Peripheral Neuropathy and Physical Therapy

Peripheral neuropathy is a disorder of the peripheral nervous system due to damage to the peripheral nerves. Damage to these nerves interrupts the communication between brain and other parts of the body.

It results from a variety of causes like trauma, infections, autoimmune disorders, systemic infections, inherited disorders, metabolic or endocrine disorders, toxic causes, alcoholism , certain cancers and benign tumors and vitamin deficiency especially vitamin B and Vitamin E. Diabetes is a very common cause of Peripheral Neuropathy.

Peripheral Neuropathy is of four types mainly

1.Sensory neuropathy, in which part of the sensory system(which connects to the skin) is damaged causing pain, tingling, numbness, or loss of sensation. It usually progress from distal to proximal i.e. it first starts in fingers or toes.

2.Motor neuropathy is characterized by damage to the motor nerves (which connects to the muscles) resulting in motor weakness and atrophy. Also symptoms of tiredness, heaviness, cramps, tremor, muscle twitch (fasciculations) and gait abnormalities are present.

3.Autonomic neuropathy is characterized by damage to the autonomic nerves(which connects to the internal organs), affecting blood pressure, heart rate, sweating, digestion, and bowel and bladder function.Symptoms may include urinary incontinence, constipation, diarrhea, dizziness and fainting.

4.Mixed neuropathy, in which two or more of the above mentioned types are present.

Treatment Dimensions– Identifying and treating the underlying the cause is most important thing. However, following measures are utmost important for symptomatic relief and restoring lost functions.

(a)Pain Relief- TENS, Transcutaneous Electrical Nerve Stimulation therapy has shown to be effective and safe in the treatment of peripheral neuropathy.

(b)Flexibility or stretching exercises-They are important for improving muscle mobility, function and blood circulation in the affected area.It also helps in maintaining range of motion.

(c)Strengthening of muscles-To regain the lost muscle strength, make muscles injury resistant and reducing the feeling of numbness and tingling.It can be done by using weights or resistance bands to target the necessary muscle.

(d)Braces or splints- To improve balance and posture.It can be used for compression neuropathies like carpal tunnel syndrome.

(e)Practicing functional activities are also important.

(f)Treatment through vibrations or ultrasound.

(g)Balance and coordination training to improve gait and posture- especially important in elderly population to decrease the risk of fall.

(h) Nerve gliding activities- Exercises to move or glide nerves to promote nourishment and healing of nerves.

Safety is an important consideration for patients with peripheral neuropathy. Muscle weakness and loss of sensation increase the risk of injuries and falls.It can be prevented by following measures.
* Avoiding open toes or high heels and not to walk barefoot.
* Take care while cooking by using heat resistant ladles and pot holders.
* Inspect your feet regularly for any cut, bruise or blister. 
* Wear socks and gloves when needed.
* Keep the skin moisturized.
* Make environment safe by removing obstacles in home, use adequate light at night, use handrails while ascending or descending stairs and using non slip bath mats in bathroom.

Send your queries to bloggerarorae@gmail.com

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