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Diabetic Polyneuropathy and Physical Therapy

According to the Centers for Disease Control, there were nearly 19 million people with a diagnosis of diabetes in 2011. Diabetes is a chronic disease in which the body’s glucose levels are higher than normal, resulting from the body’s inability to produce and/or use insulin properly.  There are several different types of Diabetes, including Type I Diabetes, Type II Diabetes, and Gestational Diabetes.

Complications of Diabetes include heart disease, stroke, high blood pressure, polyneuropathy, impaired sensation, blindness, kidney dysfunction, periodontal disease, Diabetic ulcers and other chronic wounds, charcot deformity, lower limb amputations, coma and death.

What is Diabetic Polyneuropathy?

Neuropathy is a pathological change of the nerves.  Diabetic polyneuropathy is a type of neuropathy that is associated with diabetes mellitus.  It is thought to occur as the result of vascular changes experienced by those with diabetes.  There are many types of diabetic polyneuropathy, but general signs and symptoms of diabetic polyneuropathy include:

•    A burning sensation in the hands and/or feet
•    Numbness and/or tingling in the extremities
•    Abnormal sensation
•    Muscle weakness
•    Erectile dysfunction
•    Urinary incontinence
•    Dizziness
•    Vision changes

Sensorimotor polyneuropathy affects the body’s sensory and motor apparatuses.  It is marked by a “sock and glove” pattern of sensory changes that affects the toes first, then advances proximally up the foot and leg.  Symptoms include numbness, tingling, abnormal sensation, decreased sensation, and/or pain.  The pain, which often occurs at night, is described as dull, achy, burning, or prickly.  As a result of the decreased sensation caused by neuropathy, people with diabetes are at increased risk for developing ulcers on their feet, as they are unable to feel when they step on sharp objects, develop blisters from ill-fitting shoes, or experience any type of injury to the skin on the bottom of the foot.  Proprioception, or the awareness of one’s body position in space, is also affected by neuropathy, which may lead to decreased balance and resulting falls.  Charcot foot, a degenerative condition that causes fractures to the foot bones and an eventual rocker-bottom deformity, is also common among those with diabetic neuropathy.

Autonomic neuropathy causes dysfunction of the body’s autonomic functions.  Common signs and symptoms include dizziness upon standing (orthostatic hypotension), arrhythmia, bloating, nausea, diarrhea, and urinary retention, frequency, or incontinence.

Cranial neuropathy affects the cranial nerves, primarily those responsible for eye movements.

Treatment of Diabetic Polyneuropathy

There are many treatment options for patients with diabetic polyneuropathy.  While the neuropathy itself is a progressive condition, the symptoms and their resulting functional impairments can be treated.

Drugs are primarily prescribed to relieve the pain caused by neuropathy.  These drugs include tricyclic antidepressants, serotonin-norepinephrine reuptake inhibitors, anti-epileptic drugs, and analgesics.

Physical therapy helps to maintain or regain the functional status of those with diabetic polyneuropathy, as it helps with pain control, maintaining strength and balance, and prevention and treatment of diabetic foot ulcers.  Modalities used in Physical Therapy, primarily electrical stimulation, can assist in pain relief, edema control, and treatment of ulcers.  Physical Therapists can also prescribe individualized exercise programs to strengthen weak muscles, regain postural control, and help maintain balance in those with neuropathy.  If a patient has a diabetic foot ulcer, a Physical Therapist can perform the wound care, instruct the patient in proper foot care, and recommend appropriate footwear.  In the case of a charcot foot or amputation, Physical Therapists perform transfer and gait training to help patients to be able to move themselves within the community as independently as possible.  Again, a PT would recommend appropriate footwear, as well as any needed assistive devices such as canes or walkers.

While diabetic polyneuropathy cannot be reversed, those with Diabetes can take steps to prevent or slow its development.  Preventative measures include maintaining control of one’s blood glucose levels, attending regular check-ups with an orthopedic or foot surgeon, performing daily foot inspections, wearing proper footwear, and using caution to prevent injury.  If someone with Diabetes develops any symptoms of polyneuropathy, he or she should consult a physician as soon as possible.

Contact Us:

New Jersey locations:

Bloomfield NJ Physical Therapy 44 Park Street Bloomfield , NJ 07003 Phone: 9736852335 Email us

Clifton NJ Physical Therapy  - 1070 Clifton Ave 1070 Clifton Ave #1A Clifton , NJ 07013 Phone: 973-246-6565 Email us

Clifton NJ Physical Therapy  - 1700 Rte 3 West 1700 Rte 3 West #Grnd Clifton , NJ 07013 Phone: 862-591-1000 Email us

Fair Lawn NJ Physical Therapy  - Holsman Physical and Occupational Therapy 15-01 Broadway Ste 12 Fair Lawn , NJ 07410 Phone: 201-355-5199 Email us

Kearny NJ Physical Therapy  711 Kearny Ave Kearny , NJ 07032 Phone: 201-535-8555 Email us

Rahway NJ Physical Therapy 1600 Saint Georges Ave #107 Rahway , NJ 07065 Phone: 732-428-5566 Email us

Cedar Grove NJ Physical Therapy  408 Pompton Ave Cedar Grove , NJ 07009 Phone: 973-433-0732 Email us

Caldwell NJ Physical Therapy  378 Bloomfield Ave Caldwell , NJ 07006 Phone: 973-968-6002 Email us

Fair Lawn NJ Physical Therapy  - Holsman Children's Therapy Center 15-01 Broadway Ste 14C Fair Lawn , NJ 07410 Phone: 201-351-1682 Email us

Newark NJ Physical Therapy  1060 Broad St #Bsmt Newark , NJ 07102 Phone: 973-457-4232 Email us

Jersey City NJ Physical Therapy  361 Montgomery St Jersey City , NJ 07302 Phone: 201-932-2656 Email us

Paterson NJ Physical Therapy 764 Main St. Suite 401 Paterson, NJ 07503 Phone: 973-705-7255 Email us

New York Locations:

Bronx NY Physical Therapy - 817 E 180th St 817 E 180th St Bronx , NY 10460 Phone: 718-355-9652 Email us

Bronx NY Morris Park  Physical Therapy - 799 Morris Park Ave 799 Morris Park Ave Bronx , NY 10462 Phone: 718-684-6300 Email us

Brooklyn NY Physical Therapy  423 Lincoln Pl Brooklyn , NY 11238-5499 Phone: 347-708-9701 Email us

 

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