[Numbness and Pain in the Limbs: A Practical Approach to the Diagnosis and Treatment of Numbness and Pain].

This review provides a practical approach to evaluating and managing patients presenting with numbness and pain in the extremities. It emphasizes that careful history-taking and neurological examination remain the foundation of anatomic localization before imaging or electrophysiological studies are considered. The review summarizes the epidemiology, differential diagnosis, appropriate laboratory testing and neurophysiological investigations, indications for specialist referral, and current treatment strategies. Particular attention is given to distinguishing among nociceptive pain, neuropathic pain, and the recently recognized category of nociplastic pain because each requires a different therapeutic approach. The review also discusses chronic sensory symptoms frequently encountered in older adults, including patients with idiopathic distal sensory polyneuropathy and small-fiber neuropathy, in whom conventional investigations may be inconclusive. The review places these conditions within the spectrum of age-related peripheral nerve dysfunction while acknowledging emerging evidence for previously unrecognized etiologies. The review concludes that neurologists should focus not only on identifying serious neurological disorders but also on recognizing and validating patients' subjective sensory symptoms. A systematic clinical approach, combined with appropriate referral and individualized management, can substantially improve diagnostic accuracy and patient care in routine neurological practice.