Burning feet, numb toes, and that pins-and-needles buzz are not just part of getting older. Here is how peripheral neuropathy is recognized, diagnosed, and treated — and what effective care in Southlake looks like.
Dr. William Greenlee
Neuropathy & Nerve Pain Specialist
Most people describe it the same way the first time they sit down with us. A tingling that starts in the toes and creeps upward. Feet that feel like they are wrapped in socks even when they are bare. Nights when the burning is loud enough to keep you awake, and mornings when the floor feels strangely muffled.
Peripheral neuropathy is damage to the nerves outside the brain and spinal cord — the long nerves that carry sensation and signal from your feet, legs, hands, and arms back to the rest of your body. It is common, it is often progressive, and it is frequently dismissed for years as something you just have to live with. You don't.
Below is a clear walkthrough of what peripheral neuropathy looks like, what causes it, how it is diagnosed, and — most importantly — how it is treated here in Southlake, Texas.
Symptoms usually begin in the feet and move upward in a stocking-like pattern, which is why so many people notice their toes first. The most common sensations include:
Worth knowing: numbness is more dangerous than it sounds. When you can't feel your feet, small cuts, blisters, and hot surfaces go unnoticed — and that is how ulcers and infections start. If your symptoms have been building for months, they're worth a proper evaluation rather than more waiting.
Peripheral neuropathy is not one condition — it is a pattern of nerve damage with many possible drivers. In our clinic, we rarely find just one. Most cases are a stack of contributing factors that compound over time.
Sustained high blood sugar damages the small vessels that feed the nerves. Diabetes is the single most common cause of peripheral neuropathy in the U.S.
Nerves need a steady blood supply. Vascular disease and narrowing arteries starve the longest nerves first — the ones reaching your feet.
A bulging disc, narrowed foramen, or arthritic spine can pinch the nerve root feeding a leg — producing symptoms that mimic classic neuropathy.
Some chemotherapy drugs, certain antibiotics, and long-term prescriptions can be directly toxic to peripheral nerves.
Low vitamin B12, vitamin D, or thyroid imbalance can quietly undermine nerve health and are easy to miss without lab work.
Heavy alcohol use, smoking, and long stretches of inactivity all chip away at nerve and vessel health over the years.
In a sizable share of cases — sometimes called idiopathic neuropathy — we can't pin it to one obvious culprit. That's not a dead end. It just means the treatment plan has to be built around your symptoms and exam findings rather than a single label.
A proper neuropathy workup is not a single test — it is a process of elimination. The goal is to separate nerve damage from circulation problems, spinal compression, and blood sugar issues, because each one points to a different treatment.
Where it started, how it has spread, what makes it worse, and what you've already tried. The pattern itself is often diagnostic.
Reflexes, vibration and pinprick sensation, muscle strength, gait, and skin appearance all get tested. These in-office findings usually tell us more than a lab value alone.
Checking pulses, skin temperature, and blood flow helps us see whether the nerves are starved of blood — which changes the treatment focus entirely.
Blood sugar and A1c, B12, vitamin D, thyroid function, and other markers as needed — because correctable deficiencies should never be missed.
When the exam suggests a spinal or structural component, imaging can confirm whether a nerve root is being compressed upstream.
You can read more about who we are and how this evaluation works on our neuropathy doctor in Southlake page.
There is no single pill that reverses peripheral neuropathy, and anyone promising one is overselling. What works is a combination approach that targets the specific causes we found during the exam — circulation, compression, inflammation, and nerve signaling. Here's what that looks like in our Southlake clinic.
Specific wavelengths of light reach into tissue where cells use that energy to support their own repair. Patients commonly report that burning and numbness feel calmer after sessions. Learn more on our red light therapy page.
Gentle electrical currents can calm an overactive pain signal and coax weak muscles back into contracting — useful when nerve damage has left a limb feeling disconnected. See how it works in our electric stimulation therapy overview.
Nerves need blood. Graduated pressure helps move fluid and blood back up the legs, reducing swelling and that heavy end-of-day feeling. We pair it with vibration plate therapy to activate muscles without joint stress. Details are on our leg compression therapy page.
When a disc or narrowed spinal space is pinching the nerve root, the problem is upstream of the feet. Gentle, controlled traction creates space and takes pressure off the nerve. Read about spinal decompression therapy here.
Gentle mobilization, soft-tissue work, and guided corrective exercise release muscles that have been guarding a painful area and restore movement patterns that keep pressure off irritated nerves. This is slow, targeted work — not aggressive cracking — designed to help your gains hold between visits.
We won't promise overnight results, because that isn't how nerves heal. What we look for is a direction — sleeping a little better, walking a little further, fewer bad nights each week. Progress usually arrives in small increments you only notice when you look back a month.
The other honest truth is that consistency decides the outcome. Patients who pair in-office treatment with everyday habits — movement, hydration, blood sugar control — improve faster and hold their gains longer. Our article on daily habits that support healthy circulation is a good place to start.
We are a nerve pain clinic, not a general practice, and that focus shapes everything: how we evaluate, what tools we keep in-house, and how we track progress. Patients from Southlake, Grapevine, Keller, and Colleyville come to us specifically because peripheral neuropathy is what we do all day.
Care is led by Dr. William Greenlee and built around three ideas. First, find the actual cause rather than treating a symptom label. Second, combine therapies instead of leaning on any single device or prescription. Third, measure progress honestly and adjust when something isn't working. No pressure, no overselling, no endless treatment packages that never change.
If your feet have been telling you something for a while, an evaluation is the reasonable next step. You can see our full approach on the neuropathy treatment in Southlake, TX page, or explore the broader nerve pain relief options we offer for diabetic and peripheral neuropathy.
A focused evaluation at our Southlake clinic identifies what's driving your symptoms — and what a realistic treatment plan looks like. No pressure, no one-size-fits-all packages.
771 Southlake Blvd., Suite 123 · Southlake, TX · Mon–Thu 8AM–6PM
Related pages and articles to help you go deeper.
Our full approach to treating nerve pain in Southlake, TX.
The earliest signals of nerve trouble — and why they matter.
Simple daily routines that keep blood flowing to the extremities.
Dr. William Greenlee and the team behind your care.
Supervised compression to improve circulation and reduce swelling.
Relief for disc issues, sciatica, and radiating nerve pain.