What is Polyneuropathy?

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Polyneuropathy is a disease that affects the body’s nerves, especially in the feet and legs. It often leads to numbness, pain, muscle weakness and balance difficulties. Among older adults, polyneuropathy is relatively common and increases the risk of falls, particularly when combined with other conditions such as dementia or stroke.

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A disease of the peripheral nerves

Polyneuropathy means “disease of many nerves” and affects the peripheral nerves that transmit signals between the brain and the body. Since the longest nerves are most vulnerable, symptoms almost always begin in the feet and may spread upward along the legs. When nerve fibers are damaged, communication between the brain and the body is impaired.

Different forms of the disease

There are several different types of polyneuropathy. Sensory polyneuropathy affects sensation and leads to numbness, tingling or pain. Motor polyneuropathy weakens the muscles and can cause difficulty walking. Autonomic polyneuropathy affects the nerves that control internal organs, which may lead to problems with blood pressure regulation, digestion or bladder function. In many older adults, symptoms are mixed, but sensory problems are the most common.

Causes

Polyneuropathy can develop for many reasons. The most common cause in Western countries is diabetes, where long-term high blood sugar damages the nerves, known as diabetic neuropathy. Other causes include vitamin deficiencies, especially vitamin B12, and long-term heavy alcohol use. Chronic kidney disease and certain medications, such as chemotherapy, can also contribute to nerve damage. In some cases, polyneuropathy is linked to infections or autoimmune diseases. Among older adults, it is common that no clear cause is found – this is called idiopathic polyneuropathy.

Symptoms

The disease develops gradually, and symptoms almost always start in the feet. Many describe numbness, tingling or a sensation of walking on cushions. The pain can be burning or stabbing, particularly at night. Over time, balance deteriorates as sensation in the feet worsens, making it harder to feel the ground. Muscle weakness in the feet and legs may also appear, making standing and walking more difficult. In cases of autonomic polyneuropathy, symptoms can include dizziness, blood pressure drops, digestive problems or bladder issues.

Prevalence

Polyneuropathy is not uncommon, and prevalence increases with age. In the general population, about 2–3 percent are affected. Among people over 65 years, the figure rises to around 7–8 percent, and in those over 80, as many as one in five may show signs of the disease.

Diagnosis

Diagnosis is based on a thorough medical history and clinical examination. Reflexes, sensation and muscle strength are tested. Blood samples are often taken to check blood sugar, vitamin levels and kidney function. In some cases, nerve conduction studies (ENeG/EMG) are performed to measure how well the nerves transmit signals.

Treatment

There is no cure for polyneuropathy, but much can be done to relieve symptoms and slow progression. For diabetes, good blood sugar control is essential. If the cause is vitamin deficiency, supplements can make a significant difference. In cases of alcohol-related neuropathy, abstaining from alcohol is crucial. If medications are the cause, adjustments may be necessary.

Symptom relief may include medications that reduce nerve pain. Physiotherapy and balance training strengthen muscles and improve stability. Foot care and proper shoes are important to prevent sores and reduce fall risk.

Polyneuropathy and fall risk

One of the greatest challenges with polyneuropathy is the increased risk of falls. Reduced sensation in the feet makes it harder to maintain balance, particularly on uneven surfaces or in darkness. Muscle weakness contributes to instability, and in cases of autonomic neuropathy, sudden drops in blood pressure may cause falls. The risk is even higher when polyneuropathy is combined with other age-related conditions such as dementia, stroke or vision problems.

Living with polyneuropathy

Living with polyneuropathy often means adapting everyday life. Many people use a cane or walker to feel safer. Regular exercise reduces fall risk and helps maintain muscle strength, while foot care and regular checkups are important to detect problems early. For some, the fear of falling may lead to avoiding activities, which can result in both physical weakness and social isolation.

Safety alarm with automatic fall alarm can increase safety for people with an increased risk of falling

Sensorem’s personal alarm is an example of a technical aid specially developed for people who have an increased risk of falling. The personal alarm can automatically trigger the alarm in the event of a fall and then call relatives using the watch’s built-in speakerphone with two-way communication. The personal alarm works outdoors and has built-in GPS positioning so that relatives can see the user’s position on a map in the Sensorem app.