Peripheral neuropathy, or PN, is a condition that happens when nerves outside the brain and spinal cord get damaged. These nerves are a part of the peripheral nervous system, or PNS, which helps send messages from the brain and spinal cord to the rest of the body.

PN can affect many functions of the body, like movement, feeling, and automatic activity (like breathing and digestion). A person’s symptoms depend on which nerves are affected. Some types of PN have specific names based on what causes them. For example, diabetic neuropathy is caused by diabetes. Guillain-Barre syndrome develops when the body’s immune system attacks the nerves.

PN can be linked to other health problems like inherited conditions or autoimmune diseases. Sometimes, it happens in older adults without a clear reason; this is called idiopathic peripheral neuropathy. Certain cancer treatments, like chemotherapy, also can cause PN.

Symptoms may include pain, muscle weakness, numbness or tingling, and trouble with balance or coordination. Some people get better over time. However, many symptoms can last a long time. No matter what kind of PN someone has, physical therapists can help them to manage symptoms and improve their overall health and well-being.

Physical therapists are movement experts. They improve quality of life through hands-on care, patient education, and prescribed movement. You can contact a physical therapist directly for an evaluation. To find a physical therapist in your area, visit Find a PT.

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On this page

• What Is Peripheral Neuropathy?
• How Does It Feel?
• How Is It Diagnosed?
• How Can a Physical Therapist Help?
• Can This Injury or Condition Be Prevented?
• What Kind of Physical Therapist Do I Need?

What Is Peripheral Neuropathy?

There are many types of peripheral neuropathies, but they all have one thing in common. They all impact the way nerves send signals between your body and your brain or spinal cord.

Physicians give more specific names to PN based on:

• How many nerves are affected.
• What kind of nerves are involved.
• What caused the nerve damage.

Because of all the possible causes of PN, the different types of peripheral neuropathies have a wide range of symptoms. The types of nerves that can be impacted by PN are:

• Sensory nerves, which process the feeling of pain, light touch, and temperature.
• Motor nerves, which create muscle action.
• Autonomic nerves, which control heart rate, blood pressure, body temperature, breathing, and digestion.

Most types of PN are not life-threatening. Nerve damage can happen suddenly, like from an accident. Or it can occur slowly over time, like with diabetes or idiopathic peripheral neuropathy. Peripheral neuropathies can be classified as:

• Mononeuropathy. This term is used when only one nerve is affected. The condition usually occurs when a nerve is squeezed or pinched. An example of this is carpal tunnel syndrome. It occurs when the median nerve in the arm is compressed, leading to altered sensation, pain, and weakness in the hand.
• Polyneuropathy. This term defines a condition affecting two or more nerves. It is often caused by other health problems like kidney or liver disease. This type of PN can cause problems with movement, sensation, and automatic body functions. Symptoms can be mild or severe.

How Does It Feel?

When someone has peripheral neuropathy, one or more types of nerves may not work properly. Depending on which nerves are affected, a person might notice:

• Numbness and tingling, usually starting in the feet or hands, and possibly spreading up the limbs.
• Loss of feeling, like not noticing when something touches your skin.
• Pain, which may feel like burning, stabbing, or electric.
• Extra sensitivity, where even light touch can hurt.
• Trouble with coordination, making someone feel clumsy.
• Muscle weakness or even paralysis.
• Bowel or bladder changes (incontinence).
• Feeling too hot or too cold.
• Trouble with balance, which may lead to falls.
• Slow healing of cuts or wounds.
• Sweating too much or skin dryness.
• Skin that looks red or pale.
• Nail growth changes.
• Difficulty doing everyday activities.

CAUTION: If you or a loved one are experiencing any of the above symptoms, consult a medical doctor.

How Is It Diagnosed?

Peripheral neuropathy can happen for many reasons. Doctors use several kinds of tests to figure out what is causing it. Depending on the situation, different types of health care providers may help with diagnosis. These may include a:

• Primary care physician (family doctor).
• Neurologist (brain and nerve specialist).
• Endocrinologist (hormone specialist).
• Cardiologist (heart doctor).
• Geriatrician (senior care doctor).
• Orthopedist (bone and joint doctor).
• Oncologist (cancer doctor).
• Rheumatologist (immune system doctor).

If a physical therapist thinks you might have peripheral neuropathy, they will check your reflexes, sensation (how you feel things), and muscle strength.

A team of health care providers can be used to treat the symptoms of peripheral neuropathy. With the right care, it’s possible to reduce how bad symptoms feel and improve your overall well-being.

How Can a Physical Therapist Help?

Physical therapists play an important role in helping people move better and stay active when PN affects their body. Your physical therapist will create a treatment plan that fits your personal needs and goals.

Because PN can have different causes and symptoms, the care you receive will be tailored to your situation. Your physical therapist may recommend:

Nerve gliding exercises. Nerves need movement, blood flow, and space to work properly. These exercises help your nerves move, which can reduce symptoms and support healing. Your physical therapist will teach you how to do these exercises safely.

Moderate-intensity exercise. Your physical therapist may recommend moderate-intensity exercises to help improve your strength and how your body works.

Balance and coordination activities. PN can affect your ability to stay steady and move smoothly. Your physical therapist will offer exercises and strategies to improve your safety.

Bracing. Your physical therapist may prescribe bracing to address a nerve injury, joint pain, or muscle injury, and help promote safe movement.

Education. Your physical therapist will teach you how to manage PN in your daily life. This may include tips to stay safe, avoid further problems, and find different ways to perform some tasks.

Can This Injury or Condition Be Prevented?

Peripheral neuropathy is a condition that can be caused or worsened by various health issues. Fortunately, the same healthy lifestyle habits that help prevent chronic diseases like diabetes can lower your risk of developing PN. Habits that may specifically reduce your risk for PN include:

• Using proper body movements (ergonomics) during work and leisure activities.
• Staying physically active.
• Eating a nutritious diet.
• Avoiding exposure to harmful substances and chemicals.
• Keeping up with recommended vaccines such as the shingles vaccine.

Physical therapists support your wellness goals by offering programs that promote an active lifestyle. If you do develop PN, they are trained to help manage your symptoms and improve your overall well-being.

What Kind of Physical Therapist Do I Need?

All physical therapists are prepared through education and experience to treat conditions such as PN. However, when seeking a provider you may want to consider:

• A physical therapist who is a board-certified clinical specialist. They may be a: geriatric clinical specialist (GCS), neurologic clinical specialist (NCS), or orthopedic clinical specialist (OCS). These physical therapists have the advanced knowledge, experience, and skills that may apply to your condition.
• A physical therapist who has a practice focusing on geriatrics, neurology, or orthopedics or who is experienced in the treating peoplw with PN or other neuropathic disorders.

You can search for physical therapists near you who have these and other credentials by using Find a PT, the online tool built by the American Physical Therapy Association.

General tips when you're looking for a physical therapist (or any other health care provider):

• Get recommendations from family and friends or from other health care providers.
• When you contact a physical therapy clinic for an appointment, ask about the physical therapists' experience in helping people with peripheral neuropathy.
• Be prepared to describe your symptoms in as much detail as possible. Keep a journal highlighting when you experience pain. This will help your physical therapist identify the best approach to your care.