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Alcoholic Neuropathy: Symptoms, Diagnosis, and Outlook

While drinking for some can result in feeling carefree or at ease, for others, it can result in much more serious problems. Having your hands tingling after drinking or experiencing leg pain from alcohol can be signs that you need help.

Chronic, heavy alcohol use can adversely impact several organ systems throughout the body, including the central nervous system (CNS). Alcoholic neuropathy is one of the more common harmful effects of drinking heavily for long periods of time.1 If you are struggling with alcohol use and know or suspect that you’re experiencing neurological consequences of heavy drinking, learning more about alcoholic neuropathy and treatment can help you make more informed decisions about your health and wellbeing.

This article will help you understand:

  • What alcoholic neuropathy is.
  • Alcoholic neuropathy symptoms.
  • Alcoholic neuropathy causes.
  • How alcoholic neuropathy is diagnosed.
  • Treatment and outlook.

What Is Alcoholic Neuropathy?

Alcoholic neuropathy, also sometimes referred to as alcoholic peripheral neuropathy or alcohol-induced neuropathy, is a potentially painful condition that results from progressive peripheral nerve damage.2

Alcohol-related neuropathy may result from chronic, heavy alcohol use, and can have a range of unpleasant and debilitating symptoms.2 Some studies estimate that as many as 66% of people with chronic alcohol use disorder (AUD) may have some degree of neuropathy from alcohol.1

Though the precise cause isn’t well understood, several factors may play a role in the development of alcoholic neuropathy.1 Though it continues to be researched, it’s known that chronic, heavy alcohol use can lead to neuropathy as a result of directly toxic neurological effects of alcohol and its metabolites as well as drinking-related nutritional deficiencies.1

For instance, over time, alcohol and byproducts of alcohol metabolism may cause axonal degeneration and demyelination (deterioration of the protective coating) of neurons.1 Regarding the influence of chronic heavy drinking on nutrition, people who misuse alcohol commonly have deficiencies in thiamine (vitamin B1) which can affect neuronal health and ultimately hasten the development of alcohol-induced neuropathy.1 Other drinking-related nutritional issues can result from the poor intake and absorption of B-vitamins, folic acid, and vitamin E. These nutritional deficiencies may also be associated with this alcohol nerve damage.1

Alcoholic Neuropathy Symptoms

Alcoholic neuropathy is one of the potential long-term effects of alcohol misuse. A range of unpleasant and potentially painful symptoms may arise as a result of cumulative alcohol-related nervous system toxicity and injury.4

Common symptoms of alcoholic neuropathy include:4, 5

  • Painful sensations that may include burning, cramping, or itching.
  • Pin and needles sensation after drinking alcohol.
  • Hyperalgesia, or abnormally intense sensations elicited by painful stimuli.
  • Allodynia, or painful sensations elicited by otherwise non-painful stimuli.
  • Dysesthesia, or abnormal sensations.
  • Loss of sensation.
  • Weakness or numbness after drinking alcohol in the extremities.
  • Feeling cold in the feet.
  • Impaired gait or movement of the limbs.
  • Muscle aches, cramps, or spasms, specifically experiencing leg pain after drinking alcohol.
  • Weakness and muscle atrophy.

How Much Alcohol Causes Neuropathy?

Multiple factors play a role in the development of neuropathy, especially the duration and quantity of a person’s alcohol use.1 One study suggests that a quantity of more than 100 g/day over several years was more likely to cause peripheral neuropathy.1

Because alcoholic neuropathy is the result of chronic, heavy drinking, it can be helpful to understand what constitutes a standard drink and heavy drinking. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) states that 1 standard drink (such as 12 oz of regular beer, 1 oz of distilled spirits, or 5 oz of wine) contains 14 grams of pure alcohol.6

Binge drinking is defined as a pattern of drinking that brings a person’s blood alcohol concentration (BAC) to 0.08% (or 0.08 grams of alcohol per deciliter) or higher. This translates to around 5 drinks for men or 4 drinks for women in around 2 hours.7

The Substance Abuse and Mental Health Administration (SAMHSA) defines heavy drinking as binge drinking on 5 or more days per month. The NIAAA defines heavy drinking as more than 4 drinks on any day or more than 14 drinks per week for men or more than 3 drinks on any day or more than 7 drinks per week for women.7 Both of these patterns of alcohol use can increase a person’s chances of developing an alcohol use disorder (AUD), the clinical diagnosis for alcohol addiction.7

Diagnosing Alcoholic Neuropathy

There are no specific laboratory tests to definitively diagnose alcoholic neuropathy.1 Clinicians typically rely on a complete medical history and a physical examination, as well as additional tests, to exclude other potential causes and support an accurate diagnosis.1, 5

Tests a person may undergo can include:1, 5

  • A blood chemistry test and complete blood count (CBC).
  • Upper GI endoscopy or X-rays of the gastrointestinal tract if a person is experiencing vomiting and nausea for an unknown reason.
  • Electromyography and nerve conduction tests and, in some cases, a nerve biopsy.
  • A neurological exam to test sensory functions and reflexes.
  • Diabetes testing, as this can cause symptoms that are similar to alcoholic neuropathy.
  • Vitamin testing that might specifically analyze thiamine, folate, and vitamin B12 levels.
  • Testing for heavy metals, which could cause neuropathy in the extremities.
  • HIV and syphilis tests, which can also cause nerve damage when the diseases are in their advanced states.

Alcoholic Neuropathy Treatment and Outlook

Treatment aims to stop further damage to the peripheral nerves and help nerves resume normal functioning.4 Abstinence is usually the first step in  alcoholic neuropathy treatment; it can significantly help improve the outlook of the condition.1 Alcohol cessation for several months to years has been shown to help improve alcoholic neuropathy symptoms, and studies involving clinical exams and electroneurography tests show that many people regain complete nerve functioning after a period of abstinence.1

Additionally, treatment can involve eating a nutritionally sound diet or B vitamin supplementation.4 Acute pain may be managed with a range of pharmacotherapeutic agents, including amitriptyline, tricyclic antidepressants, gabapentin, anticonvulsants, topical capsaicin, or over-the-counter pain medications, such as acetaminophen or aspirin. Though these medications may be provided for much-needed symptomatic relief, they do not resolve the underlying problem.4

Other possible alternative treatments that have been evaluated in studies for their potential benefits include alpha-lipoic acid, acetyl-L-carnitine, and vitamin E supplementation.4

Achieving abstinence from alcohol can be challenging, especially if you try to quit drinking on your own. Medical alcohol detox for safe withdrawal management, followed by a period of alcohol treatment, which may involve a combination of behavioral therapy, medications, and mutual support groups, can be a helpful way to begin recovery and maintain sobriety.8 Rehab and abstinence may help improve symptoms of alcoholic neuropathy, your overall health, and your quality of life.1, 5, 8

Research has shown that treatment is effective for many people. According to the NIAAA, studies show that around 1/3 of people who receive treatment for alcohol-related problems have no further symptoms 1 year later, and many others make significant reductions in their drinking and report fewer alcohol-related problems.8

If you are ready to learn more about addiction treatment, American Addiction Centers (AAC) is ready to help. AAC is a leading provider of evidence-based addiction treatment with facilities across the U.S. You can call our free, confidential helpline at for more information about rehab, and easily verify your insurance by filling out the form below.

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