Numbness, tingling or burning, usually starting in the feet. Finding a treatable cause is the priority.
Assessed and treated by a GMC-registered GP
Prescriptions, sick notes and referral letters included
A written treatment plan after every appointment
Your NHS records in the room, with your consent
Care led personally by Dr Khan
Attentive, unhurried care that listens properly
Five-star Google reviews from the people we have looked after
Registered with the Care Quality Commission
Peripheral neuropathy is damage to the nerves outside the brain and spinal cord, most often affecting the longest nerves first — which is why it nearly always starts in the feet.
The classic pattern is symmetrical and gradual, described as numbness, pins and needles, burning, or a sensation of walking on gravel or in socks that are not there. It typically creeps up in a "stocking" distribution, and only later affects the hands in a "glove" pattern.
The single most important point: a meaningful proportion of cases have a treatable cause, and it is worth looking properly. Diabetes and alcohol are the commonest, but B12 deficiency, thyroid disease and medication side effects are all reversible if caught — and all are missed regularly.
In a substantial minority no cause is ever found. That is a recognised outcome rather than a failure of investigation.
Numbness carries a specific danger: you can injure a foot without feeling it. Blisters, ulcers and burns from hot water bottles are genuinely common and can be serious.
Frequently overlooked, and sometimes reversible on stopping: chemotherapy agents, metronidazole with prolonged use, isoniazid, amiodarone, nitrofurantoin with long-term use, and phenytoin.
The pattern does most of the diagnostic work — which nerves, which distribution, how quickly it came on, and whether it is symmetrical.
That panel identifies a treatable cause in a meaningful proportion of people, and it is straightforward to arrange.
Nerve conduction studies and EMG confirm the type and distribution, and are arranged by neurology where the picture is unclear, rapidly progressive, asymmetrical, or predominantly motor.
The most useful thing we do is the search for a cause, and that is well suited to remote care — the history plus a comprehensive blood panel we can arrange quickly.
We cannot examine your reflexes, test sensation, or assess your gait — all of which matter. Where the picture is not a straightforward symmetrical sensory neuropathy, we will arrange in-person or neurology assessment rather than treat it remotely.
A prescription is never guaranteed, and neuropathic pain medicines need titration and review rather than a one-off supply.
NHS care covers all of this — the blood tests, neurology referral, nerve conduction studies, podiatry, and the medicines. Diabetic foot protection services are free and genuinely good, and anyone with diabetes and numb feet should be under one.
Anyone on medication for diabetes is entitled to free NHS prescriptions in England via a medical exemption certificate.
Where a private consultation earns its fee is speed and thoroughness of the work-up. The commonest failure in neuropathy is not a missing scan — it is an incomplete set of blood tests done piecemeal over months, so a treatable cause sits undetected. We can arrange the full panel at once.
It is also useful for the medication conversation, since neuropathic pain drugs need explaining and titrating, and people commonly abandon them at too low a dose.
This page follows NICE CG173 on neuropathic pain in adults, which sets out amitriptyline, duloxetine, gabapentin and pregabalin as first-line options and specifically advises against using paracetamol or NSAIDs alone for neuropathic pain.
The investigation panel reflects NICE Clinical Knowledge Summaries on peripheral neuropathy and standard UK neurology practice.
Foot care advice follows NICE NG19 on diabetic foot problems, including the recommendation for annual foot checks and prompt same-day assessment of any new foot ulceration.
The warning on excess vitamin B6 reflects long-established evidence that pyridoxine in high doses is itself neurotoxic — a cause that is easily overlooked because the supplement is taken as a remedy.
It depends entirely on the cause. B12 deficiency and thyroid disease can improve substantially if treated early. Diabetic neuropathy usually stabilises rather than reverses, and good glucose control slows it. Where no cause is found, it often progresses very slowly and many people remain stable for years.
Because nerve pain does not respond to paracetamol or ibuprofen. It needs a different class — amitriptyline, duloxetine, gabapentin or pregabalin — which work on nerve signalling rather than inflammation.
At minimum HbA1c, B12 and folate, thyroid function, full blood count, kidney and liver function, inflammatory markers and coeliac serology. An incomplete panel is the commonest reason a treatable cause is missed.
Possibly — and this is worth checking. Long-term nitrofurantoin, metronidazole, amiodarone, isoniazid, phenytoin and chemotherapy can all cause it. So can high-dose vitamin B6 supplements.
Because the longest nerves are affected first, and the nerves to the feet are the longest in the body. It is also why it moves up the legs before reaching the hands.
The numbness is more dangerous than the pain — you can burn or injure a foot without knowing. Daily foot checks and never using a hot water bottle on numb feet prevent most serious complications.
Rapidly progressive weakness, especially spreading up from the legs, or anything affecting breathing or swallowing. That needs emergency assessment the same day.
September 8, 2026
Ongoing
Time to be seen
Appointment length
Your NHS record in the room
Written treatment plan
Told when a test isn’t needed
Cost
Same day, usually
20 minutes
Yes, with your consent
Included
Yes, and told why
£40 for 20 minutes
Varies by practice
Typically 10 minutes
Yes, your full record
Not routinely
Usually
Free
Same day
Often 10 to 15 minutes
Usually not
Sometimes charged
Varies by provider
Often a subscription
Same-day access is usually available, from 6am to 10pm, seven days a week. You choose a time that suits you rather than waiting on hold at 8am.
Yes. Care is led personally by Dr Mohammad Khan, so you are not passed between clinicians. Continuity is the point of a small practice: someone who knows your history and is listening attentively rather than working through a checklist.
Yes, with your consent. We can access your Summary Care Record during the consultation, so your current medications, allergies and significant history are in the room. That means fewer questions you have already answered elsewhere, and safer prescribing.
No. We are not here to replace GPs, only to support them. Your NHS practice remains responsible for your ongoing care, and with your consent we write to them after the consultation. We are useful when you need to be seen sooner, or want more time than a standard appointment allows.
Twenty unhurried minutes and a comprehensive assessment. A written treatment plan is included, along with any prescription, sick note or referral letter arising from the consultation, at no extra charge.
£40 for 20 minutes, self-pay. Membership is optional and never required. Priced for fairness, because we are not here to charge extortionate amounts for access to a doctor.
It means the diagnosis can usually be made from your history and photographs, and that treatment can be arranged safely without examining you. Where a condition is not marked treatable online, it is because examination is the diagnosis — listening to a chest, feeling an abdomen, examining an ear or a joint — or because a procedure or device is needed.
Yes, where there is a genuine bacterial infection — cellulitis, impetigo, bacterial urine infections, confirmed strep throat. We will also frequently tell you that you do not need one. Most sore throats, coughs, colds and earaches are viral, and an antibiotic gives you the side effects with none of the benefit.
If your problem turns out to be genuinely outside what we can do remotely, the doctor will tell you straight away, point you to the right service, and refund your fee in full. We would rather do that than fill twenty minutes to justify the charge.
Call 999 or go to A&E — do not book an online appointment and do not wait for a reply to an email. For urgent problems that are not emergencies, NHS 111 is available 24 hours a day, online or by phone, and can direct you to the right service.
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