Symptoms
- ■ Numbness, tingling, or a 'pins and needles' sensation in the feet and hands
- ■ Burning or electric shock-like pain, often worse at night
- ■ Muscle weakness and difficulty lifting the front of the foot (foot drop)
- ■ Loss of proprioception causing unsteadiness and increased fall risk
- ■ Skin, hair, or nail changes and impaired autonomic functions in some types
Causes
- ■ Diabetes mellitus causing hyperglycaemia-induced nerve microvascular damage
- ■ Chemotherapy agents (vincristine, paclitaxel, cisplatin) causing direct axonal toxicity
- ■ Vitamin B1, B6, or B12 deficiency impairing myelin synthesis
- ■ Autoimmune conditions such as rheumatoid arthritis or Sjögren's syndrome
- ■ Chronic alcohol overuse causing combined toxic and nutritional nerve damage
Diagnosis
- ■ Detailed sensory examination using monofilaments, vibration tuning fork, and sharp-blunt discrimination
- ■ Nerve conduction velocity (NCV) and EMG studies to quantify nerve damage extent
- ■ Balance and proprioception testing using Romberg test and dynamic posturography
- ■ Comprehensive blood tests for HbA1c, B12, B1, thyroid function, and autoimmune markers
* Evidence-Based Interventions
Clinical
Approaches
Sensory Re-education
Graded exposure to different textures and temperatures to retrain peripheral sensory pathways.
Balance Training
Proprioceptive loading exercises on unstable surfaces to compensate for sensory loss.
Strengthening
Focused resistance exercises for intrinsic foot muscles, ankle dorsiflexors, and hand intrinsics.
TENS & Infrared Therapy
Non-invasive pain modulation to reduce burning neuropathic pain and improve circulation.
🏠 Home Exercises Guide
Strengthen your recovery. Perform these exercises strictly under pain-free limits:
📋 Execution Blueprint: Toe Intrinsic Strengthening (Towel Scrunches)
- 1Sit in a chair with bare feet flat on the floor over a small towel.
- 2Curl your toes downward to scrunch and gather the towel toward you.
- 3Hold the scrunched position for 3 seconds, then spread toes to release.
- 4Flatten the towel and repeat.
- 5Complete 15 repetitions to strengthen intrinsic foot muscles weakened by motor neuropathy.
People Also Search For
* FAQs
Common Questions
Depending on the cause, partial reversal is possible. Diabetic neuropathy may improve with excellent glucose control; vitamin B12 deficiency neuropathy improves with supplementation. Chemotherapy-induced neuropathy often stabilizes and partially improves after treatment ends.
At night, reduced distracting sensory input and activity allows the nervous system to focus more on pain signals. Additionally, temperature changes and altered circulation during sleep can amplify neuropathic pain perception.
Yes, regular walking is safe and beneficial. However, protective footwear is essential to guard against injury from undetected pressure or abrasion due to reduced sensation. Inspect feet after every walk.
We recommend deep, wide-toe box shoes with removable insoles, cushioned soles, and no internal seams. Custom orthotic insoles redistribute pressure and protect insensate areas of the foot.
Yes, specialized balance rehabilitation, sensory retraining, and strengthening programs have demonstrated significant benefit in managing CIPN symptoms and reducing fall risk during and after chemotherapy.
We use Romberg's test (standing with eyes closed), monofilament testing to grade protective sensation, vibration perception with a tuning fork, and dynamic balance testing on foam surfaces.
Foot drop occurs when weakness of the ankle dorsiflexors (peroneal nerve) causes the foot to drag during walking. We treat it with targeted strengthening, ankle-foot orthoses (AFOs), and functional electrical stimulation (FES).
No, properly graded exercise actually improves nerve function over time by enhancing circulation to nerves and stimulating nerve growth factor production. Avoid high-impact activities if sensation is severely reduced.
Begin Your
Recovery Today*
Comprehensive clinical assessment within 48 hours.
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Free Initial Assessment
Includes clinical check, analysis, and personal recovery planning for Peripheral Neuropathy under Dr. Karolin Rockson, PT (BPT), Ex. CMC - Vellore.
Verified Author Protocol
Dr. Karolin Rockson, PT (BPT), Ex. CMC - Vellore
Board: Indian Association of Physiotherapists (IAP)
Reg No: PT-84729