Exercising Safely With Peripheral Neuropathy: Tips and Precautions

Understanding Neuropathy

Neuropathy refers to nerve damage that results in weakness, numbness, pain or other abnormal sensations. It often affects the peripheral nerves, which are the nerves that connect your brain and spinal cord to the rest of your body. Peripheral neuropathy has a variety of potential causes, including diabetes, injury, infections, autoimmune diseases and exposure to toxins. It can affect one nerve group, such as the motor nerves that control muscle movement, or sensory nerves that transmit sensations to your brain. The symptoms and progression of the condition can vary significantly between individuals.

Common Forms of Neuropathy

Some of the most frequently diagnosed forms of peripheral neuropathy include:

• Diabetic neuropathy: High blood sugar levels associated with diabetes can damage peripheral nerves over time. This is one of the most common causes of neuropathy.
• Chemotherapy-induced neuropathy: Anti-cancer drugs frequently used in chemotherapy kill not only cancer cells but also some normal cells, including peripheral nerve cells.
• HIV/AIDS neuropathy: Up to one third of people with HIV develop peripheral nerve damage.
• Autoimmune diseases: Disorders like lupus and rheumatoid arthritis cause the body's immune system to attack itself, including peripheral nerves.

In many cases, an exact cause for someone's neuropathy cannot be identified. This is known as idiopathic neuropathy. The treatment in these situations focuses on managing symptoms rather than addressing an underlying condition.

How Neuropathy Can Impact Exercise

For those managing neuropathy, exercise provides many benefits, including improving strength, cardiovascular fitness, balance, coordination, mood and sleep. However, having damaged peripheral nerves can also complicate exercise routines and increase the risk of complications or injuries.

Some of the main ways that peripheral neuropathy may impact exercise include:

• Numbness and loss of sensation: You may be unable to feel touch, temperature changes or pain signals well, increasing the chance of developing blisters, cuts or more serious foot injuries during exercise without realizing it.
• Muscle weakness or paralysis: Nerve damage can cause noticeable muscle weakness, atrophy or paralysis, limiting strength and mobility for exercise.
• Loss of balance and coordination: Proprioception refers to your body's internal system for sensing body position and movement. Neuropathy hampers this, decreasing balance and control.
• Increased falls risk: All of the factors above contribute to a higher falls risk, especially while exercising, which could lead to injury.
• Pain or uncomfortable sensations: Some forms of neuropathy cause constant or intermittent pain, numbness, tingling or hypersensitivity to touch, compounding exercise difficulties.

Potential Dangers of Unmonitored Exercise

Without taking the right precautions tailored to your individual neuropathy symptoms, starting or continuing an exercise program could unintentionally do more harm than good.

Potential risks could include:

• Falling and sustaining an injury like a bone fracture or head trauma
• Developing large blisters or skin wounds without realizing it
• Imbalance between muscle groups leading to strains or other injuries
• Exacerbating pain or neurological symptoms
• Further damaging peripheral nerves

For these reasons, anyone with peripheral neuropathy needs to approach exercise in a gradual, safe way in communication with their healthcare providers.

Tips for Safe Exercise

While exercise with neuropathy requires special attention, almost anyone can adapt a fitness regimen to their abilities and symptoms.

Work with Your Doctor

First, consult your physician before beginning or advancing any workout program. A doctor can help identify activities most suitable for your situation and precautions relevant to your health history.

Questions to ask may include:

• What type of exercises seem safest based on my neuropathy symptoms and severity?
• Are there activities I should avoid or modify?
• Should I take medication before exercising if I usually have pain?
• What should I monitor while working out regarding potential complications?

Choose Appropriate Exercises

With your doctors input, select activities less likely to exacerbate balance and mobility challenges. Options to consider include:

• Walking: Start with smooth, flat surfaces at a slow to moderate pace. Progress gradually in speed or distance.
• Swimming: Buoyancy and warmth helps limit strain to the body while exercising muscles.
• Cycling: Upright and recumbent bikes provide aerobic activity while supporting body weight.
• Strength training: Lifting low weights in seated or supported positions can improve muscle tone.
• Tai chi: Controlled movements focused on balance and strength training help prevent falls.

As stamina improves, you may consider adding more challenging exercises under your doctors supervision, such as using an elliptical or light jogging.

Exercise Cautiously

Regardless of chosen activities, some universal tips can help people with neuropathy exercise more safely:

• Wear well-fitted footwear and comfortable, loose clothing appropriate for working out.
• Test sensory perception in feet and hands before starting. Can you feel touch, pressure and temperature adequately?
• Begin each session with 5-10 minutes of simple walking or gentle stretching.
• Start slowly and focus on proper form over speed, distance or weight.
• Add intensity or impact gradually over weeks to months.
• Exercise with a partner for safety if high fall risk.
• Stop immediately if you feel sharp or worsening pain, numbness or tingling.
• Stay well hydrated before, during and after exercising.

By closely monitoring your body's signals and responses, you can keep workouts as rewarding as possible while optimizing safety.

Other Considerations

Medications and Supplements

Some medications and supplements used to manage neuropathy and related health conditions can affect exercise capacity, such as by exacerbating fatigue or lightheadedness.

Discuss your medications with your doctor regarding ideal timing around planned workouts and any other precautions. In some cases, adjustments may be advised to promote exercise readiness.

Supportive Gear and Tools

Certain equipment can enhance stability for those with neuropathy, including:

• Walking poles or hiking sticks
• Ankle or knee braces
• Unweighted support belts or vests
• Chair grab bars if exercising while seated
• Supportive fitness shoes with a stable sole

Consider consulting a physical therapist or athletic trainer for personalized product recommendations.

Mindfulness

Finally, mindfulness while exercising is especially vital with neuropathy.

Stay focused on posture, form, technique and your bodys responses at all times, rather than pushing yourself to meet subjective performance goals. Tuning into warning signs promptly can promote safety and prevent overexertion injuries.

By progressing gently and focusing inward, exercise can still provide wonderful wellness benefits for people with diabetic, chemotherapy-induced, HIV and other forms of peripheral neuropathy.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.