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Peripheral Neuropathy

Villanueva Institute of Pain and Spine

Peripheral Neuropathy Treatment in Burbank, CA

Peripheral neuropathy can make your feet, legs, hands, or arms feel like they no longer respond the way they should. You may feel burning, tingling, numbness, pins and needles, electric pain, coldness, hypersensitivity, weakness, or a strange feeling that your balance is not as steady as it used to be.

For many patients, neuropathy changes small parts of the day first. Walking barefoot can become uncomfortable, shoes can feel irritating, sleep can be interrupted by burning feet, stairs can feel less secure, and more.

I am Dr. John Villanueva, double board-certified in PM&R and interventional pain management at Villanueva Institute of Pain and Spine (VIPS). When I evaluate peripheral neuropathy, I look at your symptoms, nerve pattern, medical history, medications, prior testing, balance, strength, sensation, and how the pain or numbness affects your daily life.

Neuropathy care starts with understanding what kind of nerve problem you have and what may be causing it. Diabetes, chemotherapy, vitamin deficiencies, thyroid problems, alcohol use, autoimmune conditions, kidney disease, infections, medication side effects, hereditary conditions, and prior injuries can all play a role. Sometimes the cause isn’t immediately clear, but the pattern still deserves careful evaluation.

If you are looking for peripheral neuropathy treatment in Burbank, CA, call VIPS at (818) 669-8895 or request an appointment online. We are located in Burbank and see patients from Glendale, Pasadena, Van Nuys, Toluca Lake, Studio City, Sherman Oaks, North Hollywood, Sun Valley, La Cañada, La Crescenta, Los Feliz, Atwater Village, Silver Lake, Echo Park, and communities throughout the San Fernando Valley and greater Los Angeles area.

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What Is Peripheral Neuropathy?

Peripheral neuropathy happens when nerves outside the brain and spinal cord are damaged, irritated, or not functioning normally. These nerves help control sensation, movement, balance, and automatic body functions.

Many patients think of neuropathy as a foot problem because symptoms often begin in the toes or feet. That is common, but neuropathy can also affect the legs, hands, arms, or other areas depending on which nerves are involved.

Peripheral neuropathy can affect sensory nerves, motor nerves, autonomic nerves, or more than one type at the same time. Sensory nerve symptoms may include burning, tingling, numbness, pain, or sensitivity to touch. Motor nerve symptoms may include weakness, cramping, or difficulty with movement. Autonomic nerve involvement can affect functions such as sweating, digestion, blood pressure, or bladder control.

The most useful question is not only whether you have neuropathy. It is what kind of neuropathy pattern you have, what may be causing it, and what can be done to reduce symptoms, improve safety, and protect function.

What Peripheral Neuropathy Can Feel Like

Peripheral neuropathy can be painful, numb, or both. Some patients feel severe burning pain but still have areas of numbness. Others have little pain, but their balance and foot sensation are affected.

Patients often describe:

  • Burning pain in the feet or hands
  • Tingling, pins and needles, or crawling sensations
  • Numbness in the toes, feet, fingers, or hands
  • Electric, shooting, stabbing, or zapping pain
  • Feet that feel cold, tight, swollen, or wrapped even when they look normal
  • Pain that worsens at night
  • Sensitivity to socks, shoes, sheets, or light touch
  • Loss of balance or feeling unsteady when walking
  • Weakness, cramping, or heaviness in the legs
  • Trouble feeling the floor clearly
  • Difficulty with buttons, writing, gripping, or fine hand movements
  • Symptoms that started after chemotherapy, illness, injury, surgery, or a medical diagnosis such as diabetes


When gradual changes happen, it is worth getting evaluated instead of waiting until the symptoms become harder to manage.

Common Causes of Peripheral Neuropathy

Peripheral neuropathy has many possible causes. Sometimes the cause is clear from the medical history. Other times, testing is necessary to look for treatable contributors.

Diabetic Peripheral Neuropathy

Diabetes is one of the most common causes of peripheral neuropathy. High blood sugar over time can damage nerves and small blood vessels, often leading to numbness, tingling, burning, pain, or reduced sensation in the feet.

Diabetic neuropathy matters because numbness can reduce protective sensation. If you do not feel a blister, cut, pressure spot, or injury, a small foot problem can become more serious. Pain control is important, but so are foot care, balance, blood sugar management, and coordination with your primary care doctor, endocrinologist, podiatrist, or other clinicians when needed.

Some chemotherapy medications can damage peripheral nerves. Symptoms may begin during treatment or after treatment has ended. Patients may notice burning, tingling, numbness, weakness, balance changes, or hand and foot sensitivity.

Chemotherapy-induced neuropathy can be frustrating because it may appear at a time when the patient has already been through so much. A careful plan may include medication management, therapy, balance work, safety planning, and coordination with oncology when appropriate.

Low vitamin B12, thyroid problems, kidney disease, liver disease, and other metabolic issues can contribute to neuropathy symptoms. These causes are important because some may be treatable or manageable when identified.

Lab work may be part of the evaluation, especially when symptoms are new, worsening, unexplained, or not yet clearly tied to a known diagnosis.

Long-term alcohol use can affect nerve health and contribute to numbness, tingling, burning pain, weakness, or balance problems. Nutrition can also play a role.

When alcohol-related neuropathy is part of the picture, treatment may involve pain control, nutritional review, safety planning, rehabilitation, and support for the underlying cause.

Some neuropathies are related to autoimmune or inflammatory conditions. These can require evaluation by neurology, rheumatology, or another specialist, especially when symptoms progress quickly, involve weakness, or do not follow the usual pattern.

Pain management may help with symptoms, but the underlying immune or inflammatory process may need separate treatment.

Peripheral nerves can be injured by trauma, surgery, scar tissue, compression, repetitive strain, or entrapment. Carpal tunnel syndrome, ulnar neuropathy, peroneal neuropathy, and other focal nerve problems are examples.

These patterns are different from a length-dependent neuropathy that affects both feet first. A focal nerve injury may need EMG/NCS testing, bracing, therapy, injection, surgical evaluation, or another targeted approach.

Sometimes testing does not identify a clear cause, and we refer to this as idiopathic neuropathy.

That can be frustrating to hear, but it does not mean nothing can be done. Even when the cause is not fully known, treatment can still focus on reducing pain, improving sleep, protecting balance, supporting mobility, and monitoring for changes.

Peripheral Neuropathy vs. Radiculopathy

Peripheral neuropathy and radiculopathy can feel similar, but they begin in different places.

Peripheral neuropathy affects nerves outside the brain and spinal cord. It often causes symptoms in both feet, both hands, or a stocking-and-glove pattern. Patients may feel burning, tingling, numbness, sensitivity, or balance problems.

Radiculopathy starts at a spinal nerve root. It often travels from the neck into one arm or from the low back into one leg. Sciatica is a common example of lumbar radiculopathy.

This distinction matters because the treatment plan can differ greatly; a patient with diabetic neuropathy may need medication management, balance work, foot care, and possibly spinal cord stimulation for severe painful diabetic neuropathy, while a patient with sciatica from a herniated disc may need spine imaging, an epidural steroid injection, or another spine-focused treatment.

Some patients have both. That is why I look closely at the pattern before recommending care.

When Peripheral Neuropathy Needs Prompt Medical Attention

Some neuropathy symptoms should be evaluated quickly. Seek urgent medical care if you develop sudden weakness, rapidly worsening numbness, trouble walking, loss of bowel or bladder control, new numbness in the groin or saddle area, severe back pain with leg weakness, or symptoms that come on suddenly on one side of the body.

If you have diabetes or reduced foot sensation, you should also seek prompt care for foot wounds, ulcers, redness, swelling, drainage, infection signs, or an injury you cannot feel clearly.

For neuropathy symptoms that are ongoing but stable, a pain management evaluation can help clarify the pattern and treatment options.

Peripheral Neuropathy Treatment Options

Peripheral neuropathy treatment depends on the cause, symptom pattern, severity, and how much it affects your function. The plan may involve treating an underlying medical condition, reducing nerve pain, improving balance, supporting sleep, and protecting daily mobility.

Treating the Underlying Cause

When the cause is known, treating or managing that cause is one of the most important parts of care. That may mean improving blood sugar control, correcting a vitamin deficiency, addressing thyroid disease, reviewing medications, coordinating after chemotherapy, treating autoimmune disease, or managing another medical condition.

Pain treatment can help symptoms, but nerve health also depends on the larger medical picture.

Neuropathy can affect balance because the feet may not send clear information to the brain. Physical therapy can help improve strength, walking confidence, balance strategies, fall prevention, and safe movement.

For some patients, therapy focuses on gait and balance. For others, it may include strengthening, stretching, endurance, assistive device guidance, or ways to move more safely during daily activity.

If neuropathy affects the feet, foot care matters. Reduced sensation can make it easier to miss blisters, wounds, pressure areas, or injuries.

Safety planning may include daily foot checks, properly fitting shoes, podiatry care, fall prevention, home safety changes, and careful attention to skin changes. This is especially important for patients with diabetes.

Some patients benefit from topical medications or local pain strategies for burning, sensitivity, or focal nerve pain. These options may be considered when symptoms are limited to certain areas or when oral medications cause side effects.

Nerve blocks may be discussed when there is a specific nerve pathway that appears to be contributing to pain. This is more common with focal nerve irritation, entrapment, post-surgical nerve pain, or certain regional pain patterns.

For diffuse peripheral neuropathy in both feet and hands, nerve blocks are usually not the main treatment. I will explain when a nerve block fits the pattern and when another approach makes more sense.

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Spinal cord stimulation, or SCS, may be considered for certain patients with severe painful diabetic neuropathy that has not responded well enough to more conservative treatment.

SCS begins with a temporary trial, which gives you and me a chance to see whether stimulation meaningfully reduces pain and improves function before a permanent implant is discussed. I use a device-agnostic approach, which means the system should be selected based on your anatomy, pain pattern, medical needs, lifestyle, preferences, and trial response.

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Medication can be useful when neuropathy is making it difficult to sleep, walk, work, exercise, or get through the day comfortably. Depending on the symptoms, we may discuss options that calm nerve-related pain, reduce burning or electric sensations, support sleep, or make activity more tolerable.

I choose medication carefully based on your diagnosis, medical history, current prescriptions, side effect risk, and prior response. Neuropathy medications often need thoughtful adjustment rather than a one-size-fits-all approach.

Peripheral neuropathy often benefits from coordinated care. Depending on the cause, your plan may involve primary care, endocrinology, neurology, podiatry, oncology, rheumatology, physical therapy, or another specialist.

At VIPS, I focus on the pain, function, nerve pattern, and treatment options within pain management while helping you understand where other clinicians may fit into the larger plan.

How Peripheral Neuropathy Is Diagnosed

Diagnosing peripheral neuropathy starts with the story. I want to know where symptoms began, whether they are spreading, whether they affect both sides, what the pain feels like, and whether weakness or balance problems are present.

During your exam, I may check strength, sensation, reflexes, balance, gait, coordination, skin changes, foot sensitivity, and whether symptoms follow a peripheral nerve pattern or a spinal nerve root pattern.

Testing may include:

  • EMG and nerve conduction studies to evaluate nerve and muscle function
  • Bloodwork to look for diabetes, vitamin deficiencies, thyroid problems, kidney disease, liver disease, inflammation, autoimmune markers, or other contributors
  • Imaging when symptoms suggest spine-related nerve compression or another structural problem
  • Medication review to look for drugs that may contribute to neuropathy
  • Coordination with neurology, primary care, endocrinology, podiatry, oncology, rheumatology, or another specialist when needed


EMG/NCS testing can be especially helpful when numbness, tingling, burning, weakness, or nerve injury needs clarification. It can help show whether symptoms are more consistent with peripheral neuropathy, radiculopathy, focal nerve entrapment, or another nerve or muscle condition.

Good Candidates for Peripheral Neuropathy Treatment

You may benefit from a peripheral neuropathy evaluation if nerve symptoms are affecting comfort, sleep, walking, balance, or daily activity.

Patients often come in with:

  • Burning, tingling, numbness, or electric pain in the feet or hands
  • Pain that worsens at night
  • Sensitivity to socks, shoes, sheets, or touch
  • Loss of balance or feeling unsteady while walking
  • Symptoms related to diabetes, chemotherapy, vitamin deficiency, or another medical condition
  • Numbness or tingling that is spreading
  • Weakness, cramping, heaviness, or reduced coordination
  • Nerve pain that has not improved enough with medication or prior treatment
  • Questions about EMG/NCS testing
  • Questions about spinal cord stimulation for painful diabetic neuropathy


You do not need to know whether the symptoms are coming from neuropathy, the spine, a pinched nerve, or another condition before coming in. The consultation is where we begin sorting that out.

How I Evaluate You Before Recommending Treatment

Before recommending treatment, I want to understand the nerve pattern clearly. Neuropathy is not always straightforward, and symptoms can overlap with spine problems, vascular problems, joint pain, muscle conditions, and medication side effects.

Two patients can both describe burning feet and need different plans. One may have diabetic peripheral neuropathy. Another may have chemotherapy-induced neuropathy. Another may have lumbar spinal stenosis or radiculopathy. Another may have a vitamin deficiency, focal nerve entrapment, or more than one issue at the same time.

During your consultation, I review your medical history, medications, prior testing, symptoms, neurological exam, and functional concerns. I may recommend EMG/NCS testing, lab work, imaging, or coordination with another specialist depending on what the pattern suggests.

I also ask what would make the biggest difference in your life. Sleeping through the night. Walking with more confidence. Feeling safer on stairs. Getting through work without burning foot pain. Standing long enough to cook. Returning to exercise without worrying about balance. Those details help shape the plan.

Why Choose VIPS for Peripheral Neuropathy Treatment?

Peripheral neuropathy care works best when the plan is specific to the nerve pattern, the cause, and the way symptoms are affecting daily life. At VIPS, I evaluate neuropathy through the lens of pain, function, movement, safety, and quality of life.

When you choose VIPS, you can expect:

I am double board-certified in PM&R and interventional pain management. My PM&R training helps me evaluate nerve symptoms, strength, movement, balance, rehabilitation, and daily function. My interventional training allows me to consider targeted pain procedures when they fit the diagnosis. My qualifications extend beyond double-board certification. As a Certified Life Care Planner, I have advanced specialized training in evaluating the long-term medical, rehabilitation, and future care needs of individuals with complex injuries and disabilities, further strengthening the expertise I bring to medical-legal consulting and expert witness services.

I review your symptoms, exam findings, medications, medical history, prior testing, and functional limits before recommending treatment.

Electrodiagnostic testing can help clarify whether symptoms are coming from peripheral neuropathy, radiculopathy, focal nerve entrapment, or another nerve or muscle problem.

Burning, tingling, numbness, weakness, and balance problems can come from several sources. I take time to understand which pattern fits your symptoms.

Care may include medication management, physical therapy, balance training, topical options, nerve blocks for selected focal patterns, spinal cord stimulation for selected painful diabetic neuropathy, diagnostic testing, or coordination with another specialist.

I want to know whether neuropathy is limiting sleep, walking, stairs, work, driving, exercise, travel, or your confidence moving through daily life.

Many patients with neuropathy have been told to live with numbness or burning pain without much explanation. I want you to leave with a clearer understanding of what may be happening and what options are worth considering.

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What Happens During Peripheral Neuropathy Treatment?

Your treatment depends on the cause and pattern of your neuropathy.

If symptoms appear related to diabetes, chemotherapy, vitamin deficiency, thyroid disease, medication effects, or another medical condition, we may coordinate with the appropriate clinician while addressing pain and function. If symptoms suggest a spinal nerve problem, imaging or spine-focused treatment may be part of the workup. If EMG/NCS testing is needed, that can help clarify the diagnosis.

For painful neuropathy, treatment may include medication management, therapy, topical options, balance work, or advanced treatments such as spinal cord stimulation for selected patients with painful diabetic neuropathy. For focal nerve pain, a nerve block or other targeted approach may be discussed.

Before recommending any treatment, I explain what we are trying to improve, why the option fits your pattern, what to expect, and how we will judge your response.

What Should You Expect From Peripheral Neuropathy Care?

Peripheral neuropathy improvement depends on the cause, severity, how long symptoms have been present, and whether the underlying nerve damage can be slowed, treated, or managed.

Some patients notice improved sleep or less burning pain after medication adjustment. Others make progress through balance work, gait training, foot care, or treatment of an underlying medical issue. Patients who undergo spinal cord stimulation begin with a trial to see whether it improves real symptoms in daily life.

I encourage patients to track practical changes. Are you sleeping better? Walking more confidently? Having fewer nighttime flares? Feeling safer on stairs? Using less rescue medication? Standing longer with less burning? Paying attention to these details helps us adjust the plan in a way that actually serves your life.

Peripheral Neuropathy Treatment in Burbank, CA

VIPS is located in Burbank, CA, in the Magnolia Park neighborhood. The office is designed to feel welcoming and personal, with comfortable seating, warm finishes, and original artwork from patients who are working artists.

This is a place where complicated nerve pain stories have time to be heard. I live and work in Burbank, and I care about building a practice where patients feel known, respected, and well informed.

We see patients from Burbank, Glendale, Pasadena, Van Nuys, Toluca Lake, Studio City, Sherman Oaks, North Hollywood, Sun Valley, La Cañada, La Crescenta, Los Feliz, Atwater Village, Silver Lake, Echo Park, and communities throughout the San Fernando Valley and greater Los Angeles area.

Burbank Peripheral Neuropathy FAQs

To schedule a peripheral neuropathy consultation in Burbank, CA, call (818) 669-8895 or contact VIPS online today. The right plan may help you better understand your nerve pain, protect your function, and move through daily life with more confidence.

Diabetic neuropathy is one type of peripheral neuropathy. It occurs when diabetes damages peripheral nerves, often causing burning, tingling, numbness, pain, or reduced sensation in the feet.

No. Sciatica usually comes from irritation of a spinal nerve root in the lower back and often travels down one leg. Peripheral neuropathy affects nerves outside the spine and often causes symptoms in both feet, both hands, or a stocking-and-glove pattern.

EMG and nerve conduction studies evaluate how nerves and muscles are functioning. These tests can help determine whether symptoms are coming from peripheral neuropathy, radiculopathy, focal nerve entrapment, or another nerve or muscle condition.

Bloodwork may be recommended to look for treatable causes or contributors such as diabetes, vitamin B12 deficiency, thyroid disease, kidney disease, liver disease, inflammation, autoimmune markers, or other medical issues.

Some causes of neuropathy can be treated or improved, while others are managed over time. Treatment may focus on controlling the underlying cause, reducing pain, improving sleep, improving balance, and protecting daily function.

Spinal cord stimulation may be considered for certain patients with severe painful diabetic neuropathy that has not responded well enough to more conservative treatment. Patients start with a temporary trial before a permanent implant is discussed.

Nerve blocks may help select focal nerve pain patterns, but they are not usually the main treatment for diffuse neuropathy in feet or hands. I will explain whether a nerve block fits your specific pattern.

The cost of peripheral neuropathy treatment in Burbank can vary depending on the evaluation, medication plan, EMG/NCS testing, lab work, physical therapy, imaging, spinal cord stimulation evaluation, or specialist coordination involved. During your consultation, my team can help you understand what information may be needed for scheduling, authorization, and cost review.

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