If you (or someone you care about) are concerned about the effects of alcohol on your body, you may wish to learn more about this potentially debilitating condition and how you can prevent or treat it. Continue reading to learn more about alcoholic neuropathy, how it’s diagnosed, how common the condition is, signs and symptoms, and how it’s treated.

What is Alcoholic Neuropathy?

Alcoholic neuropathy, sometimes referred to as alcoholic peripheral neuropathy, is progressive peripheral nerve damage that can develop as a result of chronic alcohol abuse. It involves progressive peripheral nerve damage that can result in nerve pain and a range of other symptoms.¹ Exactly how alcohol exposure leads to the development of alcohol-related neuropathy isn’t entirely clear, though several mechanisms have been considered. It is thought that alcohol-related neuropathy could be the result of direct damage at the nerves as well as the toxic effects of low thiamine or other nutritional deficiencies associated with chronic, heavy alcohol use.^1,2

Chronic drinking is sometimes associated with certain nutritional deficits, including deficiencies in several B vitamins such as thiamine, folate, and B12.¹ Deficiencies can occur due to lack of proper food intake or when a person’s body is unable to store or use these nutrients as a result of their excessive alcohol use.^1,3

Chronic, heavy alcohol use may also have direct toxic effects on nerves.³ Your peripheral nervous system includes clusters of nerve fibers that transmit electrical impulses.³ A portion of these fibers is covered by a protective sheath, known as myelin, which helps to swiftly conduct brain signals through nerve cells.³ The toxic effects of alcohol can directly damage delicate nerve fibers and result in demyelination (damage to the protective sheath), which can disrupt the normal transmission of electrical impulses through the nervous system, all of which can lead to neuropathy.³

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Signs & Symptoms of Alcoholic Neuropathy

Signs and symptoms of alcohol-related neuropathy include:^1,2,4

• Numbness in your extremities.
• Pins and needles sensations (i.e., paresthesia).
• Pain with or without burning sensations.
• Muscle problems, such as spasms, cramps, or aches.
• Weakness in your extremities.
• Abnormal gait.
• Intolerance for heat, especially after you’ve exercised.
• Impotence.
• Difficulties with swallowing or talking.
• Autonomic nervous system dysfunction (in relatively severe cases).

How Much Alcohol Causes Alcoholic Neuropathy?

Though a precise amount of alcohol that might lead to alcohol-related neuropathy is difficult to estimate from one person to the next, both the duration of heavy alcohol use and the amount consumed over the course of a lifetime can influence the development of this neurological condition. One past study has suggested that more than 100 grams of alcohol per day over many years can lead to an alcohol-related peripheral neuropathy.⁴

For reference, the National Institute on Alcohol Abuse and Alcoholism (NIAAA) states that one standard drink (such as 12 oz of regular beer or 5 oz of wine) contains 14 grams of pure alcohol.⁵ The Substance Abuse and Mental Health Services Administration (SAMHSA) defines binge drinking as 5 or more drinks for men, or 4 or more drinks women on a single occasion on at least 1 day in the past month, while heavy alcohol use involves binge drinking 5 or more days in the past month.⁶ 

How Common Is Alcoholic Neuropathy?

• Rough estimates indicate that as many as half of those who are long-term heavy drinkers may develop alcoholic neuropathy.¹
• Past studies have more specifically indicated that 25% to 66% of chronic alcohol users may experience alcohol-related peripheral neuropathy.⁴
• Women may be at higher risk of developing alcohol polyneuropathy, with relatively more rapid disease progression and severe symptomatology.⁴

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Alcoholic Neuropathy Treatment & Outcomes

The goal of treatment for alcohol-related neuropathy is to minimize nerve damage and restore proper nerve functioning.⁷ The treatment and recovery process can look different for everyone, and everyone responds to interventions in different ways. However,  some people with alcohol-related neuropathy can improve through abstinence and alcohol abuse treatment.^4,7 In other cases, though, the neurological deficits associated with alcoholic neuropathy can be permanent, and it can worsen if a person keeps drinking.¹

The first step in treating alcohol-related neuropathy is to stop drinking. People seeking help for an alcohol use disorder may first undergo medical detox to manage the unpleasant and potentially risky symptoms of alcohol withdrawal, and later continue with alcohol rehabilitation.⁷ This might mean considering options such as residential rehab or outpatient treatment, as deemed appropriate for your needs.

Additional treatment includes correcting potential nutritional deficiencies with an improved diet and initiation of thiamine, folate, and, and vitamin B12 supplementation as directed by your physician.^1,7 You may also receive medication to manage neuropathic pain, such as gabapentin, pregabalin, and carbamazepine.^1,3

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Depending on the range of symptoms and any functional deficits, you may receive physical therapy or orthopedic devices like splints to help maintain the ability to use your muscles, or compression stockings to assist with dizziness upon standing (orthostasis).¹

For those struggling with alcohol use disorder and concerned about the neurological complications of chronic alcohol use, treatment may help. American Addiction Centers operates several treatment centers throughout the country that can help those looking to recover from Alcohol Use Disorder (AUD) with medical detox, rehab, and other treatment interventions proven to aid in your recovery from AUD.

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Sources

1. S. National Library of Medicine. (2021, May 4). MedlinePlus: Alcoholic neuropathy.
2. Chopra, K., & Tiwari, V. (2012). Alcoholic neuropathy: possible mechanisms and future treatment possibilities. British journal of clinical pharmacology, 73(3), 348–362.
3. Pullen Jr, R. L., & Ruiz, G. A. (2019). Management of alcohol-induced peripheral neuropathy. Nursing made incredibly easy, 17(6), 28-36.
4. Sadowski, A. & Houck, R. (2021, September 18). Alcoholic Neuropathy. In: StatPearls [Internet]. Treasure Island, FL: StatPearls Publishing.
5. National Institute on Alcohol Abuse and Alcoholism. (n.d.). What is a standard drink?
6. National Institute on Alcohol Abuse and Alcoholism. (n.d.). Drinking levels defined.
7. Dudek, I., Hajduga, D., Sieńko, C., Maani, A., Sitarz, E., Sitarz, M., & Forma, A. (2020). Alcohol-induced neuropathy in chronic alcoholism: causes, pathophysiology, diagnosis, and treatment options. Current Pathobiology Reports, 1-11.