Symptoms depend on the type of nerve affected (sensory, motor, or autonomic) and the extent of the damage.

• Sensory Neuropathy (damage to nerves that control sensation):
  • Numbness: Often starts in the hands and feet and can spread upwards (stocking-glove distribution).
  • Tingling or “pins and needles” sensation (paresthesia).
  • Burning, shooting, stabbing, or electric-shock-like pain.
  • Extreme sensitivity to touch (allodynia): Pain from normally non-painful stimuli like light touch or clothing.
  • Increased sensitivity to painful stimuli (hyperalgesia): Normal pain feels much worse.
  • Loss of balance and coordination due to impaired proprioception (sense of body position).
  • Reduced ability to feel temperature changes or pain, increasing risk of injuries, burns, or infections.
• Motor Neuropathy (damage to nerves that control muscle movement):
  • Muscle weakness: Difficulty with daily tasks like gripping objects, walking, or rising from a chair.
  • Muscle cramps and spasms.
  • Muscle twitching (fasciculations).
  • Muscle wasting (atrophy) or shrinking of muscles.
  • Foot drop: Difficulty lifting the front part of the foot, leading to tripping.
  • Paralysis in severe cases.
• Autonomic Neuropathy (damage to nerves that control involuntary body functions):
  • Digestive problems: Nausea, vomiting, bloating, constipation, diarrhea.
  • Bladder problems: Difficulty emptying the bladder, incontinence, frequent urination.
  • Cardiovascular issues: Dizziness or lightheadedness when standing (orthostatic hypotension) due to blood pressure drops, irregular heart rate.
  • Sweating abnormalities: Excessive sweating (hyperhidrosis) or inability to sweat (anhidrosis).
  • Sexual dysfunction: Erectile dysfunction in men, vaginal dryness or difficulty with arousal in women.
  • Difficulty adjusting to temperature changes.
  • Hypoglycemia unawareness: In diabetics, not feeling the usual symptoms of low blood sugar.
• Combination Neuropathies (affecting multiple nerve types):
  • Polyneuropathy: Damage to multiple nerves, often symmetrical (e.g., diabetic neuropathy affecting both feet).
  • Mononeuropathy: Damage to a single nerve (e.g., carpal tunnel syndrome, Bell’s palsy).
  • Mononeuropathy multiplex: Damage to two or more distinct nerves in different areas.
  • Proximal neuropathy: Affects nerves in the hips, buttocks, or thighs, often unilaterally.

Physiotherapy for Neuropathies

• Pain management: Reduce neuropathic pain and discomfort.
• Maintain/Improve muscle strength and endurance: Combat muscle weakness and prevent atrophy.
• Improve balance and coordination: Reduce fall risk.
• Enhance functional independence: Help with daily activities, mobility, and participation in life roles.
• Prevent complications: Such as contractures, skin breakdown, or deformities.
• Patient education and self-management.