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Physical Therapy for Peripheral Neuropathy

John212's picture
John212
Posts: 116
Joined: Jan 2015

Tomorrow I'm starting a course of Physical Therapy to try to mitigate the symptoms of Chemotherapy Induced Peripheral Neuropathy. I'm using the PT department of the hospital where I had my surgery and later treatment. While there is no cure for neuropathy, there is some hope that therapy can help persuade the nervous system to, in layman's terms, build some new pathways to restore feeling to numb feet and fingers.

Has anyone else done PT for neuropathy? What was your experience?

I will update this as I go along.

hippiechicks
Posts: 509
Joined: Sep 2012

Hi John .. I have been in PT since my last surgery over 2 years ago.  It is part of my routine, and I find it essential to my healing process.  I did try to stop for a short time and things went badly fast.  I was in a lot of pain and numbness was much much worse.  I highly recommend it and wish you much luck.  I hope you have postive results. 

John212's picture
John212
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Glad you chimed in. What sorts of exercises or activities have you been doing in PT?

hippiechicks
Posts: 509
Joined: Sep 2012

For the most part I am streched.  For some reason, since my chemo/surgery my fascia tissue goes bonkers if I do not continually have it stretched.  I spasm from literally head to toe. It has pulled me to the point of needing chiropractic adjustment for alignment.  Keeping my body exercised and stretched is the only way to stay pain free and aligned.

Heat such as ultra sound has been used and I also heat different areas of my body several times a day when needed.  I use a microwave heat pack and just apply where needed.  I also use whirlpool tub/jet tub for heat and circulation.  All of these techniques have helped my neuropathy in my hand and foot (I seem only affected on my left side).  

I try to do things like type and wear good shoes that require my toes to grip to keep them active and help nerve pathways also. 

Another great therapy I used was called zero balance.  This was remarkable for the fascia tissue.  However, not many PT places do that. 

I also have found accupuncture to be a wonderful help during chemo and beyond. 

I also use message therapy.  My hospital provided this during chemo, and a local organization later for cancer patients. It has been a wonderful help to me. 

I wish you the best tomorrow and hope this information is of help to you. 

John212's picture
John212
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Joined: Jan 2015

Hippicichicks, thanks for the details.

Today was primarily about assessing the damage and talking about where we'll go from here. My first actual therapy session will happen this Saturday. One treatment the therapist described that she knows we'll do involves a vibrating plate. Most of what we'll do will revolve around increasing circulation to the affected areas. We also talked about ways that I'll be able to exercise that won't hurt and will possibly supplemnnt the therapy. It's going to be an intersting ride.

NewHere's picture
NewHere
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I started looking into some things based on the discussions for the Peripheral Neuropathy and know some people who do yoga, so I started looking around.  I am guessing that any activity can probably help, but there looks to be some gentler movmenets in yoga that may work.  

hippiechicks
Posts: 509
Joined: Sep 2012

Yes!! I have heard this as well.  For me it has been challenging to find/attend one, but is on my "to do soon" list! 

hippiechicks
Posts: 509
Joined: Sep 2012

Hi John212, A vibrating plate?? How interesting!  Please share your experience .. I look forward  to hearing about this! 

I did not have good luck when I tried to leave therapy for the gym .. it actually set me back just about one entire year! I developed severe planter fasciatis and foot drop.  Both have since been corrected with lots of PT ... I will not stray that way again without a personal trainer or something of the sort. 

John212's picture
John212
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Joined: Jan 2015

I've been a bit reluctant to exercise as well, though for different reasons. I tried swimming since that doesn't put pressure on the feet, but I'm so out of shape that I could only walk. The bottom of the pool hurt my feet. Back to square 1. We're going to try a stationary bike and a couple of simple floor exercises to build strength in my legs. I'm definitely holding to whatever exercise the Physical Therapist recommends and not stray far from her ideas at all.

I'll see if I can remember to get a brand name on the vibrating plate or take a picture with my phone and post it. 

John212's picture
John212
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Joined: Jan 2015

Saturday was the first session of actual physical therapy. We opened with several minutes of stationary bike to get warmed up, and then went through a series of exercises to loosen certain muscle groups and then to strengthen some. I have especially tight calves and hamstrings, so we did a lot of strethces there. My hips are weak, so we started doing some work on my core. The rationale for this is that I need to improve my balance. Because neuropathy causes us to lose much of our proprioception that would usually come through the bottoms of our feet, we need to make sure that the other contributing factors to balance can make up the difference.

Finally, as the last act of the session, we used the Vibra-Flex machine. It looks a bit like a short square treadmill, but the surface vibrates rather than passing over a set of rollers. I sat next to it and rested my feet on the pad and it shook the heck out of my feet for 6 minutes. I get the impression that we'll increase the time and vibration frequency as we go along.

After the session, I felt more pins-and-needles in my feet and ankles than usual. Normally, they just feel numb unless I'm walking and then there's pain as well. This change lasted for a few hours. I'll take that as a sign that what we did during the session had some impace. Whether this will translate to permanent improvement over time is another question.

abrub's picture
abrub
Posts: 2158
Joined: Mar 2010

I recently discovered Zeta Acupressure insoles; they've helped my feet tremendously.  I got them on Amazon for $13, but the price recently doubled.  I swear by them!

Alice

John212's picture
John212
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Joined: Jan 2015

Seems like I read about those insoles somewhere else and plenty of people have found them useful. I suppose all the stimulation from the little bubbles increases the circulation in your foot, which is a good thing.

abrub's picture
abrub
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I mentioned them on another thread a while ago.  I swear by them.  And my husband, a great skeptic, now swears by them too.  For the first time in years, his feet aren't aching in his XC ski boots.

John212's picture
John212
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Joined: Jan 2015

I've now had three sessions with a physical therapist and I can report some small changes already. The bottoms of my feet feel more "alive" than they used to, though the amount of change is subtle. I get pain in my toes in places that used to be too numb for pain. The feet still feel like bricks when I walk outside in the cold but I can imagine that might be one of the last symptoms to recede.

We've been working on balance and strength a lot. In each session we've been challenging my body to find balance under more and more difficult conditions. The worst so far has been to stand on a foam pad (about 3" thick) with my feet in a heel-to-toe arrangement, so one in front of the other. I can manage to stay well balanced like this for about a minute, though my legs are a bit wobbly most of the time. But then she tells me to close my eyes and I fall on my a** in ten seconds or less. Walking on a balance beam on the floor is also pretty tricky, but seems to be getting a little easier as we go along.

So, I feel like I'm noticing some tiny improvements with the PT. And that's very encouraging.

NewHere's picture
NewHere
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Sounds like you have having things go the right direction with the PT.  Happy to hear you have pain in your toes - well you know what I mean Laughing  Keep up the great work, it sounds like you are responding already.  

John212's picture
John212
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Joined: Jan 2015

One of the features of my PT regimen is trying to trick the nerves in my legs and feet to work differently. That's one of the reasons for all the balance work, for example. And here's another: my therapist has me doing massage on myself at home. To do this, I'm using several different items as massage tools: a couple of hair brushes, a comb, a wash cloth, and my hands. The idea is to give the nerves there lots of different kinds of input, so there's no limit to the kinds of things you could use for this. I rub my calves, ankles, and feet with these different items, including the backs of the hair brushes for a minute or so each in the morning and then again at night. It feels good and may well be contributing to some change.

Trubrit's picture
Trubrit
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I am 18 months out of treatment, and this week, when my husband was playing with me, he tickeled my feet and I FELT IT.  I was so excited   .

Anyway, I have never been to PT, but I do brush my feet and legs (my neuropathy went clear up to my knees in the early stages). I also have one of those shower heads that have several different settings. I use each one directly on my feet whenever I shower (the shower has a detacable hose. I don't want you to think I cock my leg up toward the shower head. HA!). I have found both the brushing and shower to be stimulating, and hoping that they have helped me get where I am today. 

With this weeks progress, I am really hoping that one day I will have normal feet again as I confess to have given up hope. 

John212's picture
John212
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Joined: Jan 2015

This is great news indeed. I don't know much about the science of all this, but it is clear from numerous case studies and other research that our nervous system can be amazingly plastic (capable of change, that is). People who suffer brain injury and initially lose their speech, can learn again how to speak. It seems to be largely about making the nervous system find new pathways for the information since the old ones are like washed out roads.

Keep up the tickling. It may pay off in other ways, too. Laughing

hippiechicks
Posts: 509
Joined: Sep 2012

This is fantastic news!  So glad things seem to be helping!

I am going to bring the balance information to my PT appointment.  I still fall fairly often, miss steps and such. 

I have also been told to do exercises such as standing on tip toes and down several times a day.  I find holding on to something is most helpful. Wink

John212's picture
John212
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Joined: Jan 2015

Last week I had my final PT session, which was largely about making sure I knew what to do as I continued to exercise on my own. I've had enough improvement that it seems clear that at least some of the things we were doing during PT have worked. I have more feeling in my toes and I can control my toes better. So now I'm doing a 1 hour workout three times each week. About half the workout is exercises we did in PT, revolving around balance and strength in my lower legs and ankles. The other half is spent using various weight machines to build some core strength and upper body strength, which are both pretty low right now.

For anyone considering this route, I'd say it's worth a try. The worst thing that will happen is that you'll develop an arsenal of exercises that will make you stronger and more physically secure. And you might just see some improvemnt in your neuropathy.

 

 

NewHere's picture
NewHere
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That the PT is helping and you are continuing on your own.

Each time should improve things more and more.  I need to start getting some exercise myself during the good points between chemo sessions, going to start with walking until my port is healed enough to do a bit more.

John212's picture
John212
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Joined: Jan 2015

I ignored exercise while I was in treatment and I think it might have been a mistake. I hope you find something beyond walking, but even that will help you stay fit and keep your mind a little sharper.

MAliceR's picture
MAliceR
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I had 36 sessions of acupunture for neuropathy in my hands and feet. My oncologist had me start before I was finished with my chemo and then continue after it was over. I found it vital to controling the numbness. I also walked and on rainy days, used a treadmill. I didn't go very fast at first as I was tired from the chemo and my balance was a bit off from the numbness in my feet, but just being up and moving helped. I didn't do PT because the acupunture and walking seemed to control it pretty well. Although I have been left with a small bit of numbness in the very ends of my fingers, the tips of my toes and the balls of my feet. I can deal with it, I just don't plan on wearing heels anytime soon, but with good supportive walking shoes was able to climb Siamond Head in Hawaii. If I miss a couple of days walking, I find the numbness increases. So movement and being active really does help. I also used a warm foot massager for a few minutes morning and night. It also seemed to wake things up a bit. Not sure any of this will help anyone, but thought I would share my experience.

Blessings,

MAlice

John212's picture
John212
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Thank you for your post. I have a friend who had a nearly identical diagnosis to mine about 6 months ahead of me. He had had some neuropathy before starting chemo, courtesy of diabetes and last time I saw him he had just started acupuncture for it. I'm looking forward to hearing how it has helped him. If you don't mind, what kind of warm foot massager do you use?

MAliceR's picture
MAliceR
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Joined: Mar 2015

I bought a regular foot massager at Bed, Bath and Beyond. It was about $40 if I remember correctly. It massaged and heated. I used it a couple times a day and found it really helped. Along with the acupunture. I was at the Dr earlier in the week and passed all the neuroptathy feeling tests with flying colors. For me it is vitally important to walk and stay miving. If I get lazy, the numbing begins to build again. 

Good luck! I hope you are successful in finding something that works for you.

MAlice

NewHere's picture
NewHere
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Since you mentioned it helped, I may get one today. Not to far from Bed, Bath and Beyond.   Bought comb, brushes, insoles as suggested and a pair of sandals with the little nubs on them.   Was also thinking perhaps the parafin therabaths.  Session 5 is tomorrow and want to get out ahead of this. 

It is interesting what you mentioned about moving.  For some reason the first week or so this round I had something opposite, which threw me off.  If I started walking around it went to my feet and a bit of my hands.  Maybe I did not give it enough time.  Was a bit of a bummer, because the doctor has exercise as something I should be doing as much as possible. Maybe this time will be better, but I m still trying to see if there is any pattern so far for me, other than being tired building up and last longer (another 20 hours or so of sleep in the last 24 and next hook up tomorrow) and the cold drink syndrome lasting.

 

schnauzerheads's picture
schnauzerheads
Posts: 53
Joined: Jan 2011

Thanks for bringing this up. I've been dealing with Neuropathy for years, had pretty much decided to accept it, but this has given me some inspiration to try to conquer it once again. Great suggestions.

 

John212's picture
John212
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Joined: Jan 2015

Given that neuropathy usually means dead nerve tissue, I don't think it would matter very much that you're starting up with some treatment or exercise plan later rather than earlier. Please let us know what you decide to try and how it works out.

NewHere's picture
NewHere
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Joined: Feb 2015

I used to have something ike this

http://www.amazon.com/adidas-Originals-Mens-Adissage-Sandal/dp/B001HZZ6YW

Could not find them in the house, so ordered the above.  Been wearing them since I got home from connection today when I walk.  Last session my feet immeditatley started.  This time (so far and granted short time) nothing.  Went outside in regular sneakers to grab something and my feet felt good.  Adding it to the arsenal of brushes, combs, insoles.  Figured for under $20 was woth a flyer.  Will let you know how it goes.   These are not quite as "nibby" as my old pair which took getting used to and always felt more massagey (a new word I just made up) but so far, fingers crossed.

John212's picture
John212
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Joined: Jan 2015

What's it like to walk with your whole body weight on those nubs? Looks kind of painful. That can't be the case, though, right?

NewHere's picture
NewHere
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Joined: Feb 2015

The other pair I misplaced (different brand) did take some getting used to.

These are fine and comfortable. I figured for the price it was worth a flyer.  Right now I have a pair of socks on with them (old pair and really not much too them), and will try without sox (better fashion statement I think that way ;)) at some poiint.    

A couple of times I got up and walked, felt tingling, put these on and they helped quickly.  I am now wearing them, whenever I remember, when walking around the house.  I take them off when lying on the couch.  But right now I am front of computer doing some work and have them on. Periodically rub feet and toes over them, guess a variation of the brush and other items you mentioned.  No numbness or tingling.  The last session my feet hit immediately and hard.  This time is it really okay.  I had a bit of nausea yesterday so they gave me some Ativan, perhaps that is also helping somehow in the overall scheme.   Guess I will see more as the days progress. This is a good cycle for me now - on of the two 17 day ones because of Memorial Day.  Looking forward to the bonus good days :)

I have had a weird thing overall - when I move the tingling and numbness is worse, which seems backwards.  But this round is easier.  

 

 

Matta's picture
Matta
Posts: 39
Joined: Jun 2011

It´s 4 years now since my last chemo and my neuropathy got very bad just before I got out of chemo.  At first I did not want anything because my doctor told me that this pain would go away after 3 - 6 weeks.  Well after about 6 MONTHS I almost got crazy out of the pain but I did not have anything to ease it until almost 2 years later and then I had Qutenza patches, it´s made out of chili pepper.  I had to have help from the hospital every 12 weeks to put the patches on my feet.  At last I gave up on this, it did not give me a good results and I had proplem with the hospital, the did not have any space for me to do this, they asked me if I could have it done somewhere else.  I was hoping for more support from them, this was all so
difficult so I could not try this any longer and gave up and talked to my doctor about a diffrent patches that I had been reading about.  It´s morphine, Fentanyl, at first I had 25mcg but that did not do enough for me, then I had 50mcg and have been on that since November and I feel that I have some of my life back, at last.  I use some extra medicine for break thru pain.  I had been thinking about that I lost so much of my quality of life that I was sinking into a depression, I was not ready to use some serious medicine like morphine but after living like this for so long I had to think all of this over, I had to think about what I want from this life and yes I need to have one more day that I can feel joy, not constantly in pain.  And now I sometimes feel joy and can forget the horrible neuropathy pain, with out the morphine I could not do it.  So, I´m glad I found my way to enjoy some of my life again.   

I hope you all will find what will help you, it´s so important not to just sit and wait for the pain to go away, I just sat here for more than two years and that is too much if you can find something that can help you to get up!

:) 

John212's picture
John212
Posts: 116
Joined: Jan 2015

Matta, thank you for sharing your story here. You clearly have had a very hard time with this, so I'm happy to see that you finally found some relief. I started out thinking the same way: they said it would only last a short while so I'll just live with it. Eventually the pain was hard to handle so I tried a drug - Gabapentin. It didn't really work and I just didn't want to take any more drugs so I gave it up. Now, the physical therapy and exercise seem to be making a small difference. I wish you all the best and many, mazny days of feeling joy.

DD3's picture
DD3
Posts: 134
Joined: May 2013

has neuropathy from good ole Oxy.  Seemed to get better after a year and was manageable with Gabapentin.  Fast forward a year later and it seemed to get worse.  She tried accupunture...  not much help at all.  She says it is the worse in the arch of her feet.  Tried insoles.  Not much help there either.  Talked to a nuerologist and he said try Capzine (Sp?).  Basically its jalapeno juice type stuff.  Boy a little goes a long way.  Seems to help her... although tolerating it is another matter entirely.  She does run 2-3 miles a day.  Somes days and she says "is a stuggle" with the neuropathy. 

 

John212's picture
John212
Posts: 116
Joined: Jan 2015

I tried one of those capsaicin creams and found that all it did was tingle for a few minutes after application, so I gave it up. I'm in awe of your wife keeping up with her running even with the neuropathy. That's fabulous!

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