Peripheral neuropathy is a condition that affects the nerves of your body. It is generally classified by the number of nerves affected, the type of nerve cells affected, or the process affecting the nerves. Depending on these factors, the symptoms of PN vary widely, and can include sensory (touch), motor (movement), and/or autonomic (nervous system) issues. See the "How Does It Feel" section below for more details.

Common classifications of PN include:

• Mononeuropathy. This is a condition only affecting 1 nerve. It is often a result of the compression of a nerve, which creates an onset of symptoms. Carpal tunnel syndrome is an example of a mononeuropathy, in which compression of the median nerve in the arm results in altered sensation, pain, and weakness of the hand.
• Polyneuropathy. This is a condition affecting 2 or more nerves and is generally a result of a disease process that affects the entire body. This type of PN can result in an individual experiencing symptoms in various body parts, on both sides of the body.
• Neuritis. This is a condition that results from inflammation of a nerve. There are many causes of this type of PN including infection, injury, or exposure to chemicals.

To understand symptoms of PN, we must first understand that nerves have influence over 3 primary functions, all of which may be altered by PN:

1. Sensation.
2. Motor function (movement).
3. Autonomic (nervous system) function.

Depending on the location and type of nerve(s) involved, people with PN may experience:

• Numbness and tingling, most commonly starting in the feet and hands, and possibly spreading up the limbs.
• Loss or absence of sensation (the ability to sense contact with outside objects).
• Pain, often described as burning, sharp, or "electric-like."
• Increased sensitivity to light touch.
• Clumsiness or decreased coordination in the affected limb(s).
• Weakness or paralysis in the muscles or parts of the body affected by the nerve or nerves.
• Bowel or bladder changes (incontinence). Nerves controlling these functions may be affected.
• Temperature intolerances.
• Decreased balance.
• Falls.
• Poor wound healing.
• Excessive sweating or skin dryness.
• Flushed or pale skin.
• Abnormal nail growth.
• Decreased ability to participate in normal functional activities.

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

A thorough examination by a medical professional will help determine if you have symptoms of PN. There are several methods and tests a clinician may use to make a diagnosis, such as testing your reflexes, sensation, and muscle strength.

If you have suspected symptoms, your physician may also order blood work, diagnostic imaging (such as an MRI), or nerve-conduction testing. These tests are generally ordered based on the suspected origin of symptoms.

Physical therapists play a vital role in helping individuals improve and maintain functions that may be limited by PN. Your physical therapist will work with you to develop a treatment plan to help address your specific needs and goals.

Because the cause, type, and symptoms of PN can all vary, the approach to care will also vary. Your physical therapist may provide the following recommendations and care:

Nerve gliding activities. To function well, nerves require 3 things: movement, blood, and space. Exercises that move and "glide" your nerves are often effective at helping to manage symptoms of PN, as well as promote nourishment and healing of the nerve. Your physical therapist can show you effective exercises that move and glide your nerves.

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

Balance and coordination activities. Your physical therapist may work on strategies to improve your balance and coordination, both of which may be altered by PN. Improving balance and coordination can help decrease your risk of falling.

Bracing. Your physical therapist may prescribe bracing for your nerve injury. Braces can be used to protect injured nerves or to help you move safely.

Education. Your physical therapist will educate you on how to safely manage PN. Your education will vary based on your individual needs, and may focus on improving your safety, preventing further complications, and finding alternative ways to perform certain tasks.

Because there are many conditions associated with PN, some basic lifestyle modifications can help reduce the risk of its development. Examples of lifestyle modification include avoidance of specific activities that put nerves at risk for injury, avoidance of specific environmental chemicals that may aggravate a preexisting nerve injury, and incorporating daily exercise into one’s lifestyle to better control diseases that may aggravate nerve injuries.

Maintaining an active, healthy lifestyle with routine checkups by your physical therapist may help reduce your risk of developing certain types of PN and the complications associated with it. Your physical therapist is trained to notice any changes in factors, such as your strength, sensation, and functional ability, which could suggest development of PN — and to work with you to help prevent its further development.

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, such as a board-certified geriatric clinical specialist (GCS), board-certified neurologic clinical specialist (NCS), or board-certified orthopaedic clinical specialist (OCS), or who has advanced knowledge, experience, and skills that may apply to your condition. You want to seek a physical therapist who is well-versed in the treatment of PN or other neuropathic disorders.

You can find physical therapists who have these and other credentials by using Find a PT, the online tool built by the American Physical Therapy Association to help you search for physical therapists with specific clinical expertise in your geographic area.

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, and keeping a journal highlighting when you experience pain will help the physical therapist identify the best way of approaching care.