Peripheral neuropathy is a condition of the nervous system that causes numbness, tingling, pins and needles sensation, or complaints of pain in the arms and legs. The pattern of the altered sensation starts in the toes or fingertips. If the condition worsens, this feeling gradually climbs up the foot or hand, as if you are putting on a stocking or a glove. In the legs, the condition can go above the ankle, but for most of the patients I have met, it has been less common for it to travel above the knee. This problem can occur when a person has diabetes, or it can occur without any history of diabetes.
Sometimes people have it off and on. Others say that they only notice it at night when they are lying in bed. Others have these altered sensations constantly. Some people say their symptoms are mild, and they basically ignore it, while others have severe symptoms that can be annoying, painful, or debilitating.
If the peripheral neuropathy is severe, it can affect one’s balance. This seems
to be the case if a person has peripheral neuropathy, in addition to other
problems such as visual or inner ear disorders. The reason for this is that the
sensation that we have in our feet sends messages to the brain that tells our
brain how we are shifting our weight. Our brain uses this information, in
addition to the information it gets from the inner ear balance system and the
visual system, to tell our joints and muscles what to do to maintain our balance.
Usually our brains can compensate when one of these systems is sending poor
information, but it is very tough to balance when two or more of these systems
are not sending good information (for example, a person has peripheral
neuropathy in addition to an inner ear problem and/or a visual problem).
Medical treatments to decrease the pain and discomfort of peripheral neuropathy need to be discussed with a physician.
Treatments to decrease the imbalance caused by peripheral neuropathy need to be addressed with a physical therapist that specializes in treating complex balance problems. I would recommend a vestibular specialist.
With many of my physical therapy balance patients in Sarasota, Florida, as we work together to evaluate their peripheral neuropathy further, we come to recognize that even though the sensation in the feet is altered, the brain has the ability to re-learn how to use the information even though it is not how it used to be, or “normal”. When the peripheral neuropathy is so severe that the person cannot feel the ground at all, compensations such as walking with trekking poles or a cane can make a big difference, because then the person can learn how to substitute feeling the ground with the cane for the missing sensation in their feet.
If you are having problems like these, there are things that can be done to help.
Painting: The Black Stocking by Felix Vallotton, 1904
