What is Peripheral Neuropathy?

The word “neuropathy” refers to nerve damage. The term “peripheral” is defined as “being situated on the edge or outermost part of something.”

Thus, when medical professionals refer to peripheral neuropathy, they refer to nerve damage that occurs in the most distant parts of the body. This includes nerve damage in the fingers, toes, hands, feet, arms, or legs.

Employing the best physical therapists in NEPA, the staff at Cawley Physical Therapy & Rehabilitation has years of experience treating peripheral neuropathy. We believe it is essential for patients and potential patients, caregivers, and family and friends, to understand what peripheral neuropathy is, how it works, and what treatment is available.

Below, we’ll discuss four common types of peripheral neuropathy, some of the causes, and how physical therapy can reduce the symptoms associated with this debilitating and painful disease.

What Are the Four Types of Neuropathy?

Nerves play a vital role in helping individuals become aware of pressure (e.g., a hand or foot “falls asleep”) and relaying pain signals to the brain, such as when a person touches a hot stove. They also play a critical role in controlling muscle function and overall movement.

Many types of nerves regulate different bodily functions, such as urination, defecation, sweating, heart rate, digestion, and much more. Determining what nerves have been affected by neuropathy can help decide which approach to nerve damage physical therapy will most benefit.


This type of neuropathy is often seen in diabetic patients. It refers to nerve damage found in the same area of each extremity, hence the term symmetrical. Symmetrical neuropathy usually begins in the toes and fingers in each extremity, then gradually moves to encompass both feet or hands.


Mononeuropathies refer to nerve damage that only affects one nerve. Often the damage occurs from an injury. One of the most common types of mononeuropathy is carpal tunnel syndrome. Without treatment, the single median nerve in the wrist can become damaged from the chronic pressure stemming from swollen tissue.

Thoracic/Lumbar Root/Proximal

The term “proximal” refers to an area close to the middle of the body. Nerve damage that occurs near the middle of the body can affect the chest wall area (thoracic region) or the lower back (lumbar region), which, in turn, can affect leg function.


Autonomic neuropathy refers to issues that occur when certain nerves in charge of controlling involuntary bodily functions become damaged. This type of damage can affect an individual’s blood pressure, temperature control (sweat glands), and heart rate, among other things.

A person with autonomic neuropathy may become dizzy, or they may faint after trying to stand. They may also have difficulty with exercise because their heart rate does not properly adjust to an increased activity level.

What Causes Nerve Damage?

Nerve damage can occur for a variety of reasons. Carpal tunnel syndrome is one example of a nerve injury that occurs from repetitive motion. Sometimes nerve damage can occur from a vehicle accident or sports injury.

Certain drugs, such as antibiotics or statins, can lead to nerve damage, along with the damage that occurs from chemotherapy treatment or chronic infections. By far, the most common cause of nerve damage, however, is diabetes.

What Are the Symptoms of Nerve Damage?

The symptoms that stem from nerve damage can vary depending upon where the damaged nerves are located. If a person’s fingers or wrist have nerve damage, they will typically experience nerve pain, numbness, tingling, burning, and perhaps even weakness in these areas.

Meanwhile, Suppose a person has nerve damage in their feet. In that case, they will likely experience these same symptoms, and they may even fall or experience a loss of balance since numbness makes it difficult to discern where one’s feet are in relation to the ground. They may also have trouble feeling the acceleration and brake pedals while driving.

Other peripheral neuropathy symptoms include an abnormal sensitivity to hot or cold temperatures, muscle weakness in the extremities such as the fingers, arms, legs, and decreased coordination and impaired balance.

Individuals with autonomic nerve damage may experience a wide range of symptoms, including difficulty standing, urinary problems, sweating abnormalities, sexual challenges, and more. This is because autonomic nerves play a critical role in managing body temperature, controlling heart rate, and other autonomic nerve responses. 

Physical Therapy Treatments

Regardless of one’s type of neuropathy, physical therapy treatment can reduce a patient’s pain and discomfort and strengthen muscles weakened from nerve damage. Additionally, nerve flossing can help heal the damaged nerves themselves.

By improving a patient’s range of motion, posture, strength levels, and ability to balance, patients can regain their former functioning level.

While a patient is recovering, a physical therapist can spot other issues such as unstable footwear, make recommendations for safer footwear, and appropriately use a cane or walker until a person is back on their feet and able to walk on their own once again.

If you would like more information on how physical therapy can help with neuropathy issues, please contact Cawley Physical Therapy & Rehabilitation at 570-208-2787.