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Peripheral Neuropathy: Symptoms, Causes, & How Therapy Can Help

Posted on 12/15/22 by Michael in Peter B. Lewis Aquatic Center

What is peripheral neuropathy?

There are two parts to the nervous system, the peripheral nervous system, which includes the nerves exiting the spinal cord to the ends of the body, and the central nervous system, which includes the brain and spinal cord. Peripheral neuropathy is when damage occurs to the nervous system at the ends of the peripheral nerves causing symptoms at the ends of the nerves farthest from the body, which control both sensation and muscle strength in the extremities.

Symptoms of peripheral neuropathy

Damage to the peripheral nervous system from peripheral neuropathy can cause changes in sensation, resulting in numbness, tingling or burning pain, as well as changes in muscle strength, resulting in weakness. Because these symptoms begin appearing at the end of the extremities, symptoms are often first seen in the fingertips and toes. Symptoms from peripheral neuropathy will present across the entire extremity on both sides, which makes it different from other nerve injuries that typically only affect part of the extremity and will only present on one side. Over time, symptoms can progress further up the extremity, which is described as stocking-glove distribution because it resembles someone wearing stockings on the lower extremities or gloves on their hands.

Peripheral Neuropathy: Symptoms, Causes, & How Therapy Can Help


Causes of peripheral neuropathy

Peripheral neuropathy can occur from a variety of reasons including trauma, infections, metabolic problems and toxins. Two common causes include diabetic peripheral neuropathy and chemotherapy induced peripheral neuropathy.1

Diabetic neuropathy

Diabetic neuropathy occurs due to prolonged uncontrolled blood sugar levels that causes damage to the nerves. It is the most common cause of peripheral neuropathy with more than half of individuals affected by diabetes developing neuropathy.1

Chemotherapy-induced peripheral neuropathy

Another common cause of peripheral neuropathy is chemotherapy-induced peripheral neuropathy, which occurs when there is damage to the peripheral nervous system as a side effect of chemotherapy treatment. This damage occurs due to drug interactions in the body and will vary based on the drug used, the dosage and the duration of exposure. The highest incidence of chemotherapy induced peripheral neuropathy occurs with platinum chemotherapy drugs.2

Impact on Function

The symptoms of peripheral neuropathy can have a significant impact on an individual’s daily activities including fine motor control, balance, walking and safety.

Fine Motor Control

Damage to the peripheral nervous system in the hands and fingertips can impact fine motor control and the ability to complete daily tasks, such as buttoning a shirt, picking things up or holding an item. Occupational therapists work with patients to modify these activities of daily living in effort to make them easier to complete.


Balance is controlled by three main systems in the body including the vestibular system, or inner ear, visual system and somatosensory system, which includes sensation. Muscle strength is also an important part of balance, as it can help to stabilize the joints and react to any loss of balance.

Peripheral Neuropathy: Symptoms, Causes, & How Therapy Can Help


Symptoms of peripheral neuropathy can affect both sensation and muscle strength which can significantly impact balance and increase the risk of falling. Physical therapists can help to address balance deficits with exercises to improve muscle strength, vestibular function, and balance reaction. They can also provide patients with instructions on how to use an appropriate assistive device as part of a comprehensive program to help reduce fall risk.

For more information about physical or occupational therapy for peripheral neuropathy or to schedule an appointment, contact us online or call us today at 216-595-7345.





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