Neuropathy is a condition that affects millions of people, especially as they age. While it is often associated with discomfort or pain in the hands and feet, one of the most profound and often overlooked effects of neuropathy is how it can impact balance. As our bodies rely heavily on the nervous system for coordination and stability, damage to the nerves can disrupt these essential functions, increasing the risk of falls and injuries.
Physical therapists can be a crucial part of a neuropathy treatment plan, as they can assess functional movement and create a treatment plan to restore balance and independence. Our physical therapists at EW Motion Therapy create treatment plans like this every day, and we also offer group balance classes for those looking to move better. Even if you decide that our services don’t fit your needs, you can still read this article, as we explore how neuropathy can affect balance, examine the common causes and symptoms of the condition, and discuss how physical therapy can be an essential part of managing and improving balance for individuals living with neuropathy.
Understanding neuropathy
Neuropathy, or peripheral neuropathy, is a term used to describe damage to the peripheral nerves, which transmit signals between the central nervous system (the brain and spinal cord) and the rest of the body. These nerves control sensations, motor functions, and autonomic activities such as blood pressure regulation. When peripheral nerves are damaged, they may no longer function properly, leading to a variety of symptoms that can significantly impair daily life.
Common symptoms of neuropathy
The symptoms of neuropathy vary depending on which nerves are affected, but they typically include the following:
- Numbness or tingling: People with neuropathy often report numbness, tingling, or a "pins and needles" sensation, particularly in the hands and feet.
- Burning or sharp pain: Neuropathic pain can feel like burning, stabbing, or shooting pain and may worsen at night.
- Muscle weakness: Nerve damage can lead to muscle weakness or loss of muscle control, particularly in the legs and arms.
- Sensitivity to touch: People with neuropathy might become hypersensitive to touch, even from something as light as clothing or bedsheets.
- Loss of coordination: Damage to the sensory nerves that help the body maintain spatial awareness can lead to coordination problems.
- Balance issues: One of the more serious complications, especially for older individuals, is the loss of balance, which is directly tied to how well the nervous system communicates with the muscles.
Causes of neuropathy
Neuropathy can develop for a variety of reasons, and understanding the cause is essential to managing the condition effectively. The most common causes include:
- Diabetes: Diabetic neuropathy is one of the most common forms of peripheral neuropathy, affecting more than half of people with diabetes. High blood sugar levels can damage nerves over time, particularly in the feet and legs.
- Injury or trauma: Physical injury, including accidents, fractures, or surgery, can cause damage to peripheral nerves.
- Infections: Certain infections, such as shingles or Lyme disease, can lead to nerve damage.
- Autoimmune disorders: Conditions like rheumatoid arthritis, lupus, or Guillain-Barré syndrome can cause the immune system to attack the peripheral nerves.
- Alcoholism: Chronic alcohol use can damage nerves due to poor nutrition and the toxic effects of alcohol on the body.
- Chemotherapy: Some cancer treatments can result in neuropathy as a side effect of chemotherapy drugs.
- Vitamin deficiencies: A lack of essential nutrients, particularly B vitamins, can contribute to nerve damage.
Whatever the cause, neuropathy can be a progressive condition that worsens over time, further impacting a person’s ability to maintain balance and coordination.
How neuropathy affects balance
Balance is a complex function that relies on sensory input from multiple sources, including vision, the vestibular system (inner ear), and proprioception (the body's ability to sense its position in space). Neuropathy can interfere with this system in several ways:
Impaired sensory input
Neuropathy damages the nerves that transmit sensory information to the brain. This means that people with neuropathy may not be able to feel their feet or know where their body is in space. Without this feedback, it becomes more difficult to make the small adjustments necessary to maintain balance.
Muscle weakness
Neuropathy often leads to muscle weakness, particularly in the legs and feet. Weak muscles are less able to provide the stability needed for activities like walking or standing still.
Delayed reflexes
Reflexes play a crucial role in maintaining balance. For instance, if you trip or begin to fall, your body automatically makes adjustments to keep you upright. Neuropathy can slow down or disrupt these reflexes, making falls more likely.
Loss of coordination
Coordination is the smooth and efficient interaction of muscles, joints, and nerves. When the nerves aren’t functioning correctly, it can lead to a lack of coordination, further contributing to balance problems.
For people with neuropathy, these challenges can make daily activities—such as walking, climbing stairs, or even standing for extended periods—dangerous. Falls are one of the leading causes of injury among people with neuropathy, and the risk of serious complications like fractures or head injuries is significant.
How physical therapy can help improve balance for neuropathy patients
Physical therapy can be a powerful tool in managing the balance issues caused by neuropathy. While it cannot reverse nerve damage, physical therapy can help improve muscle strength, coordination, and balance, helping individuals maintain a higher quality of life. Here’s how:
Balance training
Physical therapists are trained to assess an individual’s balance and create personalized programs to address deficits. Balance exercises might include activities like standing on one leg, using balance boards, or performing specific movements that challenge the body’s proprioception. By practicing these exercises, patients can improve their ability to stabilize themselves in various situations.
Strengthening exercises
Since muscle weakness is a common symptom of neuropathy, strengthening exercises are a vital part of any treatment plan. Strengthening the muscles of the legs, core, and back can provide better support and stability, reducing the risk of falls. These exercises may include leg lifts, squats, or resistance band workouts designed to target weakened areas.
Gait training
Neuropathy can change the way a person walks, leading to an uneven gait that increases the likelihood of trips and falls. Gait training helps individuals with neuropathy learn how to walk with greater stability, ensuring that their steps are controlled and balanced. Physical therapists may use tools like parallel bars, walking aids, or specialized footwear to assist with this training.
Stretching and flexibility work
Stiffness and limited flexibility can make movement even more challenging for individuals with neuropathy. Stretching exercises can help improve flexibility and range of motion, making it easier to move and maintain balance.
Assistive devices
For those with more severe balance issues, physical therapists may recommend assistive devices like canes, walkers, or orthotic insoles to provide additional support. These devices can help distribute weight more evenly and make walking less hazardous.
Education and fall prevention strategies
Physical therapists also play a critical role in educating patients about fall prevention. This can include advice on how to modify the home environment to reduce tripping hazards, using appropriate footwear, and avoiding uneven surfaces when walking.
Neuropathy is a challenging condition that can significantly affect a person’s ability to maintain balance, leading to an increased risk of falls and injury. However, with the right approach, it’s possible to manage these balance issues effectively. Physical therapy offers a variety of tools, from balance and strength training to gait rehabilitation, that can help people with neuropathy regain confidence and stability in their daily lives. If you or someone you love is struggling with balance issues due to neuropathy, a physical therapist can be a valuable partner in creating a tailored plan that addresses your unique needs.
We consider it a privilege to be this partner for our neuropathy patients at EW Motion Therapy, as we evaluate a patient’s lifestyle and daily routine to create a treatment plan that is tailored to them. To learn more about what physical therapy might cost, click the button below to download our free pricing guide.
