Physical Therapy For Peripheral Neuropathy

Your nerves convert information about the outside world into signals that travel to your brain, which translates them into what you can sense and move. Neuropathy can interfere with these signals, which can lead to pain, weakness and numbness.

Medical treatments for neuropathy include medications, acupuncture and mind/body techniques like yoga and tai chi. Your doctor will start with blood and urine tests to check for diabetes, vitamin deficiencies and other conditions that can cause neuropathy.

Physical Therapy

Physical therapy for peripheral neuropathy involves a variety of techniques. In some cases, mechanical aids like foot or hand splints can help reduce pain and discomfort. A specialized treatment, called TENS (transcutaneous electrical nerve stimulation), uses small electrodes to send a mild, harmless electrical current through your skin to relieve pain and improve function.

Neuropathies may be caused by infections, diseases, and autoimmune disorders. A neurologist can identify a specific cause and treat it. A complete medical history and physical and neurological exam are important to diagnose the disorder. Lab tests may include blood glucose levels, vitamin deficiencies, liver and kidney function, a clotting test, and electromyography (EMG). A nerve biopsy can also identify the type of neuropathy.

Doctors can prescribe medications to control the underlying cause of neuropathy. Immunosuppressive drugs such as prednisone, cyclosporine, and azathioprine can help to decrease inflammation and suppress abnormal immune system activity. Plasmapheresis, a procedure in which your blood is removed and cleansed of your immune system cells and antibodies, can also reduce inflammation.

Medication

Although neuropathy is not usually dangerous, its symptoms can have a serious impact on your daily activities. Fortunately, NYU Langone neurologists often can help improve or eliminate these disruptive symptoms.

Your doctor will ask about your symptoms, your lifestyle, exposure to toxins, and family history of nervous system diseases like diabetes. Then, he or she will perform a physical and neurological exam to check your tendon reflexes, muscle strength and tone, balance and coordination, and the ability to feel certain sensations like touch and temperature. Blood tests can detect low levels of vitamins, diabetes, inflammation and other metabolic problems that can cause neuropathy. Imaging tests may include a CT or MRI scan, which can look for herniated disks that compress nerves and other problems.

To treat neuropathic pain, your doctor can prescribe medications that are more effective than over-the-counter pain relievers like ibuprofen and acetaminophen. Some of these drugs work by blocking the painful signals that are sent to your brain. Others, such as lidocaine patches, work by quieting excess firing of pain cells.

Surgery

Peripheral neuropathy therapy can be managed with a combination of techniques. A healthcare provider will work to control the underlying condition that’s causing it, such as diabetes, kidney disease, or vitamin deficiencies. Then medications will be used to treat the pain symptoms of neuropathy.

When nerve damage is severe, surgery may be the best option. It can take pressure off of damaged nerves, such as in the case of carpal tunnel syndrome or a tumor pressing on a spinal cord nerve.

Before surgery, a doctor will do a physical exam and ask about your medical history. They will check your muscles and reflexes to see how the affected area is functioning. They will order blood tests to look for diabetes, vitamin deficiencies, or other health issues that could be causing the neuropathy. They will also do an electromyogram or a nerve conduction velocity test to pinpoint the problem areas. A lumbar puncture — or spinal tap — is sometimes done to identify an infection that might be causing the pain.

Mind/Body Techniques

Your peripheral nerves carry motor signals, or commands, from your brain to your muscles. When these connections become weak from nerve deterioration, you may develop muscle weakness in your feet, legs and hands. You also may experience clumsiness from loss of balance control and uncontrolled movements.

Nerve damage can cause numbness and tingling, often starting in your feet or hands and spreading up your limbs. You may also feel pain (allodynia) from even the lightest touch, such as draping bedsheets over your body.

Your doctor will run tests to check for underlying causes of neuropathic pain, such as blood sugar levels, vitamin deficiencies and autoimmune diseases. Treatment of the underlying condition can help relieve the neuropathy. Other treatments that may improve your symptoms include taking warm baths, which stimulate your nerves and increase your blood circulation. Acupuncture is another mind/body technique that promotes natural healing by stimulating pressure points in your body. It also has been shown to lower stress and boost mood-boosting neurotransmitters.