Peripheral neuropathy is damage to the nerves that carry signals between your brain and the rest of your body. The most common presentation is tingling, burning, or numbness that starts in the feet and hands and slowly works its way inward — a 'stocking and glove' pattern. Over 20 million adults in the United States have some form of peripheral neuropathy. In Doral and across Miami-Dade, the most common cause we see is diabetes, followed by vitamin B12 deficiency, thyroid disease, and medication side effects. The right treatment depends on finding the cause, so our first visit focuses as much on diagnosis as on symptom relief. Neuropathy care at Viva Centers is led by our neurology team and coordinated with your primary care provider in the same Doral clinic, in English or Spanish. Call (305) 209-0001 to schedule, or message our WhatsApp booking line at +1 (305) 209-0716.
Conditions We Evaluate and Treat
Neuropathy is not one disease — it is a pattern of nerve damage with dozens of possible causes. These are the ones we evaluate and manage most often in Doral:
- Diabetic peripheral neuropathy — the most common cause in Doral and the one most responsive to early glucose control
- Post-chemotherapy neuropathy (CIPN)
- Vitamin B12, folate, or thyroid deficiency neuropathy
- Alcohol-related neuropathy
- Autoimmune neuropathy and small-fiber neuropathy
- Idiopathic neuropathy — when workup does not identify a cause
- Compressive neuropathies (carpal tunnel, ulnar, peroneal) evaluated and referred appropriately
- Neuropathy with balance problems or falls, where gait and safety are the priority
Neuropathy Symptoms: When to Get Evaluated
Patients often wait months because the symptoms come and go. These are the signs that deserve an evaluation rather than another few weeks of waiting:
- Tingling, pins-and-needles, or burning in the toes or fingertips — especially if it is worse at night
- Numbness that feels like wearing thin socks or gloves that are not there
- Sharp, electric, or stabbing pain that comes in waves
- Weakness in the feet or hands — tripping, dropping objects, difficulty with buttons
- Balance problems, unsteadiness in the dark, or a recent fall
- A foot wound, blister, or callus that you did not feel developing — urgent for patients with diabetes
- Symptoms that started after a new medication, chemotherapy, or a change in alcohol use
What Your First Visit Looks Like
Neuropathy is a clinical diagnosis refined with targeted testing. The first visit is focused on history, a neurological exam, and ordering the tests that actually change treatment.
- Detailed history — when it started, what it feels like, what makes it better or worse
- Sensory, motor, and reflex exam to map the distribution of nerve involvement
- Blood work panel — glucose, HbA1c, B12, folate, thyroid, kidney, liver, and inflammation markers
- Nerve conduction studies or EMG referral when the exam suggests large-fiber involvement
- Review of all current medications to identify nerve-toxic agents
- Foot exam and risk assessment for patients with diabetes
- A written plan before you leave — what we are treating now, what we are still testing for, and when we will see you again
Managing Nerve Pain and Symptoms
Symptom treatment starts at the first visit. Root-cause treatment takes longer but is what slows or stops progression.
- Prescription options for neuropathic pain — we discuss the class, not a brand name, and pick what fits your other medications and conditions
- Topical treatments for focal burning or allodynia
- Physical therapy referral for balance, gait, and fall-prevention training
- Supplement recommendations where evidence supports it (alpha-lipoic acid, targeted B-vitamin repletion when deficient)
- Foot-care education for patients with diabetic neuropathy to prevent ulcers
- Referral to pain management or neurosurgery when focal entrapment is the culprit
Root-Cause Treatment
Treating the underlying cause is what changes the long-term trajectory. Most of the common causes are modifiable.
- Tight glucose control for diabetic neuropathy, coordinated with our primary care team
- Repletion of B12 or folate when lab-confirmed
- Thyroid correction when hypothyroidism is present
- Alcohol counseling and referral when alcohol use is contributing
- Medication review to stop or substitute nerve-toxic agents where possible
- Referral to rheumatology or hematology when autoimmune or hematologic causes are identified
Diabetic Neuropathy: Why Early Care Matters
How We Measure Progress
Nerve pain is subjective, so we track it on purpose. At each follow-up we compare the same markers so you and your provider can see whether the plan is working or needs to change:
- A 0–10 pain score and a sleep score, recorded the same way every visit
- Sensation mapping — how far up the foot or hand the numbness reaches, repeated with the same monofilament and tuning-fork exam
- Function — walking distance, balance on one foot, and the daily tasks you told us were hard at the first visit
- Labs that explain the cause — HbA1c, B12, and thyroid levels trended over time
- Medication effect versus side effects, so a dose is changed on evidence rather than on a guess
- Foot skin and nail checks for patients with diabetes, documented so a small change is caught early
Living With Neuropathy — Long-Term Support
- Quarterly follow-ups to track symptom change, side effects, and labs
- Foot exam at every visit for patients with diabetic neuropathy
- Coordination with a podiatrist for at-risk feet
- Medication adjustments as symptoms evolve
- Fall-risk screening and home-safety counseling for patients with balance or gait issues
- Mental health support — nerve pain often coexists with anxiety and low mood, and we screen for both
Neuropathy Care for Doral, Hialeah, Kendall and All of Miami-Dade
Insurance and Scheduling
- In-network with Oscar Health, Aetna, Cigna, Humana, Medicare Advantage, Ambetter, UnitedHealthcare
- Same-day evaluation available for acute worsening
- Telehealth follow-ups for medication adjustments and lab review
- Bilingual care in English and Spanish
- Self-pay rates available for patients without insurance
Sources
- NINDS — Peripheral Neuropathy — National Institute of Neurological Disorders and Stroke (NIH)
- NIDDK — Diabetic Neuropathy (Nerve Damage) — National Institute of Diabetes and Digestive and Kidney Diseases (NIH)
- MedlinePlus — Peripheral Nerve Disorders — U.S. National Library of Medicine (NIH)
- StatPearls — Peripheral Neuropathy (NCBI Bookshelf) — NCBI Bookshelf / StatPearls (peer-reviewed)
Frequently Asked Questions
What are the first signs of peripheral neuropathy?
Usually tingling, pins-and-needles, or burning in the toes and fingertips. Some patients describe it as numbness, like wearing thin socks that aren't there. The pattern often worsens at night. Early evaluation matters because treating the underlying cause — especially uncontrolled blood sugar — can slow or even reverse nerve damage.
Can diabetic neuropathy be reversed?
Partially, sometimes. Early diabetic neuropathy can improve significantly with tight glucose control, and many patients see less pain and better sensation within 6-12 months. Longstanding neuropathy tends to stabilize rather than reverse, which is why starting treatment early matters. We coordinate diabetes management and neuropathy treatment in the same clinic.
What tests will I need?
A blood panel looking at glucose, HbA1c, vitamin B12, folate, thyroid, kidney function, and a few inflammatory markers. If the exam suggests large-fiber involvement, we refer for nerve conduction studies or EMG. Most patients do not need an MRI unless the pattern suggests a nerve-root or spinal cord cause.
Is the treatment lifelong?
Symptom treatment often is, but the underlying cause treatment can change the picture. Patients with B12 deficiency, for example, may recover fully once levels are restored. Patients with diabetic neuropathy usually need both long-term symptom control and glucose management, but the plan is reassessed at every visit.
Do you accept Medicare for neuropathy care?
Yes. We accept traditional Medicare (Part B) and most Medicare Advantage plans in-network, including Aetna, Cigna HealthSpring, Humana, and several regional Medicare Advantage carriers. Call (305) 209-0001 with your plan name for a quick verification.
Can telehealth work for neuropathy follow-up?
Yes for follow-ups — medication adjustments, lab review, and symptom tracking. The initial evaluation is usually in-person because we need to perform a neurological exam. Once the plan is established, most patients alternate between in-person and telehealth visits, which keeps care consistent when pain makes travel harder.