Peripheral Neuropathy is a condition used to describe damage to the peripheral nerves of the body resulting in numbness and pain. The condition most commonly affects the feet and hands with the nerves that act to send messages from the central nervous system (brain and spinal cord) to the peripheries via the peripheral nervous system damaged. Peripheral neuropathy has multiple causes including; traumatic injuries and pressure on the nerves, infections, metabolic problems including diabetes mellitus, inherited/genetic conditions, and exposure to toxins. Peripheral neuropathy can affect sensory, motor and autonomic nerves resulting in a wide variety of symptoms. Symptoms include: stabbing pain, burning and tingling, lack of co-ordination and falls, weakness in the area and paralysis.
A variety of exercises have demonstrated the ability to assist with the symptoms of Peripheral Neuropathy when prescribed using the correct dose and pain response. Exercise should aim to increase strength, endurance, flexibility, co-ordination, function and mobility whilst minimising muscle wastage and pain. Research has indicated that pushing through the pain can result in an increase of affected area requiring close monitoring during the initial phases of exercise rehabilitation. Patients and practitioners should also be aware of the remittance response. Due the often-cyclic nature of Peripheral Neuropathy symptoms, an improvement in symptoms may not be the best indicator of an improvement of the condition, rather an emphasis is required on functional capacity.
Given the complex nature of Peripheral Neuropathy what exercise is best? Research has demonstrated the implementation of hydrotherapy in the correct dose to be highly effective with recommendations of 30-60minutes performed three times per week. Hydrotherapy treatment needs to be maintained for approximately 1 month to see the full benefits and exercises should be prescribed by a qualified professional. Mirror therapy has also been demonstrated to reduce symptoms and improve function when the Peripheral Neuropathy affects only one limb. Mirror therapy improves the messages sent to the affected limb by copying the unaffected limb. In this way the affected limbs can move with reduced pain messages through tricking the brain to mirror the movement.
The Exercise Physiologists at Absolute Balance design individualised programmes for sufferers of Peripheral Neuropathy with close monitoring and dose effect progressions. Given the complex nature of the condition expert advise can help maintain your function and address co-morbidities including diabetes mellitus.
Ingrid Hand (BSc – ExHealthSc, GraddipSc – ExRehab, MSc – HumMvt)
Exercise Rehabilitation Manager – Accredited Exercise Physiologist (AEP) (ESSAM)
Akyus., G & Kenis, O. (2013). Physical therapy modalities and rehabilitation techniques in the treatment of neuropathic pain. International Journal