Peripheral neuropathy is surprisingly common. An estimated 14.8% of U.S. adults over 40 have the condition, making it one of the most widespread neurological problems in the country. That figure translates to tens of millions of Americans living with some degree of nerve damage in their hands, feet, or other extremities.
Prevalence by Age
The risk of peripheral neuropathy climbs steadily with age. Among adults 65 to 74, about 26% have at least one measurable sensory deficit. That rises to 36% for those 75 to 84, and by age 85 and older, more than half (54%) are affected. This steep increase reflects the cumulative toll of diabetes, medication exposure, nutritional deficiencies, and the gradual wear on nerve fibers that comes with aging.
Younger adults can develop neuropathy too, particularly those with diabetes or autoimmune conditions, but age remains the single strongest predictor of who will be affected.
Diabetes Is the Leading Cause
Diabetes accounts for more cases of peripheral neuropathy than any other condition. Up to 50% of people with diabetes develop nerve damage at some point, and for many of them the neuropathy is painful. Among women with diabetes in one large population study, the prevalence of neuropathy reached 40.9%, nearly double the rate in women without diabetes.
The financial burden reflects this severity. Annual healthcare costs for someone with painful diabetic neuropathy average around $23,000, and for those with severe painful neuropathy, costs climb to roughly $34,500 per year. That’s about $17,800 more per patient annually than for someone with diabetic neuropathy that isn’t painful, driven largely by more frequent doctor visits, prescriptions, and emergency care.
Chemotherapy Is Another Major Driver
Cancer treatment causes neuropathy at strikingly high rates. About 70% of patients experience nerve symptoms within the first month of chemotherapy. That number drops to 60% at three months and 30% at six months or later, meaning many people do recover, but a significant minority don’t.
Among those who develop chemotherapy-induced neuropathy, roughly 41% go on to have chronic nerve pain. Certain drug classes hit harder than others: taxanes (commonly used for breast cancer) are associated with painful or moderate-to-severe neuropathy in about 56% of patients, while platinum-based agents cause similar problems in about 44%. Breast cancer, multiple myeloma, and lung cancer patients report the highest rates of lasting nerve pain after treatment, at 61%, 54%, and 51% respectively.
Gender and Ethnicity Differences
Research on whether neuropathy affects certain racial or ethnic groups more than others has produced mixed results. Some studies find minimal differences, while others suggest slightly lower rates among African American and Hispanic adults compared to white adults. One consistent finding across multiple studies is that Japanese American women have significantly lower odds of neuropathy, roughly 67% lower than white women even after adjusting for diabetes and other risk factors. The reasons for this aren’t fully understood but may involve genetic, dietary, or metabolic differences.
Gender-specific data is limited, though one large cohort study of women aged 60 to 73 found that 26.1% of the total sample had peripheral neuropathy, a rate consistent with the broader age-related estimates seen in mixed-gender research.
A Surprising Number of Cases Have No Known Cause
Even after thorough medical evaluation, 25% to 46% of peripheral neuropathy cases are classified as idiopathic, meaning no underlying cause can be identified. This percentage increases with age. For patients, this can be frustrating: the numbness, tingling, or pain is real, but doctors can’t point to a specific disease or exposure driving it.
Beyond diabetes and chemotherapy, the remaining cases with identifiable causes are spread across a wide range of conditions. Alcohol use, vitamin B12 deficiency, autoimmune diseases, infections, kidney disease, and inherited genetic conditions all contribute. Some medications besides chemotherapy drugs can also damage peripheral nerves over time. Because so many different things can cause neuropathy, the condition often goes undiagnosed or is attributed to aging when a treatable cause actually exists.
Why the Numbers Are Likely Underestimated
Most prevalence studies rely on clinical testing or patient-reported symptoms, both of which miss early or mild cases. Many people with neuropathy don’t realize they have it, especially when the initial symptoms are subtle, like slightly reduced sensation in the toes. Others assume that occasional numbness or tingling is a normal part of getting older and never mention it to a doctor. The 14.8% figure for adults over 40 likely captures moderate to obvious cases, while the true prevalence including early-stage nerve damage is almost certainly higher.