Patient Education · Nerve Health & Treatment

Peripheral Neuropathy.
Pain, numbness, and finding your footing.

Nerve damage can affect how your feet feel and how steadily you walk. Understanding the cause comes first; treating pain and improving balance are different goals.

What is peripheral neuropathy?

Peripheral neuropathy means damage to nerves outside the brain and spinal cord. Symptoms can include burning, tingling, numbness, weakness, or difficulty sensing foot position. Causes include diabetes, some cancer treatments, nutritional problems, and other illnesses; sometimes no cause is identified.

Why does balance change?

Reduced sensation can make it harder to judge contact with the ground. Pain intensity alone does not measure fall risk. Evaluation may include sensation, strength, walking, medication review, and tests selected for the suspected cause. Foot protection, treatment of the cause, rehabilitation, and appropriate mobility aids remain important.

Seek prompt assessment for new weakness, rapid progression, falls, or a foot wound. Sudden one-sided weakness or breathing difficulty needs emergency care.

Different goals, different treatments

A treatment plan starts with the cause.

Treatment should match the diagnosis and the problems that matter most: pain, loss of sensation, weakness, or unsteadiness. A device is not the starting point for every patient.

Treat the underlying cause

Care may include diabetes management, correction of a confirmed deficiency, or review of a medicine or other condition contributing to nerve injury. Coordinate changes with the treating clinician; do not assume supplements will help without identifying a need.

Reduce nerve-related pain

For painful diabetic neuropathy, options may include duloxetine, gabapentin, pregabalin, or other selected medicines, and topical treatments such as capsaicin. Benefits and side effects vary. These aim to reduce symptoms, not repair nerves.

Improve function and balance

Physical therapy can address walking, strength, and balance. Appropriate shoes, home-safety changes, and a cane or walker when needed can support safer mobility. Rehabilitation remains important even when another treatment helps pain.

Protect skin and feet

Reduced feeling can hide an injury. Check feet regularly, use suitable footwear, and seek care for wounds or signs of infection. Foot-care or podiatry assessment may be appropriate, particularly with diabetes.

Explore rehabilitation and conservative care

An option for selected persistent pain

When might spinal cord stimulation help?

Spinal cord stimulation (SCS) may be considered for selected patients with chronic painful diabetic neuropathy that persists despite appropriate conventional treatment. Implanted leads deliver electrical stimulation near the spinal cord to help manage pain.

A randomized trial found benefit from adding 10-kHz SCS to conventional medical management in selected patients with refractory painful diabetic neuropathy. Specific systems have FDA-approved indications for lower-limb pain associated with diabetic neuropathy; that does not make every stimulator appropriate for every neuropathy.

Evaluation includes the diagnosis, prior treatments, medical and psychological suitability, and a temporary stimulation trial. Permanent implantation has risks, including infection, bleeding, lead movement, rare serious nerve injury, and possible revision or removal. Relief is not guaranteed.

SCS targets pain. It is not a general treatment for numb feet or balance loss, and should not be presented as a cure for nerve damage. Evidence from painful diabetic neuropathy should not automatically be applied to chemotherapy-related or unexplained neuropathy.

Read the spinal cord stimulation evaluation guide

A wearable sensory prosthesis

What is Walkasins?

Walkasins, made by RxFunction, is a prescription system worn outside the body. A shoe insert detects pressure changes; a connected module provides gentle vibration cues above the ankle, where the wearer must still be able to feel them.

How sensory feedback works · simplified concept

01 · Foot pressure
A sensor insert measures pressure inside the shoe.
02 · Lower-leg cues
The wearable module translates measurements into vibration cues.
03 · Sensory information
The nervous system can use the cues during standing and walking.

Educational explanation, not a photograph or fitting guide. The device does not restore normal foot sensation or repair nerves.

Who might be considered?

People with lower-limb sensory neuropathy and impaired walking or balance who can feel the module’s cues. Diagnosis, skin condition, circulation, fit, and walking ability need assessment; not everyone with neuropathy is a candidate.

Who should not use it?

Manufacturer contraindications include untreated lymphedema; untreated skin lesions, swelling, infection, or inflammation near use; acute thrombophlebitis or deep-vein thrombosis; untreated foot or ankle fractures; and severe peripheral vascular disease. Review the complete safety information with the prescribing team.

It cannot prevent falls. Do not rely on it alone for balance. Skin irritation or injury can occur, especially with poor fit; inspect the feet and lower legs and follow the prescribed instructions.

What does the walk2Wellness study show?

The 2020 walk2Wellness study enrolled 52 people with sensory neuropathy and high fall risk; 45 completed 10-week assessments. Several walking and balance measures improved, but not every measure did.

This was an unblinded, single-arm study without a concurrent control group, funded by RxFunction; some authors had manufacturer affiliations. It cannot establish how much improvement was caused by the device, guarantee fall prevention, or demonstrate a neuropathy cure. Overall pain scores did not significantly improve. The findings support further study, not a promise of individual benefit.

A balance device and a pain treatment answer different questions. Discuss rehabilitation, underlying-cause treatment, foot care, and symptom management alongside any device evaluation.

Common questions & patient concerns

Can neuropathy cause numbness without pain?

Yes. Reduced sensation and balance difficulty can occur without burning pain. Numb feet still need evaluation and protection from unnoticed injuries.

Can treatment reverse peripheral neuropathy?

The outlook depends on the cause, severity, and duration of nerve injury. Treating a correctable cause may help, but no single medicine or device reverses every neuropathy. Pain relief is not the same as nerve recovery.

Which medicines might help burning or tingling pain?

For painful diabetic neuropathy, options can include medicines such as duloxetine, gabapentin, or pregabalin, and selected topical treatments. Kidney function, other medicines, dizziness, sleepiness, and fall risk affect the choice. Do not start, stop, or change treatment without your clinician’s guidance.

When might spinal cord stimulation be considered?

It may be discussed for selected patients with persistent painful diabetic neuropathy despite appropriate conventional treatment. Suitability, device-specific indications, procedural risks, and response to a temporary trial must be reviewed before considering a permanent implant.

Will SCS fix numbness or prevent falls?

SCS is not a general treatment for numbness alone or a substitute for balance rehabilitation and foot protection. Do not assume that evidence for pain relief in diabetic neuropathy applies to every cause of neuropathy or guarantees nerve repair.

Is Walkasins an electrical nerve stimulator?

No. It provides mechanical vibration cues on the lower leg. It is not TENS, an implanted peripheral nerve stimulator, or spinal cord stimulation.

Will Walkasins cure neuropathy or relieve burning feet?

It is intended to help compensate for missing sensory information used in balance. It does not repair damaged nerves. The cited Walkasins study did not show a significant overall reduction in pain; it should not be presented as a proven pain treatment.

What if I cannot feel the device above my ankle?

Being able to perceive its cues is part of the indication. A clinician must test this; having numb feet alone does not establish suitability.

Can I stop using my cane, walker, or physical therapy?

Do not stop prescribed supports or rehabilitation on your own. A wearable device does not remove fall risk; mobility recommendations need individual assessment.

Do all of these treatments require surgery?

No. Medicines, rehabilitation, foot care, and the externally worn Walkasins system do not require an implant. Permanent SCS does involve implantation after an appropriate evaluation and trial.

Will insurance cover the recommended treatment?

Coverage depends on the diagnosis, proposed treatment or device, and your plan. Ask about authorization, fitting or referral arrangements, and a written cost estimate before proceeding.

Peripheral Neuropathy.Pain, numbness, and finding your footing.