Stroke Rehabilitation | Spinal Cord Injuries | Peripheral Neuropathies

Peripheral Neuropathies

• What is Peripheral Neuropathy?

• What Causes Peripheral Neuropathy?

• What Are Symptoms of Peripheral Neuropathy?

• Physical Therapy and Peripheral Neuropathy

What is Peripheral Neuropathy?

The nervous system can be divided into two major parts: the central nervous system (CNS), made up of the brain and spinal cord, and the peripheral nervous system (PNS), made up of nerves that branch off from the central nervous system (e.g. motor, autonomic, sensory). 

Peripheral neuropathy is the functional disruption and/or damage to nerves in the peripheral nervous system. The cell itself, the nerve cell axon, or its protective sheath, myelin, or both can be impacted. In most patients, a definite diagnosis can be made through use of tests, which can include electromyography (EMG), nerve conduction velocity (NCV), blood tests, spinal tap or lumbar puncture, hair analysis, and nerve or tissue biopsies.

What Causes Peripheral Neuropathy?

The causes of peripheral neuropathy are too numerous to recount, but following are the most common causes:

• Diabetes (diabetic neuropathy)

• Entrapment or compressions of a nerve (pinched nerve)

• Ischemic (abnormal blood flow to the artery)

• Orthopedic trauma (e.g. contusions, dislocations, fractures, crushing injuries)

• Penetrating injuries

• Disc herniation

• Tumors

• Exposure to cold or radiation

• Lyme disease

• HIV

• Infection

• Systemic diseases such as vascular or collagen disorders (e.g. rheumatoid arthritis, lupus, scleroderma, sarcoidosis)

• Inherited disorders

• Guillain-Barre syndrome (a viral infection) 

• Inflammatory demyelination (inflammation destroys the nerve covering)

• Cancer & related treatment

• Vitamin deficiencies (e.g. B6 or B12) and malnutrition

• Toxins in drugs, industrial chemicals and the environment (e.g. arsenic, lead, mercury, thallium)

• Leprosy (a bacterial infection)

• Shingles

• Alcoholism

What Are Symptoms of Peripheral Neuropathy?

Just as the causes vary, so do the symptoms. The commonality is impact on or disruption of how the peripheral nervous system functions. 

• Cramping or spasms of muscles

• Abnormal movement or weakness in a particular muscle group, resulting in atrophy

• Paresthesia or abnormal sensations of the sensory system (e.g. hypersensitivity, prickling, tingling, burning, numbness, pain)

• Dysfunction of the bladder and bowels

• Fainting or light headedness when standing

• Excessive or inadequate sweat, tears or saliva

• Impotence

Physical Therapy and Peripheral Neuropathy

Since peripheral neuropathy has such a wide variety of causes, effective treatment depends on identifying the specific cause of this nerve damage. In addition to medication, acupuncture, magnetotherapy, surgery, and nutritional & vitamin therapy, physical therapy can play an important role in alleviating symptoms of some peripheral neuropathies.

Modalities used in physical therapy can help prevent or treat the shortening of muscles around joints (contractures), strengthen muscles impacted by nerve damage, improve circulation through exercise, massage and whirlpool, prevent pain signals from reaching the brain by used a TENS device (transcutaneous electrical nerve stimulation), relieve pressure on a nerve or compressions through stretching exercises, reduce muscle tension using yoga type exercises.

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