Peripheral Neuropathy and Balance Diabetic Peripheral Neuropathy is thought to be a process that progresses and cannot be reversed. It is characterized by numbness and tingling in the feet and sometimes the hands. Sometimes it produces pain in the feet that can be bothersome, with a side effect of poor sleep as well. In fact, our patients tell us sometimes that they cannot stand to have sheets touch their toes in bed at night. It may feel like a sock is rolled up in your shoe, yet when you look it can be fine. No wonder these patients are so frustrated. Another problem that can be subtle in peripheral neuropathy is difficulties with balance. One patient told me “It’s difficult; when I can’t walk or do the things I need to, it takes the stuffing out of me. I’m afraid of falling.” Unfortunately, most medical practitioners believe nothing can be done other than to give pain medications and cover up the pain. While treating pain is a good idea, if the patient already has numbness in the feet, poor balance, and trouble with falling, the medicine may reduce the pain but make the patient dizzy and increase the falling! Not good. Approximately $12 billion in the US was spent for fall-related injuries last year, including fractures, head injuries, and trauma care. Unfortunately, most people are not aware of the problem until they start falling. By then, it may be too late. If patients show loss of sensation with testing and they complain of stumbling or balance problems, we evaluate their balance. What we find is that when vision is reduced, such as in a dark room, it creates more problems for these patients. When they can see, they can compensate for the fact that they can’t feel their feet too well. However, sometimes they look too far ahead, or if outside, they step off a curb that is higher than anticipated; it is times like these when patients fall. Interestingly, several studies show that Anodyne Infrared Light Therapy can help reverse this numbness. It has been my experience that when I measure the sensation of peoples’ feet when they have peripheral neuropathy that they have very poor sensation. I measure this by touching them with a nerve testing device that measures pressure over a surface of the foot. When I first see them, the device shows that I have to push quite hard with about an eighth to even a quarter of a pound before they can feel it! After 7 to 8 weeks of treatment, 80% of the patients have improved so much that they can now feel the device at the very light feather touch of about 5 grams! We see that these improvements in sensation also help improve balance. We provide specific balance training in a safe manner to help improve their balance further. The results have been fairly impressive. Probably the happiest patients are the elderly, who can walk better and for longer periods of time. They can resume grocery shopping and going to the mall. Typically, they show improved balance scores and the ability to remain on their feet for longer periods of time. This helps them maintain their independence. Loss of sensation in the feet can be an issue with driving as well. If you can’t feel the pedals, driving becomes much more difficult and dangerous. With treatment, some of our patients have been able to resume driving. A recent study involving Anodyne Light Therapy at Oxford University was published in “The Journal of Age and Aging” on November 22, 2005. It showed a reversal of peripheral neuropathy and decreased falls, as well as improvements in daily living. Interestingly, it also reported that these improvements were still there one year later! When people with peripheral neuropathy receive Anodyne Light Therapy, they show increased protective sensation in the feet and hands, and reduced falling as well as improved standing and walking tolerance. They also could do their chores more independently. If you or someone you know is having these problems, give us a call or talk to your doctor about seeing us for an evaluation. Instead of sitting your life away, get back into your life and get back to enjoying yourself! Call (301) 759-4263 for questions or appointments. Thank you. Tips In peripheral neuropathy, your legs may feel heavy and you may tire easily or experience stumbling or difficulty climbing stairs. Balance disorders are serious and may be a sign of a problem with the brain, heart, or circulation of the blood. Get yourself checked! Balance problems are a leading cause of falls in older people. Watch your posture when sitting and getting up. Place grab bars at a convenient height for maneuvering in the bathroom. Check your medications with your doctor; some produce side effects affecting balance. Use night lights to light your way from the bedroom to the bathroom. Don’t go barefoot! |
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