Amy, the problem is needling into an area that is insensate and certainly that has decreased circulation. If you feel they are able to be needled I would focus on paravertebrals and down the nerve distributions that are specifically involved. Low volume and use of ENS is suggested.
Hope that helps

Hi Amy!

How long has the patient been diagnosed with peripheral neuropathy? Did they have a formal nerve conduction study to be diagnosed with peripheral neuropathy? As mentioned above, you never want to dry needling in an insensate area. However, dry needling the homeostatic points and paravertebral points associated with this patient's sensation loss is safe. Performing a QST exam will help you create realistic expectations for your patient and how many sessions it may take to expect an outcome.

I've had success in patient's who were diagnosed with "peripheral neuropathy" that did not have a formal nerve conduction study confirmation. My guess is their neuropathy was coming from deficits in the lumbar spine/distal entrapments.

Good luck, and let me know if you need any further clarification.