Peripheral Neuropathy and Parkinson's: The Connection

3 min read

People with Parkinson's disease (PD) can sometimes have problems with their hands and feet, including weakness, numbness, and pain.¹

Those with this discomfort might be unsure whether these are signs of PD or something else. Studies have been done to determine whether peripheral neuropathy (PN) is more common among people with PD. Peripheral neuropathy is common in the general population. That makes it harder to know if it is more common among people with PD.¹

What is the peripheral nervous system?

The peripheral nervous system is the part of the nervous system that is outside the brain and spinal cord. Peripheral nerves carry messages to and from the central nervous system, which is made up of the brain and spinal cord.¹

The peripheral nervous system has different types of nerves:¹

Autonomic nerves control things that happen in our body without us thinking about them. This includes breathing, heart rate, blood pressure, and digestion.
Motor nerves control muscle movement and contraction.
Sensory nerves send information about what is being felt in the body, like pain, temperature, and touch.

What is peripheral neuropathy?

Peripheral neuropathy is a condition that occurs when there is damage to the nerves of the peripheral nervous system. This damage can cause weakness, numbness, tingling, and pain in the affected area.²

PN can be caused by a number of things, including diabetes, physical injury, certain medicines, vitamin B deficiencies, and infections. PN is most commonly seen in adults over the age of 50.^2,3

Symptoms of PN

Peripheral neuropathy can cause a wide range of symptoms, depending on the nerves affected and how severe the neuropathy is. The most common place to feel symptoms is in your hands and feet. These symptoms include:^2,3

Numbness and tingling
Pain
Burning sensations
Lack of coordination

In some cases, certain types of PN can lead to more severe problems such as muscle weakness or paralysis. It can also cause issues with the autonomic nervous system, which may lead to problems regulating blood pressure or digestion.³

What is the link between PD and PD?

Researchers have looked at the link between PD and PN. But the studies that have been done report mixed results. This may be because the studies:¹

Defined symptoms of PN differently
Used different methods to find causes of PN
Included people that had other conditions which could cause PN (like diabetes or vitamin deficiencies)

Several studies have looked at whether use of the PD drug levodopa may lead to PN. Some have shown that the drug increases the risk of developing PN. However, other studies did not find this. These mixed results are confusing to both those with PD and researchers.¹

There may be a link between PD and PN when a person has a vitamin B12 deficiency. Taking levodopa may increase the risk of developing peripheral neuropathy if this vitamin level is low. Many doctors will check your B12 level if you have PD. You may need to take a B12 vitamin supplement.¹

What does this mean?

More research is needed to confirm a link between PD and PN. If you have PD and have symptoms of PN, talk to your doctor. While there is no cure for either PD or PN, treatments are available to help with your symptoms. These usually include:⁴

Nerve pain drugs such as certain antidepressants and anticonvulsants
Physical therapy
Lifestyle changes

If you have peripheral neuropathy, it is important to work with your doctor to find a treatment plan that works for you. With the proper treatment, you can improve your quality of life and manage your symptoms.

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Marc Mitnick Member
Thank you for the very important and informative article on peripheral neuropathy. I experience it on my feet. More research is needed to relieve this symptom. Marc M., Moderator, ParkinsonsDisease.Net
RobertS Member
I was diagnosed with PD in 2010. For almost eight years my only meds were REQUIP HCL and ER, Selegiline and Amantadine. During that time my PD symptoms were practically nonexistent. However, after I realized the REQUIP had begun causing unusual and strong sexual interests that were not appropriate I removed that medication and replaced it with Senimet. Since then my symptoms have become progressively far worse and advanced at n accelerated pace.
CommunityMember3014 Member
I was diagnosed with PD in 2020 based on a DAT scan. A few months ago I started getting a very uncomfortable sensation of something in my shoes between the lower part of my toes and the balls of my feet along with some slight numbness that comes and goes. No real pain, just extreme discomfort. It only happens when I am sitting or standing, not laying down. It also is worse when wearing shoes. Originally, my MD specialist, primary care physician, and podiatrist all admittedly misdiagnosed it as peripheral neuropathy, and said they thought it was unrelated to my PD. They said unless I developed pain their was nothing they could do about it and over time it was likely to become more and more numb. I did some research online. My symptoms in my mind did not fully conform to those of peripheral neuropathy, so I pushed back on my MD specialist. After further examination on her part, she agreed I do not have peripheral neuropathy but rather that I have dystonia of my toes. Through a combination of an increase in Magnesium, toe separators for my biggest 3 toes, and wide shoes to accommodate them it has largely become a non-issue, and in fact has made me more stable. If it gets worse, I may need botox injections or DBS. So, my strong recommendation is, if a diagnosis doesn't make sense to you, keep on pushing until either you understand or a misdiagnosis is uncovered.
CommunityMember1274 Member
I don't mean to "diss" my fellow travellers on the PD journey to the hell of Stage 5, but as a Type 2 diabetic who has had this discussion with my Specialist MD, who is a Neurologist/Neurophysiologist, more people with diabetes will experience PN than those with PD. I have had two nerve Conduction Studies performed by my Specialist, and my nerves are fine, except for those making me uncomfortable with PN. Sometimes it is difficult for a Specialist to make the correct diagnosis because of comorbidities. Therefore, unless the symptoms are indicative of a disease which is going to kill us, we need to be patient. Thank you for your time.