Recovery from alcoholic polyneuropathy is usually possible, but it requires a person to stop drinking alcohol. Because severe alcohol abuse triggers this condition, comprehensive addiction treatment is generally needed.
What Is Alcoholic Polyneuropathy?
Polyneuropathy is when many peripheral nerves throughout the body malfunction simultaneously. Alcoholic polyneuropathy is polyneuropathy resulting from chronic alcohol consumption.
Alcoholic polyneuropathy can cause pain, loss of muscle control, and a burning sensation in the lower extremities. The condition isn’t fully understood, but the long-term prognosis is favorable if a patient gets properly treated, with the primary focus being on stopping alcohol abuse.
It’s estimated that 25% to 66% of chronic alcohol users in the United States experience some form of neuropathy. Continuous drinkers are more likely to be affected than episodic drinkers.
How Alcohol Use Causes Neuropathy
Exactly why alcohol can cause neuropathy isn’t known. Broadly, alcohol causes damage to nerves in the body, which can then lead to the condition. Some more specific hypothesized explanations include the following:
- Oxidative stress leading to free radical damage to nerves
- Activation of spinal cord microglia after chronic alcohol consumption
- Activation of mGlu5 receptors in the spinal cord
- Activation of the sympathoadrenal and hypothalamic-pituitary-adrenal (HPA) axis
It’s also possible that nutritional deficiency can contribute to the condition. Thiamine deficiency is much more common among people with alcohol use disorder (AUD) who are malnourished than the average American. The direct toxic effects of alcohol may also contribute to the condition.
Effects of Alcoholic Neuropathy
Alcoholic neuropathy will cause pain in the affected areas, and they may also be sensitive to touch. There may be numbness in these areas as well, with a decreased sense of touch and overall dexterity.
Alcoholic neuropathy can affect muscles. Because a person can lose their position sense (sense of the body’s positioning or the position of specific body parts) and may begin to walk and stand unsteadily, muscles that a person normally uses regularly may start to go unused. This can cause muscles to atrophy — weakening and potentially wasting away. In severe cases, muscles can become stiff and permanently shortened.
If left untreated, alcoholic neuropathy is likely to get worse. This is in addition to the other negative health effects that chronic alcohol consumption can have. It is very important to talk with a medical professional if you believe you may have alcoholic neuropathy. Prompt treatment can reduce the potential for long-term damage.
Signs & Symptoms: What to Look Out For
Alcoholic neuropathy will often start with subtle symptoms and then generally worsen over multiple weeks or months. Issues will typically begin in the lower extremities. Some very common early signs are pain, pins-and-needles sensations, and numbness in the toes.
If allowed to progress, alcoholic neuropathy will become more obvious. You may develop difficulty walking or start to feel notably weaker and less dexterous in affected areas.
If you experience any of these symptoms, talk to a doctor right away. Even if you don’t have alcoholic neuropathy, these symptoms signal something is wrong.
How the Condition Is Diagnosed
No individual test can detect alcoholic neuropathy. Once a doctor helps a patient identify that they have some form of neuropathy, they will ask questions and potentially perform some tests to start ruling out alternative explanations. Common tests conducted to get a diagnosis include the following:[2,6]
- STD testing, specifically for HIV and syphilis
- Heavy metal testing
- Nutritional testing
- Diabetes testing
- Chemistry panel
- Nerve conduction testing
- Needle electromyography (EMG)
When trying to determine if you have alcoholic neuropathy, your doctor will ask you about your alcohol consumption habits. Be honest with your doctor. Two of the most important pieces of information are how much alcohol you tend to drink and how long you have been drinking in that way.
Treating Alcoholic Neuropathy
Abstinence from alcohol for a period of several months to a year generally allows a patient with alcoholic neuropathy to improve. Most patients completely regain function.
Treatment may also involve replacing nutrients that a patient is deficient in as well as physical therapy to regain movement and functional abilities.[2,7,8]
Many people struggle to stop abusing alcohol on their own, especially if they have a history of abusing it for a long enough period that they’re at risk for alcoholic neuropathy. Comprehensive addiction treatment is needed to stop drinking and maintain recovery.
Don’t attempt to stop drinking suddenly on your own. If you have alcohol dependence, which is likely if you’ve developed alcoholic neuropathy, you need medical support and supervision during withdrawal. Some symptoms of alcohol withdrawal can be life-threatening.
In a treatment program, doctors will assess your health and potentially prescribe medications to manage the withdrawal process. Some of these medications can be used during ongoing recovery to manage AUD. You’ll also begin therapeutic work, which will be the backbone of your recovery plan.
- Polyneuropathy Merck Manual. Published April 2022. Accessed September 20, 2023.
- Alcoholic neuropathy StatPearls. Published January 2023. Accessed September 20, 2023.
- Chopra K, Tiwari V. Alcoholic neuropathy: possible mechanisms and future treatment possibilities. Br J Clin Pharmacol. 2012;73(3):348-362. doi:10.1111/j.1365-2125.2011.04111.x
- Tsay AJ, Giummarra MJ, Allen TJ, Proske U. The sensory origins of human position sense. J Physiol. 2016;594(4):1037-1049. doi:10.1113/JP271498
- Tessitore ME, Pereira-Rufino L da S, Panfilio CE, et al. Alcoholic neuropathy associated with chronic alcohol intake. IBRO Neuroscience Reports. 2022;13:177-186.
- Electrodiagnostic evaluation of peripheral neuropathy Novello BJ, Pobre T. StatPearls. Published January 2023. Accessed September 20, 2023
- Pullen, Richard L. Jr. EdD, MSN, RN, CMSRN, CNE-cl; Ruiz, Gerardo A. BSN, RN, CCRN. Management of alcohol-induced peripheral neuropathy. Nursing Made Incredibly Easy! 17(6):p 28-36, November/December 2019. | DOI: 10.1097/01.NME.0000585072.80796.bd
- Peripheral neuropathy in chronic alcoholism: a retrospective cross-sectional study in 76 subjects, A. Ammendola, M. R. Tata, C. Aurilio, G. Ciccone, D. Gemini, E. Ammendola, G. Ugolini, F. Argenzio. Alcohol and Alcoholism, Volume 36, Issue 3, May 2001, Pages 271–275,
- Kattimani S, Bharadwaj B. Clinical management of alcohol withdrawal: A systematic review. Ind Psychiatry J. 2013;22(2):100-108. doi:10.4103/0972-6748.132914