Neuropathy is a problem with nerve endings. The most common causes are diabetes and chemotherapy.
We refer to the nerves supplying the upper and lower extremities when we talk of neuropathy in general, which is why it is also called peripheral neuropathy.
Neuropathy can lead to other complications like gangrene, limb amputations, falls, persistent discomfort, and debilitation.
The numbness resulting from loss of pain sensation leads to a small skin cut to be neglected and progress to a deeper infection involving the muscles and the bones. I have seen a lady who did not look at her foot for two weeks, and that time was enough for gangrene to develop, which led to the loss of that foot.
There is a thing called position sense or proprioception, whereby we know how our body parts are positioned without looking at them. This helps the brain constantly adjust its balance and how much force is needed to move.
Loss of proprioception leads to falls and injuries that can cause fractures and internal bleeding.
Once neuropathy sets it, there are no pills to reverse that, and if the underlying condition persists, like diabetes, it will continue or worsen.
Exercise and Neuropathy
A meta-analysis was published this month in Sports Medicine that says definitive proof shows that exercise improves neuropathy.
In the report, 27 randomized controlled trials (RCT) showed exercise benefits to diabetic peripheral neuropathy, and nine RCTs among those with chemotherapy-induced neuropathy improved.
The patients with diabetic neuropathy improved in static balance, Berg Balance Scale, Timed-up-and-go-test, the nerve conduction velocity of the peroneal and sural nerve, and hemoglobin A1c (HbA1c) glycosylated hemoglobin.
HbA1c is a blood test that measures average blood sugar for the previous three months.
Sensorimotor training works best for those with diabetes and chemotherapy-induced peripheral neuropathy, while diabetes patients will also benefit from endurance exercises.
A review article describes sensorimotor training as,
Sensorimotor training emphasizes postural control and progressive challenges to the sensorimotor system to restore normal motor programs in patients with chronic musculoskeletal pain.
Patients progress through static, dynamic, and functional phases using simple rehabilitation tools such as balance boards, foam pads, and elastic bands.
A simple exercise like walking improves neuropathy by stimulating the blood vessels, nerves, bones, and muscles. Not only that, but exercise also takes care of other cardiovascular risk factors.
If you have neuropathy, ask your doctor for a physical therapy referral. Physical therapists can give you several techniques to improve the neuropathy; however, the most important thing is to continue what you will learn and make it a lifestyle.
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Reference:
Streckmann F, Balke M, Cavaletti G, Toscanelli A, Bloch W, Décard BF, Lehmann HC, Faude O. Exercise and Neuropathy: Systematic Review with Meta-Analysis. Sports Med. 2022 May;52(5):1043-1065. doi: 10.1007/s40279-021-01596-6. Epub 2021 Dec 29. PMID: 34964950.[abstract]
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