Balance & Neuropathy

By: Dr. Beth Templin

I get asked all the time about how neuropathy, or the loss of feeling in your feet, effects balance. Most people believe that there's nothing they can do to make their neuropathy better or improve their balance and that's not true.

Pain, weakness, numbness and tingling in the feet and legs are the most common symptoms reported by someone experiencing neuropathy. Depending on the underlying cause of the neuropathy, some of these symptoms can be managed.
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The most common type of neuropathy is diabetic. Your nerves are very sensitive to sugar levels in your blood, so when your sugars are too high, the nerves are damaged. This means the better your sugars are managed, the better your neuropathy symptoms will be controlled. 

Another common form of neuropathy is Vitamin B12 deficiency. When you're lacking this vitamin, you start to lose the protective layer surrounding the nerves and damage occurs. This type can be addressed with vitamin supplements. 

Issues with your back and spine such as spinal stenosis can also cause these symptoms. When there is additional pressure on the nerves as they leave the spine, this can cause damage to the nerves which leads to pain, numbness and weakness. Working on improving your alignment and strengthening weak muscles can help manage this.  

A common misconception is that if you have neuropathy you are bound to have poor balance and there's nothing you can do about it. That's actually not true. 

Your balance not only depends on the feeling in your feet, but also your leg strength, vision and inner ear. People with neuropathy have the ability to improve all of these areas, which leads to improved balance.

In physical therapy we look at several things including your ankle motion and strength. When your ankles are stiff and weak, you are less able to adapt to changes in the ground, making you more unstable. Most often these two things can be improved in people with neuropathy.

The other technique we use in therapy is called sensory integration. While you may have lost some of the feeling in your feet, you usually have not lost 100% of it. In therapy we teach you to better pay attention to the feeling you have left.

This technique improves your awareness of where your feet are and how you stand and walk on them, which of course leads to better balance.

Other things to consider when you have a diagnosis of neuropathy is proper fitting shoes with good arch support.
   
Some of our patients with neuropathy also benefit from use of an assistive device like a cane or walking poles. Using a device can provide you with increased stability when walking.

So if you have pain or numbness in your feet and you're concerned about your balance, know that there is hope and we can help!