Home » Peripheral Neuropathy – A Physical Therapy Perspective

Peripheral Neuropathy – A Physical Therapy Perspective

May 14, 2024

Do you have any of these neuropathy symptoms?  Numbness in your hands and feet?  Sleep disturbance due to painful numbness and burning in your feet?  Poor balance with fall episodes or near falls? Difficulty walking?  Difficulty using your hands/fingers for fine coordination such as fastening buttons and doing zippers?  Fatigue due to a number of symptoms?

It is estimated that there are as many as 20 million people of all ages who have a form of peripheral neuropathy.  22% of all adults ages 60-74.  50% of persons with diabetes.  Elderly persons with neuropathy have a 50% greater chance of injury due to falls.

It is important to note that all neuropathy is not the same.  There are a variety of causes of neuropathy and knowing the underlying cause should help steer the correct treatment approach.  Physical Therapists want to work with you and your doctor in order to find the best solutions for the type of neuropathy you may be experiencing.  At Optimal Physical Therapy and Sports Performance, our approach is a very individualized one.  Our evaluation of your condition will include outcome measures that you answer to provide us with your personal, internal experience with neuropathy followed by an extensive physical exam which will look at specific sensory testing, reflexes, blood flow/strength of pulse, skin integrity,  flexibility and muscle strength testing, balance testing and an evaluation of how you are walking, upper body/hand tests if needed. as well as if you experience blood pressure issues or excessive sweating.

Conditions that contribute to neuropathy include diabetes Type1 and Type2, prediabetes, exposure to chemotherapy agents, autoimmune disorders such as CIDP (Chronic Inflammatory Demyelinating Polyneuropathy), history of Lyme’s disease or HIV, nutritional deficiencies, amyloidosis with chemo treatment, hereditary disorders, others and sometimes unknown.  Physical Therapists have received training in understanding many medical conditions and how to design the best treatment plan while modifying for the nuances with which different conditions that can produce neuropathy symptoms present.  Physical Therapy is also a profession that focuses on functional activities and performance/stamina for activities.  We want to help you feel better but we also want you to move better.  We also want to teach you how to move safely within your current limitations and to improve your movement patterns.

Because neuropathy is not a single disease, there is complexity to understanding it and to managing it.  There is no direct cure however, there are several options to help manage symptoms.  It is also important to note that nerves do several different things for the body.  Some are sensory and give your nervous system information about sensation and what is happening around you.  Others are motor nerves that send signals from the brain and spinal cord to your muscles so that your muscles can contract and produce enough effort to move you.  Still others are autonomic in nature. These nerves help regulate blood pressure, body temperature and aid digestion.

At Optimal Physical Therapy and Sports Performance, all the issues surrounding your neuropathy will be assessed and discussed with you.  You may need intervention for flexibility or strength building, balance training, walking training, education on how to pace activities to avoid fatigue, equipment recommendations for foot support such as orthotics or bracing, pain management interventions and support in general to feel like you are getting your life back.  We promise a comprehensive approach and will empower you to understand all that you can do to help yourself.

Finally, here are some simple ideas that you can begin to implement for yourself:  If you have diabetes, do your best to control your blood sugar levels.  Avoid chemical toxins including alcohol consumption and smoking.  Eat a healthy diet of fruits and vegetables. Try to lose weight if needed.   Good sources of Vitamin B12 (good for nerve health) includes meats, fish, eggs, low fat dairy foods and fortified cereals.  Talk to your doctor if a B12 supplement may be a good idea.  Exercise can reduce cramps, improve muscle strength and prevent muscle wasting. Take care of your feet.  Inspect them daily to note if there is a blister, callus or cut present that needs attention.  Wear supportive and wide enough shoes to avoid compression.  Loose cotton socks are helpful as well as keeping your skin moisturized.  Dry scaly skin can contribute to sensory discomfort/pain.  Set priorities for your physical exertion.

There are things that can be done to help you at this time.  Find the right team members for your health journey.  We at Optimal Physical Therapy and Sports Performance would be happy to meet you.





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