Physiotherapy can help with Peripheral Neuropathy

Peripheral Neuropathy (PN) occurs when there is damage or disease to the nerves located outside of the brain and spinal cord (peripheral nerves, or away from the centre). Physiotherapists play a vital role in helping individuals improve and maintain functions that may be limited by PN. Peripheral neuropathy has a variety of causes, types and symptoms and therefore it is essential for the treatment plan to be tailored to help each patient address their specific needs and goals. Physiotherapy helps maintain strength, mobility, and function regardless of the underlying cause of Peripheral Neuropathy.

Research has shown that strengthening exercises for peripheral neuropathy moderately improve muscle strength in people with PN. In addition, exercises to help peripheral neuropathy, when done regularly, may reduce neuropathic pain and can help control blood sugar levels.

What does PN feel like? 

In order to understand how PN can affect us, we first need to understand nerve function. Nerves have three functions: 

1. Sensation
2. Motor (movement)
3. Autonomic (nervous system) function 

All three of these functions can be impacted with PN. 

All of the following can be symptoms of PN: 

• Numbness or tingling (it is common for this to start in the feet and hands) 
• Loss of sensation 
• Burning or electric pain 
• Clumsiness 
• Excessive sweating 
• Abnormal nail growth
• Weakness in the affected limbs
• Decreased balance, falls  
• Bowel or bladder changes 
• Decreased ability to complete normal daily activities

Physiotherapy and Peripheral Neuropathy:

• Decreasing pain and numbness
  • There are many different treatment options to help manage the patient’s symptoms, such as hands-on soft tissue work, stretching, and nerve glides. Nerve gliding/flossing are effective exercises to help ‘unstick’ the affected nerves. This type of treatment helps manage mononeuropathies (peripheral neuropathy where only one nerve is affected)
• Improving overall function by maintaining or improving range of motion
  • This can be achieved through hands-on soft tissue work, passive range of motion or home exercises/stretching
  • A physiotherapist can also recommend moderate-intensity exercises that are best suited for the patient, which will help improve their physical function
• Maintain or improve strength 
  •  A specific series of exercises would be taught given a patient’s current strength, endurance and tolerance
• Prevention of falls
  • Balance training and coordination exercises would be prescribed, as well as discussing strategies for home to help prevent a future fall
  • Physiotherapists can also recommend braces and/or splints to enhance balance and posture
• Education: 
  • A great deal of the physiotherapy treatment for any condition focuses on education. With PN the physiotherapist would coach clients on how to improve safety, avoiding further complications, and how to modify daily tasks.