Peripheral neuropathy describes damage to the peripheral nervous system, the network that transmits information from the brain and spinal cord to every other part of the body.

Physical therapists can help the patient with peripheral neuropathy by treating the problems caused by the condition.  These include:

Balance:  Often, balance is affected due to weakness, stiffness, and/or decreased sensation in the feet.  Specific exercises which target the causes of the poor balance will improve it.  By thorough balance testing, it is determined if the patient is at risk of falling, and both the patient and their family and physician will be notified.  Sometimes, a cane or walker may be necessary to prevent falls. 

Weakness:  Muscle testing done by the physical therapist will determine specific weaknesses that will be addressed by appropriate strengthening exercises

Gait Abnormalities:   The patient with peripheral neuropathy often experiences difficulty in walking.  This is often caused by the decreased sensation in the feet, as well as weaknesses and decreased range of motion in joints.  Eventually, the walking pattern becomes a habit.  A physical therapist know how to analyze gait and determine what is needed to change in order to create a more normal, comfortable, and safe gait.

Limited Range of Motion:   Often the patient with peripheral neuropathy has developed tightness in various joints.  The physical therapist will measure joint motion and develop specific stretching exercises which increase joint motion, allowing the patient more freedom of movement.

Peripheral nerves send sensory information back to the brain and spinal cord, such as a message that the feet are cold or a finger is burned. Damage to the peripheral nervous system interferes with these vital connections. Like static on a telephone line, peripheral neuropathy distorts and sometimes interrupts messages between the brain and the rest of the body.

Because every peripheral nerve has a highly specialized function, a wide array of symptoms can occur when nerves are damaged. Some people may experience temporary numbness, tingling, and prickling sensations (paresthesia), sensitivity to touch, or muscle weakness. Others may suffer more extreme symptoms, including burning pain (especially at night), muscle wasting, paralysis, or organ or gland dysfunction.

 In acute neuropathies, such as Guillain-Barré syndrome, symptoms appear suddenly, progress rapidly, and resolve slowly as damaged nerves heal.

In chronic forms, symptoms begin subtly and progress slowly.   In the most common forms of polyneuropathy, the nerve fibers (individual cells that make up the nerve) most distant from the brain and the spinal cord malfunction first. Pain and other symptoms often appear symmetrically, for example, in both feet followed by a gradual progression up both legs.