Proximal neuropathy is sensory and motor nerve damage to the peripheral nervous system (PNS) affecting primarily the hip and thigh area.

Within the body, the nervous system is made up of two main divisions: the central nervous system (CNS) and the (PNS). The CNS consists of the brain and the spinal cord. The PNS connects the brain and spinal cord to the rest of the body. These two systems control movement and sensation in the body.

Within the peripheral nervous system, the basic units are neurons (nerve cells). These cells have bundles of fibers classified as:

• Motor fibers. These nerves carry messages from the central nervous system to organs and muscles. When the muscle receives the message it reacts with an action or movement. Motor neurons are responsible for voluntary movements (those the body can control).
  
  
• Sensory fibers. These nerves carry messages from sensory receptors throughout the body. The messages, or nerve impulses, provide information about physical feelings such as pain and temperature. The messages are sent from the body to the central nervous system in the spinal cord and brain.
  
  
• Autonomic fibers. These nerves are involved with the involuntary functions of the body (things that typically are not consciously controlled). These functions include breathing, regulation of blood pressure, sweating, digestion and bladder control. The autonomic nerves help control these functions whether the individual is awake or asleep.

Proximal neuropathy affects the motor or sensory nerves in the body. It does not affect the autonomic nerves that control the involuntary systems in the body. The problems from this neuropathy vary depending on which nerves are damaged. The symptoms from this condition are caused by related damage to:

• Motor nerves (involved with muscle function). Damage to these nerves can result in muscle weakness, poor coordination and reduced movement.
  
  
• Sensory nerves (involved with the feeling of sensations). Damage to these nerves may result in tingling, pain or numbness. These problems are less common than the motor nerve damage.

Proximal neuropathy most commonly occurs in people with diabetes over the age of 50, but can also appear in youth. It is less common than some other forms of diabetic neuropathy (e.g., peripheral, autonomic).

Diabetic neuropathy is believed to be caused by several changes in the nerves. When the nerves are surrounded by a high level of glucose (blood sugar), they adjust their inner workings to be in balance with their surroundings. To create this balance, the nerve cells produce and store a sugar called sorbitol. The sorbitol damages the nerve cells, resulting in problems such as pain, numbness or motor weakness. In addition, the nerves may be damaged when they do not receive enough oxygen from the surrounding blood vessels.

The condition is more common in people with type 2 diabetes than those with type 1 diabetes. There is no difference between males and females or ethnic groups in the risk of developing this neuropathy.

As with other neuropathies, poorly controlled glucose is considered to be a factor in the onset of proximal neuropathy. Some people with diabetes may have an underlying peripheral neuropathy that can cause additional problems. Others may have no symptoms other than those associated with proximal neuropathy. Proximal neuropathy can last from several weeks to more than a year, depending on the type and severity of the nerve damage.

According to the American Diabetes Association (ADA), individuals who have had diabetes for 25 years or more have a 60 to 70 percent chance of developing some form of neuropathy. Although proximal neuropathy is not a common form of nerve damage, it can cause considerable pain and weakness. Studies have shown that tight control of glucose can reduce or eliminate symptoms of diabetic neuropathy.