Physical Therapy for Peripheral Neuropathy

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 said:

Acupressure insoles

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

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.

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 said:

Good News

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   Keep up the great work, it sounds like you are responding already.  

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 said:

Shower heads

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. 

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. 

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.