Neuropathy and Physical Therapy

August 3, 2021

What is it?

Peripheral neuropathy (PN) is a condition affecting the nerves of the body that results in a variety of symptoms including pain, changes in sensation, and changes in muscle activity. PN typically affects nerves in the extremities such as the lower legs and feet.

Information and causes?

PN can be associated with other diseases such as diabetes, injury, and overuse. It can also be associated with medication use. Neuropathy can also occur for reasons unknown. Some of these symptoms have been shown to improve over time, but many do not. It can affect the nerves in the body in various ways. It is generally classified by the number of nerves affected. The more nerves affected, the more severe the case.

Examples:

• Mononueropathy affects 1 nerve. For example, carpal tunnel affects the median nerve resulting in altered sensation and weakness in the hand.
• Polyneuropathy affects 2 or more nerves. This is usually caused by a disease process and can affect nerves in multiple body parts, on both sides of the body.
• Neuritis results from nerve inflammation. This can be caused by infection or injury. It can even be caused by chemical exposure.

The signs and symptoms?

The signs and symptoms of PN can vary. The location and type of nerves affected determine the symptoms. Those with PN may experience:

• Numbness and tingling sensations typically beginning in feet and hands, and can spread up into legs and arms
• Loss of sensation (inability to feel objects you encounter)
• Increased sensitivity to light touch
• Pain (burning, sharp, electric)
• Falls
• Poor wound healing
• Decreased ability to participate in usual functional activities
• Weakness and paralysis of muscles
• Clumsiness and decreased coordination
• Decreased balance

Treatment?

Treatment by a physical therapist can help reduce symptoms of PN in some cases and reduce the effect the symptoms have on movements and activities to improve an individual’s quality of life. Because the cause, type, and symptoms of PN can vary, the therapeutic approach will also vary. For instance, if you have loss of sensation in your feet, education and recommendations about proper footwear is imperative if not already addressed by another provider.

It is key that a person receive physical therapy as soon as possible after being diagnosed, particularly if physical function is impaired. The Physical Therapist will initially focus on educating the patient about the condition and expectations. Research shows that people who are knowledgeable about their condition have better coping abilities. Furthermore, your therapist will work to initially decrease any pain and improve mobility and gradually improve strength and function to return to life pain free and with full function. The physical therapist will design a program that is right for you and your goals.

Expectations?

At your first visit you should expect a physical therapist that is there to get to know you, your current complaints, and your goals. Using this information and the information they gather during their evaluation they will set up an individualized treatment plan that will help you reach your goals and get back to your life faster. Treatments could include modalities for pain control, manual therapy to help relieve muscle tension and promote healing, exercises to restore strength and motion, and muscular retraining to improve core activation and stabilization. These can include but are not limited to nerve gliding techniques to improve nerve function, exercise as tolerated to improve strength, balance and coordination training to reduce fall risk and improve function.

References

https://www.news-medical.net/health/Peripheral-Neuropathy-Symptoms.aspx

https://www.choosept.com/symptomsconditionsdetail/physical-therapy-guide-to-peripheral-neuropathy