Peripheral neuropathy or PN refers to a nerve damage disorder that leads to pain in the hands and feet. This discomfort can spread to other parts of the body. The nerves stop functioning and therefore lead to several issues discussed below.

This condition affects about 30 million Americans, according to the Foundation for Peripheral Neuropathy. PN attacks people of all ages, although the elderly are most affected given that 8% of those above 65 years have it.

Certain professionals, for instance, those who engage in repetitive motions, are more likely to have the mononeuropathy type of PN because of nerve compression or trauma. The annual cost of treating this condition varies. For example, treatment of diabetic peripheral neuropathy and associated complications hits $10.91 billion annually.

Symptoms of Peripheral Neuropathy

Apart from pain, peripheral neuropathy causes many other symptoms that interfere with body movement and function in the affected areas. These symptoms include:

  • mixed sensations such as numbness, burning, or tingling in the feet, legs, arms, or hands
  • poor balance due to lack of coordination that may result in falling
  • skin thinning, paleness, and dryness
  • drop in blood pressure
  • bladder or bowel changes arising from affected nerves
  • excessive sweating
  • unusual nail growth
  • changes in muscle activity leading to paralysis or muscle weakness

Causes of PN

Peripheral neuropathy is likely to develop in people with a family history of this condition. Apart from age, there are other risk factors and underlying conditions for PN like the following:

  • alcoholism, which can affect nerve tissues
  • diabetes
  • physical trauma such as falls, car accidents, fractures, and sports injuries
  • kidney and liver disorders
  • high blood pressure
  • obesity
  • vitamin E, B1, B6, B12 deficiency
  • chemical abuse or exposure to harmful chemicals like insecticides and glue; or heavy metals like mercury and lead
  • high cholesterol
  • autoimmune diseases, which affect the nervous system, for instance, lupus, Guillain-Barre syndrome, and rheumatoid arthritis
  • bacterial or viral infections that attack nerve tissues such as shingles, AIDS, chickenpox, or Lyme disease


This disorder can be very uncomfortable, but there is available treatment. Treatment options for PN aim at relieving pain, tackling the underlying causes, and preventing further damage. They include:

  1. Pharmaceuticals. This involves giving medications such as duloxetine to control symptoms. Antiepileptic medication like gabapentin, carbamazepine, or pregabalin and antidepressants like venlafaxine or duloxetine can also be administered.
  2. Bracing and other medical aids like splints and casts can be used. These aids help reduce arm or leg pain by giving support to affected parts and by enabling proper alignment of the nerves in question.
  3. Surgery is another treatment option, especially for compression-related neuropathy that results from tumors, infections, and nerve entrapment disorders.
  4. Physical therapy is a treatment option that’s beneficial regardless of the underlying causes. It helps maintain function, strengthen muscles, offer stability, and give mobility. Regular exercises can lower the pain and control the amount of blood sugar.

Modalities of Physical Therapy

These modalities involve the use of pain modulators (cold or hot packs), fluidotherapy, whirlpool, and massage. E-stim or electrical stimulation is another physical therapy modality that helps ease pain, contract weak or poorly functioning muscles, and administer inflammation medication.

One common e-stim type is TENS (Transcutaneous Electrical Nerve Stimulation) and Iontophoresis. MicroVas also involves electrical stimulation, whereby currents are directed to the treatment area to stimulate the nerves.

Physical Therapy and Peripheral Neuropathy

With the help of a physical therapist, you can create an activity routine that may include any or all of the following:

Aerobic therapy – This will raise your heart rate and breathing rate while also working your muscles. Examples of aerobic exercises include brisk walking, low-impact aerobics, swimming, and water aerobic exercises.

Strength training exercises – These help strengthen your muscles and make them injury-resistant. Therapeutic strengthening activities target, among other things, the weak nerves. These exercises involve movement and gliding over nerves to nourish and heal them because nerves function properly where there’s blood, movement, and space.

Strengthening both muscles and nerves is important, as nerves innervate muscles. With a strict routine, you can regain partial strength within the first two weeks, as this training develops neural adaptations that coordinate the brain and body’s functional movement.

Flexibility or functional mobility activities – These involve stretching to minimize chances of injury, maintain flexible joints, and encourage independence with ADLs. Examples of such exercises are squatting, climbing stairs, and bending.

Balance training – This helps you overcome stiffness, eliminate unsteadiness, and improve sensation. With simple exercises like calf raises and hip flexion, you can regain your balance and avoid falls.

If you are having challenges coping with Peripheral neuropathy or would like more information, we can help. Call us, Cawley PT and Rehab, at 570-208-2787 or email