As Pedorthists we have always worked with clients who have neuropathy. For the most part these people have usually had Diabetes or impairment of sensation from injuries or surgeries. In the past few years, we have seen increasing numbers of people with what is commonly called “idiopathic neuropathy” which means, no known or obvious cause. This lack of diagnosis makes people frustrated as there is no clear treatment plan to cope with or adapt to the problem.
What is Neuropathy?
Peripheral neuropathy happens when the nerves that are located outside of the brain and spinal cord (peripheral nerves) are damaged. This condition often causes weakness, numbness and pain, usually in the hands and feet. It also can affect other areas and body functions including digestion and urination.
The peripheral nervous system sends information from the brain and spinal cord, also called the central nervous system, to the rest of the body through motor nerves. The peripheral nerves also send sensory information to the central nervous system through sensory nerves.
What are the consequences of Neuropathy?
Having experienced this myself, I have put a fair amount of energy into things I can do to try and reduce the impact on my daily life. Part of the problem is the host of symptoms associated with loss of sensation. Many have pain and the pain can feel like burning, sharp, electrical or just continual aching. Sometimes it will be all the time or occasional and inconsistent. Many have no pain at all, just spotty or complete loss of sensation.
The one thing that is constant is how it affects our balance. Nerve receptors in the soles of our feet give information to our brains to let us know where our feet are in space and how they are conforming to the surface we are standing or walking on. This is called proprioception, and to some extent you can do exercises to try and enhance it. When sensation is impaired or delayed it puts us at risk of a stumble or fall.
When we first become aware that there is a sensory deficit, we are more apprehensive about movement and tasks that we used to take for granted. This loss of confidence often results in reduced activity that will affect our quality of life on many levels.
When I am designing an Orthotic or Orthotic/shoe combination, I am trying to provide symptomatic relief for the problem I am confronted with but there are other considerations. If we discover a history of neuropathy; then stability and fall prevention are more important. If, in examining the feet and legs, there are differences between left and right, then balance and reducing compensation are key. In truth the main complaint is usually the result of how balance, posture and gait interact.
For people who have worked their lives on hard surfaces, perhaps in inappropriate or worn footwear, the neuropathy may be more a compression type where stationary standing does not allow enough tissue activity to assist blood flow. Sometimes symptoms are worse due to friction or movement of the feet in the shoe. Often an orthotic to stabilize or a softer stocking to cushion the feet will help. Something I often see are shoes that are too soft or worn out, literally undermining you.
Another common problem is a trunk forward posture where you are keeping an eye on your feet for confirmation of what your brain is not telling you. This puts your center of gravity more towards your toes and makes your toes work harder than they should. Your center of gravity should be under your ankles with your head up and shoulders back. This would be active alert posture. Snap to it, you have your work cut out for you.
The 4 Actionable Steps to Dealing with Peripheral Neuropathy
- Maintain Proper Foot Care: Regularly inspect your feet for cuts, blisters, and sores, as reduced sensation may prevent you from noticing injuries. Keep your feet clean and moisturized, and wear well-fitted, supportive shoes to prevent damage.
- Manage Blood Sugar Levels: For those with diabetes, controlling blood sugar levels is crucial in preventing the progression of neuropathy. Regular monitoring, a healthy diet, and medication adherence are key components.
- Pain Management Strategies: Explore various pain relief options including custom foot orthotics, therapies like acupuncture, physical therapy, or TENS (transcutaneous electrical nerve stimulation) units.
- Stay Active: Regular exercise can help improve circulation and reduce neuropathy symptoms. Low-impact activities such as walking, swimming, or cycling are beneficial. Always consult with your healthcare provider before starting a new exercise regimen to ensure it’s safe for you.
More questions than answers? You can get more information on orthotics, footwear and pedorthic services at Thera-Ped Foot and Ankle Clinic by calling (506) 632-9397, or book an appointment today with our Canadian Certified Pedorthists.