DEAR MAYO CLINIC:

My doctor told me that I have peripheral neuropathy. Balancing while walking without my walker is difficult.

Can you offer me any suggestions about how to deal with this condition?

ANSWER:

Peripheral neuropathy occurs as a result of nerve damage and often leads to pain, tingling, numbness and a lack of sensation in the limbs, particularly the hands and feet.

Treatment may ease symptoms, and some lifestyle changes may also help.

The nervous system is divided into two broad categories.

The central nervous system consists of the brain and spinal cord.

All other nerves in the body are part of the peripheral nervous system, which includes sensory nerves that receive feelings such as heat, pain or touch; motor nerves that control how muscles move; and autonomic nerves that control such automatic functions as blood pressure, heart rate, digestion and bladder function.

Peripheral neuropathy isn't one disorder but actually a group of conditions that cause damage to the peripheral nerves

Peripheral neuropathy may result from trauma or pressure on a nerve, or it may be a complication of another medical condition or disease. For example, many people with diabetes develop peripheral neuropathy. Other disorders associated with peripheral neuropathy include lupus, rheumatoid arthritis, kidney disease, liver disease, and an underactive thyroid (hypothyroidism). Peripheral neuropathy can also be an inherited disorder.

Peripheral neuropathy usually affects the longest nerves which supply the feet and legs.

As a result, nerve damage can make walking difficult for several reasons. First, the condition can cause muscle weakness -- typically affecting muscles in the feet -- that makes it hard for you to hold yourself up. Some people describe it as feeling like they are walking on stilts.

Second, peripheral neuropathy can cause numbness or diminished sensation in the feet, including loss of proprioception -- the ability to tell the position of your joints, which lets you know where you are in space. Loss of proprioception can cause imbalance.

If peripheral neuropathy is caused by another underlying medical condition, careful management and treatment of that condition may relieve neuropathy symptoms, including difficulty walking.

To help maintain balance and avoid falls while experiencing these symptoms, make sure you can clearly see your surroundings.

Walk in well-lit areas. You may want to use a nightlight in your bedroom to help you get around during the night. Also, walk only on even surfaces, and avoid rough or uneven ground.

Some people with peripheral neuropathy have problems taking a shower.

They must close their eyes to keep from getting soap in them, but, as a consequence, lose their balance. One strategy is to shower while seated.

If you have muscle weakness due to peripheral neuropathy, physical therapy may help. Or, wearing braces to help overcome weakness and stabilize your legs and feet may be of assistance.

Discuss your symptoms with your doctor, so that the two of you can devise a treatment plan and additional self-care techniques that are right for your situation.

-- P. James Dyck, M.D., Neurology, Mayo Clinic, Rochester, Minn.

 

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