Peripheral neuropathy is a common condition affecting the peripheral nerves (those outside of the brain and spinal cord) and affects 1 in 50 people in the UK. The peripheral nervous system is responsible for controlling the muscles of the body, relaying sensory information to and from the body and the brain (such as heat, cold, pressure and pain), and it also helps to regulate autonomic functions of the body such as temperature regulation, and blood pressure changes.
Impairment of the peripheral nervous system can be caused by diabetes, viruses, infections, alcohol abuse, side-effects of medication, or as a result of direct trauma to the peripheral nerves. In some cases, the underlying cause is not found and this is termed ‘idiopathic peripheral neuropathy’. However, if the peripheral neuropathy is caused by an underlying medical condition (for example diabetes), the symptoms may be able to be controlled through medical treatment of that specific problem. Conditions such as Guillain Barre Syndrome, Lupus and Rheumatoid Arthritis may present with specific forms of peripheral neuropathy.
For those individuals who have sustained an injury to a peripheral nerve through trauma, the management of the presenting neuropathy will depend upon the severity of the damage sustained, the specific peripheral nerve(s) involved, and any other associated injury that presents. Surgical repair of the nerve may be necessary if healing and recovery is not taking place.
Symptoms may include:
- Numbness and tingling in the limb(s) affected
- Pain or ‘burning’ in specific areas of the body
- Muscle weakness
- Increased sensitivity to touch / pressure
- Swelling, altered circulation and temperature regulation of the affected limbs
- Some individuals may present with ‘wrist drop’ or ‘foot drop’ due to the loss of the nerve supply to the muscles around the wrist and ankle.
Any combination of these symptoms can lead to difficulties with day-to-day activities, function and recreation.
Physiotherapy management can help with the recovery of peripheral nerve damage, and the restoration of normal movement and function. Rehabilitation may include manual (hands-on) therapy techniques to restore / maintain soft tissue and joint flexibility, to prevent contractures forming, and to provide sensory stimuli to areas with altered sensation. A progressive exercise programme, including balance work and postural re-education, is essential in order to strengthen muscles, prevent compensation and capitalise on the recovery of muscle firing as soon as it occurs. The use of splinting may be important to maintain the correct position of a joint and to help with function (for example a foot drop splint to aid normal gait).
In some circumstances, the nerve recovery may be slow, and rehabilitation may need to occur at varying stages of the nerve healing process and in response to the recovery rate of each individual. This may require intense periods of physiotherapy input, or may involve more intermittent rehabilitation sessions, say once every couple of months.
If you would like to speak with one of our team of specialist Neuro Physiotherapists at Yorkshire Neuro Physiotherapy, please feel free to get in touch. We can discuss your condition over the telephone at first if you prefer, and you can find out more about who we are and what we can offer you. We can arrange an initial assessment at one of our designated clinics, or alternatively, if you prefer, we can arrange to see you in your own home.