This term refers to many conditions that involve damage to the peripheral nervous system. The peripheral nervous system is a communication network that sends signals between the central nervous system (brain and spinal cord) and all other parts of the body.
Peripheral nerves send sensory information to the central nervous system, for example messaging that your feet are cold. They also carry signal from the central nervous system to the rest of your body, most commonly the signals to the muscles telling them to contract.
These nerves can be disrupted in three ways:
- Loss of signal
- Inappropriate signalling
- Errors that stop the messages being sent
Symptoms of peripheral neuropathy. The main symptoms of peripheral neuropathy include:
- Numbness or tingling in the feet or hands
- Burning, stabbing or shooting pain in the affected area
- Muscles weakness – especially in the feet
- Loss of balance and coordination
- Cramps
- Fasciculations (uncontrolled muscle twitching)
- Sensitivity to touch
- Feeling you are wearing gloves and socks when you are not
Health conditions that may cause peripheral neuropathy include:
- Auto immune diseases – Guillain-Barre syndrome, lupus, rheumatoid arthritis, sjogren’s syndrome
- Diabetes- the most common cause, more than half will develop a neuropathy
- Infections- viral or bacteria including shingles, Lyme disease, hepatitis B and C, diphtheria, HIV
- Tumours – that press or grow on the nerves
- Bone marrow disorders
- Alcohol use – poor diet and absorption of vitamins
- Exposure to poisons – toxic substances such as lead or mercury
- Medicines – certain medicines especially chemotherapy used to treat cancer
- Injury or pressure on the nerve
- Low vitamin levels B vitamins as well as copper and vitamin E are crucial for nerve health
Treatment
Medicines
If pain is an issue nonsteroidal anti-inflammatory drugs can help. Anti-seizure medicines such as gabapentin and pregabalin often improve nerve pain. Antidepressants can improve pain by interfering with the chemical processes in the brain and spinal cord that cause you to feel pain. If the neuropathy is caused by an auto immune condition, plasma exchange, steroids and immune globin may be used.
Physiotherapy intervention for peripheral neuropathy
Physiotherapy treatment will help with your exercise tolerance, walking and balance. Exercise prescription and treatments will depend on each individual patient.
- Weight bearing through the joints
- Range of movement to the muscles and joints
- Gait re-education
- Soft tissue massage
- Individualised exercises programmes to strengthen muscles
- Exploration of objects without vision
- Mirror imaging to stimulate nerve pathways
- Pain management which may include hydrotherapy
- Advice on walking aids, orthotics, callipers and wheelchairs if needed
- Other exercise which is good which are low impact minimising stress on your joints are:
- Walking
- Swimming
- Cycling
- Tai Chi
- Yoga
An assessment with one of our physiotherapists will see how the perpherial neuropathy has affected you. Goals will be set for your rehabilitation so that you can achieve your maximum potential. Please call us on 01245 377118 to discuss arranging an appointment.
