longer transmitting temperature signals reliably. This is dangerous because it means cuts, burns, and infections on the feet can go unnoticed and untreated.

The most common cause is diabetes — about half of all people with diabetes develop some form of neuropathy. But vitamin B12 deficiency, certain medications (including chemotherapy drugs), alcohol use, and autoimmune conditions can also cause it. A nerve conduction study and blood work can identify both the presence and the likely cause. If you’re experiencing multiple symptoms on this list, mention them at your next appointment — because aging doesn’t cause neuropathy. Nerve damage does.