Substance Use

Alcoholic Neuropathy: Causes, Symptoms, Treatment, & Prevention

alcoholic foot neuropathy

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Alcoholic-related neuropathy (ALN) is a serious and irreversible condition that can lead to severe pain and physical disability. It impacts up to half of chronic drinkers.

Alcoholic neuropathy is a condition that occurs when excessive alcohol consumption damages your nerves. Specifically, alcohol consumption can lead to peripheral neuropathy (ALN). (1)

If you’re suffering from ALN, it means your peripheral nerves have been damaged, which can lead to dysfunction in sensory, motor, and autonomic processes. Here’s what you need to know about the risks of alcohol-related nerve damage and the toxic effects of alcohol.

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What is Alcoholic Neuropathy?

Alcohol-related peripheral neuropathy (ALN) can occur when someone drinks a lot of alcohol, which is often the case in individuals suffering from alcohol use disorder and high alcohol use.

It’s unknown how exactly alcohol consumption causes alcoholic neuropathy, a toxicity in the body. However, it’s thought to be the deficits of both direct nerve poisoning caused by alcohol and poor nutrition or malnutrition, which is often a side effect of alcohol addiction. According to Medline Plus, up to half of long-term heavy alcohol users will develop ALN. (2)

Risk Factors and Causes of Neuropathy

Understanding neuropathy involves peeling back the layers to reveal the intricate web of risk factors and causes contributing to this nerve-damaging condition. From the duration and quantity of heavy alcohol use to genetic predispositions and nutritional deficiencies, below are some risk factors.

  1. Duration and Quantity of Alcohol Consumption: The relationship between alcohol and neuropathy is closely tied to the duration and quantity of alcohol intake. Prolonged and excessive consumption places individuals at a heightened risk of nerve damage. Chronic alcohol abuse contributes to the direct toxic effects of ethanol on nerve tissues, leading to neuropathic symptoms. (1)
  2. Nutritional Deficiencies: Poor nutrition resulting from alcohol dependence can contribute significantly to neuropathy and other impairments. Alcohol interferes with absorbing and utilizing essential nutrients, particularly B vitamins (B1, B6, B12), vitamin E, and certain minerals. Nutritional deficiencies compromise nerve health and function, increasing susceptibility to neuropathy.
  3. Genetic Predispositions: Genetic factors play a role in determining an individual’s susceptibility to alcohol-related neuropathy. (3) Some people may have a genetic predisposition that makes them more vulnerable to the neurological consequences of alcohol abuse. Understanding one’s genetic background can provide valuable insights into personalized risk assessments.
  4. Metabolic Factors: Individuals with certain metabolic conditions, such as diabetes, are at an elevated risk of neuropathy when coupled with alcohol consumption. Diabetes already poses a threat to nerve health, and alcohol exacerbates these effects, amplifying the risk of neuropathic symptoms.
  5. Age and Gender: Age and gender can influence the likelihood of developing alcohol-related neuropathy. Older individuals may be more susceptible due to the cumulative effects of alcohol over time. Additionally, studies suggest that gender differences may exist, with some evidence indicating that women could be more vulnerable to alcohol-induced nerve damage.
  6. Liver Function: The liver plays a crucial role in metabolizing alcohol, and compromised liver function can contribute to neuropathy. Chronic alcohol abuse may lead to liver damage, impacting its ability to detoxify the body and increasing the risk of neuropathic complications. (4)
  7. Individual Sensitivity: Variability in individual sensitivity to alcohol’s neurotoxic effects contributes to divergent outcomes in terms of neuropathy risk. Some individuals may experience nerve damage even with lower levels of alcohol consumption, highlighting the importance of recognizing individual susceptibility.
  8. Co-Existing Health Conditions: The presence of other health conditions, such as autoimmune disorders or chronic infections, can amplify the impact of alcohol on nerve health. Understanding how pre-existing health conditions intersect with alcohol consumption provides a more comprehensive understanding of neuropathy risk.

Symptoms of Alcoholic Neuropathy

ALN can leave a person disabled. People who suffer from ALN often sustain multiple injuries due to falls, and in turn, they can suffer significant head trauma that can contribute to their disability.

Some of the symptoms of alcoholic neuropathy include:

  • Feeling pain and numbness in your arms and legs, likely linked to the central nervous system
  • “Pins and needles” and other strange sensations throughout your body
  • Problems with your muscles, including muscle weakness, aches, spasms, and cramps
  • Intolerance to heat, especially after physical exertion
  • Incontinence and trouble urinating
  • Stomach upset, including constipation, diarrhea, nausea, and vomiting
  • Trouble talking or swallowing
  • Feeling unsteady when walking due to issues with the spinal cord
  • Vitamin deficiencies
  • Slow degeneration

Diagnosis and Testing

If you’ve been drinking for a while, it’s important to get a physical exam and discuss any negative symptoms you may be experiencing. A nerve biopsy, nerve conduction tests, and electromyography (EMG) may all be used in the diagnostic process. (5)

In many cases, chronic drinkers are unable to store and use various vitamins and minerals, so a blood test may be used to see if you’re deficient in certain areas.

The most common deficiencies that could point to ALN include:

  • Thiamine deficiency
  • Pyridoxine
  • Pantothenic acid
  • Vitamin B12
  • Folate
  • Vitamin B3
  • Vitamin A

Other causes can lead to neuropathy besides alcohol, so your healthcare provider may order additional tests to confirm what has caused your symptoms. For instance, they may check your thyroid function, neurons, electrolyte levels, and heart health.

If it is confirmed that ALN has caused your symptoms, it’s essential to understand the impact of this diagnosis on your quality of life and the steps you can take to preserve nerve function. Knowing your future treatment possibilities is key.

The first step for addressing alcohol-related neuropathy is to go through alcohol rehab or otherwise stop drinking. From there, you can work with your healthcare team to determine the best treatment plan based on the severity of your condition.

Unfortunately, there is no cure for ALN. Rather, your treatment program will be built around the goals of controlling your symptoms and preserving your independence for as long as possible. Your healthcare team will also take strides to reduce the risk of injury.

Certain vitamin supplements, including folic acid and thiamine, will likely be provided to you during treatment since people with ALN tend to be deficient in these areas.

If you are experiencing weakness, reduced muscle function, or control, you may be given orthopedic appliances to improve your stability. You’ll likely also be asked to participate in physical therapy to help regain and maintain your strength.

If you are experiencing pain because of your condition, you may be prescribed pain medication. However, if you have a history of substance use disorder or chronic alcoholics, you may be suggested to use alternatives to regular pain medications, like massage or acupuncture.

Several neuropathy symptoms can occur with damage to the peripheral nervous system, so it’s essential to work closely with your doctor to figure out a plan that’s best for you.

For instance, some people may experience dizziness that may improve with the following:

  • Dietary changes
  • Special sleeping positions
  • Certain medications like antidepressants
  • Compression stockings

Many of the side effects resulting from ALN must be managed individually. For example, bladder problems may require medications of their own or special devices, like using catheters. (6)

There is no known reliable cure for ALN. You may need to try many therapies and options before you and your medical team work out what is best to manage your side effects, restore nerve function where possible, and prevent further damage. 

Living with Alcoholic Neuropathy

Because ALN leads to muscle weakness, an unstable gait, and reduced sensation in certain body parts (especially the arms and legs), it’s essential to take precautions to help prevent falls and injuries.

Some things that your health team might suggest to keep you safe with ALN include:

  • Use a thermometer to check the temperature of your bath or shower before you step in
  • Switching to shoes that provide a more stable foundation
  • Inspecting your feet and shoes often to remove obstructions
  • Avoiding pressure on your extremities

If you’ve been diagnosed with ALN due to high consumption of alcohol, and need help with alcohol addiction treatment, you should seek out a treatment center that’s prepared to help you manage your co-occurring disorders and symptoms while effectively treating your alcohol use disorder. (7)

Your health team may recommend practical suggestions to enhance safety and mitigate risks associated with ALN:

  1. Temperature Checks for Bath or Shower: Using a thermometer to assess the water temperature before entering helps prevent burns or discomfort, as ALN may compromise your ability to sense extreme temperatures.
  2. Footwear Considerations: Opting for shoes with a stable foundation can improve balance, reducing the risk of tripping or stumbling.
  3. Regular Foot Inspections: Regularly inspecting your feet and shoes ensures a clear path and minimizes obstructions, reducing the chances of injuries related to impaired sensation.
  4. Pressure Management: Avoiding prolonged pressure on extremities is crucial. Shifting positions regularly and employing supportive aids can prevent discomfort and potential complications.

Seeking treatment for alcohol addiction is an essential aspect of managing ALN. It’s key to find a treatment center equipped to address co-occurring disorders, manage symptoms effectively, and provide tailored care for alcohol use disorder, ensuring a comprehensive and supportive approach to your well-being.

How to Prevent Alcohol Neuropathy

Alcohol neuropathy, a condition characterized by nerve damage due to excessive alcohol consumption, can be mitigated and prevented through a multifaceted approach.

Implementing lifestyle changes, embracing early intervention, and moderating alcohol consumption are key components in preventing alcohol neuropathy.

  1. Moderation and Responsible Drinking: The most effective way to prevent alcohol neuropathy is to practice restraint and consume alcohol responsibly. Limiting the quantity and frequency of alcohol intake can significantly reduce the risk of nerve damage. Individuals should adhere to recommended guidelines for safe alcohol consumption and be mindful of the cumulative effects of drinking over time.
  2. Healthy Lifestyle Choices: Adopting a healthy lifestyle contributes to overall well-being and can protect against alcohol neuropathy. This includes maintaining a balanced diet rich in essential nutrients, engaging in regular physical activity, and prioritizing sufficient sleep. These lifestyle choices support nerve health and resilience.
  3. Early Intervention for Alcohol Use Disorder: Recognizing signs of alcohol use disorder and seeking early intervention are crucial preventive measures. Addressing AUD through counseling, therapy, or support groups can prevent the escalation of alcohol-related complications, including neuropathy. Seeking professional help allows individuals to develop coping mechanisms and establish healthier behavior patterns.
  4. Regular Medical Check-ups: Periodic medical check-ups provide an opportunity to assess overall health, including the impact of alcohol consumption on the nervous system. Healthcare professionals can identify early signs of neuropathy or other alcohol-related complications, enabling timely intervention and preventive measures.
  5. Supplemental Nutrition: Certain vitamins and nutrients are vital in nerve health. Individuals at risk of alcohol neuropathy may benefit from supplements, including B vitamins (especially B1, B6, and B12), vitamin E, and omega-3 fatty acids. Consultation with a healthcare provider can help determine appropriate supplementation based on individual needs. (1)
  6. Hydration and Hygiene: Staying adequately hydrated supports nerve function and overall health. Proper hygiene practices, especially for individuals with alcohol use disorder or alcohol abuse, can prevent infections and complications that may contribute to neuropathy. (8)
  7. Avoiding Binge Drinking: Binge drinking, defined as consuming large amounts of alcohol within a short period, significantly increases the risk of alcohol-related nerve damage. Avoiding binge drinking and spacing out alcohol consumption allows the body to process alcohol more effectively, reducing the impact on the nervous system.

By adopting a proactive and holistic approach that combines responsible drinking, healthy lifestyle choices, early intervention, and regular medical monitoring, individuals can significantly reduce the risk of alcohol neuropathy. Prevention efforts safeguard nerve health and contribute to overall physical and mental well-being.

Get Help for Alcohol Use Disorder

Heavy drinkers may experience several health scares, not short of liver failure and severe health implications like ALN. But, that doesn’t make it any easier to stop drinking.

At Zinnia Health, we know that addiction is a mental health condition, and that’s why we’re determined to help individuals overcome it through support groups, proven therapies, and a holistic approach to wellness.

We offer a range of treatment options, including inpatient and outpatient care designed around the individual. Whether you’re beginning to experience the signs of ALN, like decreased muscle strength, or if you’re trying to get away from drinking before alcohol causes irreversible damage to your body, we can help.

At our treatment centers, we provide:

  • Individual, group, and family counseling
  • One-on-one, customized treatment pathways
  • A team of experienced, caring providers

Ready to take the next step toward an alcohol-free life? Zinnia Health is standing by to help. Our team is available 24/7 to answer your questions. Dial (855) 430-9439 to get started.


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