Neuropathy doctor guide · San Francisco
Quick answer: neuropathy is treated by several kinds of doctors, including neurologists, primary care doctors, endocrinologists and podiatrists, who diagnose it and manage symptoms. But a diagnosis is only half the answer. TruSpine's chiropractic neuropathy program looks for why your nerves are struggling and treats it without drugs. This guide explains who does what and how our approach differs. See our neuropathy treatment in San Francisco.
The basics
"Neuropathy doctor" is a search term, not a medical specialty. Neuropathy means damage or dysfunction of the nerves, most often the peripheral nerves of the feet, legs, hands and arms. Because it has many possible causes, from diabetes to vitamin deficiencies to pinched nerves, treating it usually takes a team.
Finding the cause comes first, because that decides the treatment. Some causes are reversible. Others can be controlled to slow the damage. Symptoms can be eased in both cases.
Not sure what you have? Read the warning signs of peripheral neuropathy.
The care team
Several kinds of providers treat neuropathy, and each covers a different part of the problem. Here's what each does, and where TruSpine fits.
We examine the spine, joints, nerves and circulation to find what's irritating or starving your nerves, then treat it with a drug-free program of infrared light, electrostimulation, nutrition guidance and hands-on care. See our neuropathy treatment program.
Reviews your symptoms and medications, orders blood tests (blood sugar, B12, thyroid, kidney and liver) and refers you onward. Can start treatment for common causes.
Diagnoses the type of neuropathy with nerve conduction studies and EMG, and manages rapidly progressing, autoimmune, inherited or unexplained cases.
Controls blood sugar and hormone-related causes. Since diabetes is the most common cause of neuropathy, this specialist is often part of the team. Learn about medical weight loss if weight is a factor.
Checks sensation and circulation, treats calluses and wounds, and helps prevent ulcers and infections when your feet are numb.
Manages nerve pain with medication, nerve blocks and rehabilitation, and coordinates care between specialists.
Builds strength, balance and safe movement, and teaches ways to protect numb hands and feet.
Corrects deficiencies such as B12 and builds a diet that steadies blood sugar and supports nerve health.
Why TruSpine
If you've been tested, medicated or told to wait, here's how our approach is different.
Many people with neuropathy are tested extensively and still leave without a clear plan, or are told to live with it. A normal result doesn't mean your symptoms aren't real, and it doesn't mean nothing can be done.
Nerve pain medicines such as gabapentin can ease symptoms for some people, but they don't repair nerves or remove what's irritating them. We look for the causes that can still be addressed.
Spinal nerve compression, poor circulation to the nerves, nutrition gaps and blood sugar swings can all keep nerves from recovering. We check each one and build a plan around yours.
Our neuropathy program uses infrared light, electrostimulation, nutrition guidance and hands-on care, and works with your doctor. No referral needed.
Your first visit
Bring any labs, nerve tests or imaging you've had. We review them so nothing is repeated unnecessarily, and ask about your symptoms, medications, diet and daily activity.
We check sensation, reflexes, strength, balance and circulation in your feet and hands, plus your spine and joints for nerve compression.
We explain what we found, which factors are driving your symptoms, what we can treat, and what to expect.
When it's safe, treatment starts at your first visit, and you leave with a short home plan.
We re-measure sensation and symptoms as you go and adjust the plan, so you can see your progress.
Ready to find out what's behind your symptoms?
Book a neuropathy evaluation. No referral needed, and we work with your doctor.
Go to the ER or call 911 for sudden weakness or numbness, trouble speaking or walking, loss of bladder or bowel control, or numbness in the groin or inner thighs. See a doctor promptly for symptoms that spread quickly over days, a foot sore or infection that won't heal, or new weakness or falls.
Diagnosis
A good diagnosis finds the type and the cause. Here's what to expect.
Your doctor asks about symptoms, medications, alcohol use, family history and other conditions, then tests reflexes, strength, balance and how well you feel touch, vibration and temperature.
Common ones check blood sugar or HbA1c, vitamin B12, thyroid, kidney and liver function, and signs of inflammation or infection.
Nerve conduction studies and electromyography (EMG) measure how well signals travel along nerves and muscles, and help identify the type of neuropathy.
An MRI or CT can look for a pinched nerve. A skin biopsy can check small nerve fibers. These are used only when other tests don't give an answer.
Causes
There's rarely just one cause, and finding yours is the first step of treatment. These are the most common.
The most common cause. Years of high blood sugar damage small blood vessels and nerves, usually starting in the feet.
Some cancer drugs, certain antibiotics and some HIV medicines can damage nerves as a side effect.
Low B12 is a classic cause, and B6, B1 and E also matter. Metformin use, a vegetarian diet and age raise the risk of low B12.
Long-term heavy drinking is toxic to nerves and also depletes B vitamins.
Conditions such as lupus, rheumatoid arthritis, Sjogren's syndrome and Guillain-Barre syndrome can attack nerves.
Shingles, Lyme disease, hepatitis C and HIV can cause nerve damage.
Waste buildup or low thyroid hormone can interfere with nerve function.
Trauma or pressure on a nerve, such as carpal tunnel syndrome, a herniated disc or spinal stenosis, can cause neuropathy-like symptoms.
Conditions such as Charcot-Marie-Tooth disease run in families.
In a notable share of people, no cause is found even after testing. Treatment then focuses on symptoms and protecting nerves.
Treatment
Treatment has two jobs: protect the nerves by treating the cause, and relieve symptoms. These are the standard medical options.
Controlling blood sugar, replacing a vitamin deficiency, changing a nerve-damaging medication or treating an infection can stop the damage and sometimes allow recovery.
Guidelines such as NICE's list amitriptyline, duloxetine, gabapentin and pregabalin as first-line medicines for neuropathic pain. They help many people but can cause drowsiness or dizziness, so work with your prescriber on dose and duration.
Lidocaine and capsaicin creams or patches can ease localized nerve pain with fewer whole-body effects.
Physical therapy, TENS, nerve blocks and, for compression neuropathies, sometimes surgery.
At TruSpine
We work alongside your doctor, not instead of them. Our neuropathy program starts with an exam to find which nerves are affected and why, then combines these therapies.
Low-level infrared light that supports circulation to struggling nerves in the feet and hands.
Gentle electrical signals meant to stimulate under-active nerves and help quiet pain signals.
Targeted nutrition to steady blood sugar, reduce inflammation and supply the nutrients nerves use to repair.
When a nerve is compressed or irritated in the spine, adjustments can take pressure off it.
Acupuncture can ease neuropathic pain for some people, alongside conventional care.
Daily at-home therapy plus regular in-office visits, so progress continues between appointments.
What the research says: evidence for non-drug therapies varies. A 2023 meta-analysis of 25 trials found acupuncture added to conventional care reduced pain in diabetic neuropathy more than conventional care alone, though the authors call for more research. Results vary by person and cause, and we don't promise a cure. We'll tell you honestly whether we expect to help, and refer you when another specialist is the better fit.
Outlook
The honest answer depends on the cause. The sooner it's found and treated, the more nerve function can be protected.
When the cause is fixable, such as a B12 deficiency, a medication side effect, a pinched nerve or an infection, nerves often recover once it's treated.
In diabetic and many other neuropathies, nerve damage usually can't be fully undone, but controlling blood sugar and other causes can slow or stop progression, and symptoms can improve.
Damaged nerves regrow slowly, roughly a millimeter a day, so improvement is measured in months, not days. Earlier treatment protects more nerve function.
Wondering where you fit?
Book a neuropathy consultation. We'll look for the cause and explain your options, and we'll tell you honestly if we're not the right fit.
Visit us
Supreet Shah, DC leads TruSpine's neuropathy program. Both clinics are open Monday to Friday, 8am to 6pm, and you don't need a referral.
50 Francisco St, Suite 257
San Francisco, CA 94133
(415) 421-1115
Clinic details · Get directions
150 Lombard St, Suite 2
San Francisco, CA 94111
(415) 421-1115
Clinic details · Get directions
No single specialty owns neuropathy. Most people start with a primary care doctor or neurologist to find the cause, and the care team often adds an endocrinologist (for diabetes), a podiatrist (for the feet), a pain medicine specialist, a physical therapist and a dietitian. Chiropractors and acupuncturists can add non-drug options, especially when a compressed nerve or chronic nerve pain is involved.
A podiatrist treats foot problems from neuropathy, such as calluses, sores and infections, and a primary care doctor or neurologist finds the cause. If diabetes is involved, an endocrinologist manages blood sugar, which is the key to protecting your feet. Non-drug therapies like infrared light and electrostimulation are also used for foot neuropathy.
You can book directly with TruSpine, and no referral is needed. We review any labs or nerve tests you've had, examine you, and start looking for the cause right away. Many people also keep their primary care doctor or specialist involved, and we work alongside them. See a doctor promptly for sudden weakness, symptoms that spread quickly or a foot sore that won't heal. See our neuropathy treatment program.
Not always. A neurologist is most helpful for nerve testing and for severe, fast-progressing or unexplained cases. Many people with ongoing symptoms, including those who've already been tested, benefit from a program that looks for treatable causes such as spinal nerve compression, poor circulation and nutrition gaps. That's what we do at TruSpine.
A chiropractor can help when neuropathy-like symptoms come from a compressed or irritated nerve in the spine, and can offer non-drug therapies for nerve pain. For neuropathy caused by diabetes, chemotherapy or other medical conditions, research on non-drug therapies is more limited, so chiropractic care works best alongside your doctor's treatment of the cause. See our neuropathy treatment program.
It may. A 2023 meta-analysis of 25 trials involving 1,561 people with painful diabetic neuropathy found that acupuncture added to conventional treatment reduced pain more than conventional treatment alone. The authors note limitations and call for more research. Acupuncture is considered low risk when done by a trained provider.
It depends on the cause. Neuropathy from a fixable cause, such as low B12, a medication, a pinched nerve or an infection, may improve or resolve. Diabetic and many other neuropathies usually can't be fully reversed, but controlling the cause can slow or stop progression and reduce symptoms. Nerves heal slowly, so treat early.
A medical history and exam, blood tests (blood sugar, B12, thyroid, kidney and liver), and nerve conduction studies with EMG are the most common. An MRI, skin biopsy or nerve biopsy is used in selected cases.
The best treatment depends on the cause. Controlling blood sugar, correcting vitamin deficiencies and protecting the skin of your feet come first. Nerve pain medicines, topical creams, physical therapy and non-drug options such as infrared light, electrostimulation, acupuncture and nutrition can add relief.
Neurologists, especially those who focus on neuromuscular disease, are the specialists most associated with neuropathy. Podiatrists, endocrinologists and physiatrists (rehabilitation and pain medicine doctors) also treat neuropathy and its effects.
Ask your primary care doctor for a referral to a neurologist, endocrinologist or podiatrist, depending on your symptoms. If you want to add drug-free options, TruSpine offers a neuropathy program at two San Francisco clinics, and no referral is needed. See our neuropathy treatment page.
Go to the ER or call 911 for sudden weakness or numbness, trouble speaking or walking, or loss of bladder or bowel control. See a doctor promptly for symptoms that spread quickly, a foot sore or infection that won't heal, or new weakness or falls.
Book a neuropathy consultation at either of our San Francisco clinics. We'll look for the cause, explain your options and work with your doctor.
Reviewed by Supreet Shah, DC
Clinic director at TruSpine San Francisco. First published October 2024, last updated October 2026. Related: neuropathy treatment, warning signs of peripheral neuropathy, nerve pain relief.
Sources
Individual results vary. This page is for general information and is not medical advice. Our neuropathy program is designed to complement, not replace, care from your primary physician, endocrinologist, neurologist or oncologist. Never stop or change a prescribed medication without talking to your prescriber.
