Neuropathy in Your 60s and 70s: When “It’s Just Aging” Isn’t True

You’ve been told the burning, tingling, numbness, or shooting pain in your feet is just part of getting older. Maybe by your primary care doctor. Maybe by a neurologist. Maybe by another podiatrist. “It’s neuropathy. We can give you something to help with the symptoms, but there isn’t much else we can do.”

That’s not the whole truth.

I’ve spent 30+ years as a board-certified foot and ankle surgeon, with more than 40,000 patients treated at Marble Falls Podiatrist. Across that practice, I’ve seen too many patients in their 60s, 70s, and 80s accept neuropathy as a sentence — when a complete diagnostic workup and the right conservative protocol could have given them meaningful relief.

Aging doesn’t cause neuropathy. Specific underlying problems do. And many of those problems are partially or fully treatable, even in older adults.

What “just aging” misses

Peripheral neuropathy — damage to the nerves supplying the feet and lower legs — has identifiable causes. The most common in older adults:

• Diabetes and prediabetes (the leading cause)
• Vitamin B12 deficiency (extremely common, often missed)
• Medication side effects (chemotherapy agents, certain antibiotics, and others)
• Alcohol-related neuropathy
• Thyroid disease
• Autoimmune conditions
• Nerve entrapments (tarsal tunnel syndrome and others)
• Spinal nerve root compression
• Heavy metal exposure (less common but worth screening for)
• Idiopathic — meaning no identified cause despite a complete workup

The “it’s just aging” diagnosis usually means one of two things: the underlying cause was never identified, or the patient was diagnosed with idiopathic neuropathy without the full workup that would have ruled in or ruled out treatable contributors.

Both are problems. Idiopathic neuropathy is a real diagnosis — but it should only be given after the treatable causes have been ruled out.

What a real neuropathy evaluation includes

A complete neuropathy evaluation at Marble Falls Podiatrist goes well beyond “do your feet feel numb?” It includes:

• Full medical and medication history
• Detailed symptom mapping — where, when, what triggers, what helps
• Vascular assessment to evaluate blood flow to the feet
• Neurological testing: vibration, light touch, sharp/dull discrimination, deep tendon reflexes, proprioception
• In-office diagnostic imaging where indicated
• Review of recent lab work, or recommendations for what to order, particularly B12, glucose, hemoglobin A1c, thyroid function, and other relevant panels
• Evaluation for nerve entrapments that mimic generalized neuropathy
• Biomechanical evaluation, since foot mechanics affect nerve compression and symptom patterns

Many of our neuropathy patients have never had this complete workup. And many discover meaningful information through it — a B12 level that needs supplementation, a tarsal tunnel that’s locally compressed, a medication that’s contributing.

What actually helps

When the underlying cause is identified, treatment becomes specific:

• Diabetic neuropathy. Blood sugar control is foundational. Beyond that, specific protocols for foot protection, ulcer prevention, and symptom management apply.
• B12 deficiency. Often responds to oral or injection supplementation, sometimes dramatically.
• Medication-related neuropathy. Reviewing the medication list with the prescribing physician can sometimes identify a contributor that can be adjusted or replaced.
• Nerve entrapment. Specific protocols, including targeted physical therapy and selective interventions, can relieve local compression.
• Idiopathic neuropathy. Even when no specific cause is identified, conservative management — foot protection, custom medical orthotics where applicable, targeted exercise, footwear modification, advanced in-office therapies including Class IV laser, and selective medications for symptom management — can meaningfully reduce symptoms.

The phrase “nothing can be done for neuropathy” is medically inaccurate. Things can be done. The question is whether the right things have been tried.

Foot protection isn’t optional

Whatever the cause of neuropathy, foot protection becomes critical. Diminished sensation means you can’t always feel when something is hurting your foot — and that’s when problems escalate from minor to serious.

Practical protective measures we discuss with neuropathy patients:

• Daily footwear inspection. Check inside shoes for pebbles, folded seams, or objects you might not feel underfoot.
• Daily skin inspection. Look at your feet (use a mirror if needed) for cuts, blisters, redness, or color changes. Catch problems early.
• Properly fitted shoes with adequate room. No tight shoes. No barefoot walking on hard, rough, or hot surfaces.
• Custom medical orthotics in some cases, particularly when there’s a structural concern or pressure-related issue that needs offloading.
• Regular podiatric checkups. Not optional for neuropathy patients with diabetes. Periodic preventive visits catch problems before they become serious.

Why timing matters

Neuropathy that’s caught and addressed early often responds better than neuropathy that’s been progressing for years. The nerves have more capacity to recover from a recent insult than from one that’s been chronic for a decade.

That’s why “wait and see” isn’t usually the right strategy. If you have foot numbness, burning, tingling, or shooting pain — and especially if it’s progressing — a complete evaluation now matters more than next year.

What an evaluation looks like

A neuropathy consultation at Marble Falls Podiatrist takes about an hour and includes everything described above — full history, neurological testing, vascular assessment, biomechanical evaluation, and review of recent labs with recommendations for additional testing where indicated. You leave with a complete picture of your options and the time to make the decision that’s right for you. Learn more about our approach to peripheral neuropathy treatment, or review the full range of foot and ankle conditions we treat.

We see neuropathy patients from across the Highland Lakes and Hill Country, including Marble Falls, Burnet, Kingsland, Horseshoe Bay, Granite Shoals, Llano, Lakeway, and the surrounding Austin area. Many of them have been told their symptoms are just aging — and many leave their first visit with a clearer understanding of what’s actually going on, and what can be done.

The bottom line

If you’ve been told your foot numbness, burning, or tingling is just part of getting older, get a second opinion. Aging isn’t a diagnosis. Neuropathy has identifiable causes, and even when those causes can’t be reversed, the symptoms can usually be reduced with the right protocol.

You don’t have to accept neuropathy as something you have to live with. You don’t have to keep wearing shoes that hurt. And you don’t have to lose more sensation, function, or quality of life because someone told you there was nothing to be done.