This week we are going to discuss one of the most often asked questions about peripheral neuropathy: If this is a permanent condition, why prescribe therapy? Many patients develop loss of balance and falling issues as a result of peripheral neuropathy. Peripheral neuropathy is the damage to peripheral nerves in the limbs arms and legs secondary to diabetes, heavy metal poisoning, heavy smoking, heavy drinking, and other intrinsic and extrinsic causes.
Neuropathy can cause pain, burning, numbness and tinging but can also cause decreased balance and falling as a result of decreased nerve signals from the limbs as a result of the neuropathy. The neuropathy impairs the ability of the body to interpret motion ( proprioception/kinesthetic sense) as well as sensation (feeling) from the limbs.
In this way damage to the nerves results in decreased feedback from the body with regard to where the body is in space. Therefore, the patient has a much increased risk for falls secondary to this nerve damage.
Why prescribe therapy? Patients ask from time to time why is my doctor prescribing therapy if neuropathy is permanent? This is a very good question. Doctors often prescribe physical therapy for balance and coordination/strength as a result of peripheral neuropathy. Why would this be useful? The reason that therapists are able to help patients with peripheral neuropathy is that though they cannot restore the lost sensation, movement awareness, and function as a result of peripheral neuropathy, therapy does restore strength, endurance and can impart substitutional balance improvements. Therapist are able to challenge the patient’s hip, knee and ankle strategies to the point that they are actually improved over their original starting point. Patients can experience decreased fall risk, measurable improvement in strength and measurable improvement in balance.
The thought process is that by practicing increasing difficulties in balance, the patient can be challenged enough to improve other sensory pathways which are still functioning such as the vestibular pathway as well as sensory pathways further up the limb which are not impaired. Patient’s visual acuity can be challenged as well as strength in the limbs improving the patient’s overall function in walking, balance and daily activities.
As you can see, physical therapy can help in a substitutional way for a condition which is otherwise considered permanent in such as fashion that the patient benefits significantly from the treatment. Therefore, physical therapy is useful to remediate some of the balance loss due to peripheral neuropathy. For more information on peripheral neuropathy, its effects on the limbs, and how therapy can help balance, do not hesitate to contact the clinic for a no cost consultation.
Dr. Mark McDonald, PT, DPT, OCS is a lifelong Sterling native and board certified orthopedic physical therapist with over two decades of practice in Sterling. He is a clinical partner with AB Fitness/Alma Blagg, Devonshire Acres, and Northeast Plains Home Health Care in Sterling.