How Physical Therapy Helps Neuropathy

If you've been experiencing numbness, tingling, burning pain, or weakness in your hands or feet, your doctor may have diagnosed you with neuropathy and referred you to physical therapy as part of your treatment plan. While there is no single cure for neuropathy, physical therapy can play an important role in managing symptoms, improving function, and helping you maintain your independence.

Physical therapists are specially trained to evaluate conditions that affect the nerves, muscles, and movement systems of the body. They can help you understand how neuropathy is affecting your balance, strength, sensation, and mobility, and then develop a personalized treatment plan to address those challenges. Through targeted exercises, balance training, education, and therapeutic modalities, physical therapy can help reduce symptoms, improve safety, and enhance your overall quality of life.

Whether your neuropathy is caused by diabetes, chemotherapy, injury, or another medical condition, a physical therapist can provide the guidance and tools you need to stay active, reduce your risk of falls, and function at your highest level.

What Is Neuropathy?

So, what exactly is neuropathy? According to the International for the Study of Pain, neuropathy is "pain caused by a lesion or disease of the somatosensory nervous system".  In more understandable terms, the nerves outside of the brain and spinal cord, called peripheral nerves, become damaged. This causes pain and numbness in the hands and feet.

What Are the Symptoms of Neuropathy?

So, what exactly is neuropathy?

Neuropathy, or peripheral neuropathy, occurs when the peripheral nerves—the nerves outside of the brain and spinal cord—become damaged or diseased. According to the International Association for the Study of Pain (IASP), neuropathic pain is "pain caused by a lesion or disease of the somatosensory nervous system."

In simpler terms, neuropathy occurs when the nerves responsible for carrying messages between the brain, spinal cord, and the rest of the body stop functioning properly. When these nerves are damaged, they may send incorrect signals, send signals too slowly, or fail to send signals altogether.

As a result, people with neuropathy often experience symptoms such as:

• Numbness or loss of sensation
• Tingling or "pins and needles" sensations
• Burning, shooting, or stabbing pain
• Muscle weakness
• Poor balance and coordination
• Increased sensitivity to touch

Neuropathy most commonly affects the hands and feet, but it can occur anywhere in the body. While these symptoms may seem like minor inconveniences at first, they can significantly impact safety, independence, and quality of life.

Think about what happens if you can no longer feel your feet. Walking becomes more difficult because your brain receives less information about where your feet are and how they are moving. Getting in and out of a chair, navigating stairs, driving, and walking on uneven surfaces can become challenging and potentially dangerous. As sensation decreases, balance often worsens, increasing the risk of falls and injuries.

Loss of sensation can also make it difficult to recognize when an injury has occurred. A person may develop a blister, cut, bruise, or pressure sore on their foot without realizing it. Even finding comfortable footwear can become a challenge. Shoes that are too tight or too loose may cause skin breakdown, discomfort, or increase the risk of falls.

Neuropathy in the hands can be equally frustrating. When sensation is reduced, it becomes harder to grip and manipulate objects. Tasks such as holding a cup, eating with utensils, buttoning clothing, zipping a jacket, tying shoes, writing, or using a phone may become difficult. Hand and wrist weakness can further affect cooking, lifting, carrying, and other daily activities.

Another concern is the inability to accurately sense temperature. People with neuropathy may not recognize when something is too hot or too cold, increasing the risk of burns, frostbite, and other injuries. For this reason, it is important to regularly inspect the hands and feet for cuts, blisters, redness, or other signs of injury.

Because neuropathy can affect mobility, independence, work, hobbies, and social activities, it can also take a toll on emotional health. Chronic pain, functional limitations, and loss of independence may contribute to frustration, anxiety, depression, and reduced quality of life.

The good news is that treatment—including physical therapy—can help manage symptoms, improve strength and balance, reduce fall risk, and help you maintain the highest possible level of function and independence..

Who Gets Neuropathy?

Neuropathy can affect people of all ages, but it is more common in individuals with certain medical conditions or risk factors. Peripheral nerves are vulnerable to damage from a variety of causes, some of which can be prevented or managed, while others cannot.

Common causes of neuropathy include:

• Diabetes (the most common cause of peripheral neuropathy)
• Chemotherapy and other cancer treatments
• Repetitive motion or nerve compression injuries
• Autoimmune disorders such as Multiple Sclerosis, Guillain-Barré Syndrome and rhuematoid arthritis 
• Kidney disease
• Infections, including shingles, Lyme disease, and hepatitis
• Inherited or genetic conditions
• HIV/AIDS
• Exposure to toxins or certain chemicals
• Excessive alcohol use
• Vitamin deficiencies, particularly Vitamin B12

In some cases, despite extensive testing, no clear cause can be identified. When this occurs, the condition is referred to as idiopathic neuropathy.

How Do You Manage Neuropathy?

Neuropathy can be challenging to treat because damaged nerves often heal slowly and incompletely. While medications and therapies can help manage symptoms, there is rarely a single treatment that solves the problem. The most effective approach combines medical treatment, lifestyle modifications, and rehabilitation.

The first step is managing the factors you can control:

• Monitor and control blood sugar levels if you have diabetes.
• Limit or eliminate alcohol consumption.
• Address vitamin deficiencies through diet or supplements as recommended by your healthcare provider.
• Modify repetitive work or recreational activities that may contribute to nerve irritation.
• Practice good skin care and foot care to prevent injuries and infections.
• Maintain a healthy weight and stay physically active.
• Follow your physician's recommendations for managing underlying medical conditions.

Some causes of neuropathy, such as genetics or prior chemotherapy treatments, cannot be changed. That's why it is especially important to focus on the factors you can control and seek treatment early to prevent symptoms from worsening.

The good news is that several treatments can help reduce symptoms, improve function, and enhance quality of life.

A Comprehensive Approach to Treating Neuropathy

The best outcomes occur when neuropathy is treated from multiple angles. Rather than focusing solely on pain relief, a comprehensive treatment plan addresses the physical, emotional, and functional effects of the condition.

Medications

A variety of medications can help reduce nerve pain, tingling, and discomfort. Your physician will work with you to determine which medications may be most effective based on your symptoms and medical history.

Counseling and Mental Health Support

Living with chronic pain, numbness, and functional limitations can be emotionally exhausting. Neuropathy may affect your ability to work, participate in hobbies, exercise, or maintain your independence. Counseling or mental health support can help you manage stress, anxiety, depression, and the emotional challenges that often accompany chronic conditions.

Pain Management Specialists

For individuals with severe or persistent symptoms, a pain management physician may recommend additional treatments such as:

• Nerve blocks
• Steroid injections
• Peripheral nerve stimulation (PNS)
• Other interventional pain management procedures

These treatments are designed to reduce pain signals and improve function when traditional approaches are not enough.

How Physical Therapy Helps Neuropathy

One of the most effective non-surgical treatments for neuropathy is physical therapy.

Physical therapists evaluate how neuropathy is affecting your strength, balance, flexibility, mobility, and ability to perform daily activities. After a comprehensive evaluation, your therapist develops an individualized treatment plan designed to improve function and reduce symptoms.

Physical therapy may include:

Therapeutic Exercise

Exercise helps maintain strength, flexibility, endurance, and joint mobility. Staying active can reduce stiffness, improve circulation, and help compensate for nerve-related weakness.

Balance and Gait Training

Because neuropathy often affects sensation in the feet, many people experience balance problems and an increased risk of falls. Balance training helps improve stability, confidence, and safety during walking and other activities.

Manual Therapy and Soft Tissue Techniques

Hands-on treatment can help reduce muscle tension, improve flexibility, and decrease discomfort associated with compensatory movement patterns.

TENS (Transcutaneous Electrical Nerve Stimulation)

TENS uses gentle electrical stimulation to help block pain signals and provide symptom relief. Many patients benefit from home TENS units as part of their long-term management plan.

Education and Self-Management

Perhaps most importantly, physical therapists teach you how to manage neuropathy effectively. You'll learn strategies for protecting your hands and feet, preventing falls, staying active, and maintaining the highest possible level of independence.

Low-Level Laser Therapy (Cold Laser)

Another treatment that may be incorporated into your therapy program is low-level laser therapy (LLLT), also known as cold laser therapy. This non-invasive treatment uses light energy to stimulate cellular activity and support the body's natural healing processes.

Research suggests that low-level laser therapy may help:

• Reduce neuropathy-related pain
• Improve circulation
• Promote wound healing
• Decrease muscle and soft tissue tightness
• Enhance overall tissue health

Because the treatment does not generate heat and is painless, many patients find it to be a comfortable addition to their rehabilitation program. At Therapy Achievements, low-level laser therapy may be incorporated into your treatment plan when appropriate.

What Should You Do Next?

Neuropathy can be frustrating, painful, and life-changing, but you do not have to manage it alone. The best results are achieved when patients work closely with their healthcare team, including their physician, physical therapist, and other specialists as needed.

If numbness, tingling, pain, weakness, or balance problems are interfering with your daily life, it may be time to seek help. Early intervention can often prevent further decline and help you maintain your independence.

At Therapy Achievements, our experienced therapists understand the challenges neuropathy creates. We provide individualized treatment programs, patient education, balance training, pain management techniques, and advanced therapies designed to help you move better, feel better, and live your best life.

Call Therapy Achievements today to learn how physical therapy can help you take control of your neuropathy and get back to the activities you enjoy.

References

Baxter, G. D., Liu, L, Petrich, S., Spontelli Gisselman, A., Chapple, C., Anders, J. J., & Tumilty, S. (2017). Low-level laser therapy (photobiomodulation therapy) for breast cancer-related lymphedema: a systematic review. BMC Cancer, 17(833). https://doi.org/10.1186/s12885-017-3852-x.

Clijsen, R., Brunner, A., Barbero, M., Clarys, P., & Taeymans, J. (2017). Effects of low-level laser therapy on pain in patients with musculoskeletal disorders: a systematic review and meta-analysis. Edizoni Minerva Medica, 53(4). https://doi.org/10.23736/S1973-9087.17.04432-X

Murnion, B. (2018). Neuropathic pain: current definition and review of drug treatment. Australian Prescriber, 41(3). https://doi.org/10.18773/austprescr.2018.022

Szok, D., Tatjti, J., Nyari, A., & Vecsei, L. (2019). Therapeutic approaches for peripheral and central neuropathic pain. Behavioural Neurology. https://doi.org/10.1155/2019/8685954

(Murnion, 2018; Szok, et al. 2019).