Healthy Living: Peripheral Neuropathy

Healthy Living / Christine Harness

Many of our patients come to us for occupational and physical therapy reporting having problems with nerve involvement. They experience loss of feeling in their hands, and they are frustrated with frequent dropping of objects, mistrusting their hands when attempting to simply pick up items. The diagnosis is often ‘peripheral neuropathy’ (peripheral: “outer part or surface of the body”, and neuropathy: “nerve pain/nerve disease.”) This may involve nerve compression, post-surgical swelling, or nerve laceration. Long standing diabetic patients report experiencing nerve loss in their hands as well as in their feet.

Evaluation of nerve damage can be complicated. Nerve conduction studies provide good measurement of nerve damage, but not all patients tolerate the pain of testing needles. Assessment also includes many simple, objective and easy to perform sensory examinations. Patients experience changes in skin color, temperature, sweating, hair growth and atrophy, which is tissue wasting. Standardized testing includes: two-point and texture discrimination, light touch/deep pressure exam, active, passive and resistive range of motion, grip and pinch strength tests, pick up and place function, and overall self care functional ability. Patients may also have impaired reflex responses and experience jerky spasms, causing them to suddenly drop objects. As this pattern develops, they tend to cut back on their daily activities, delegating more to family members. Weakness and pain become their primary complaints. Their pain level is so subjective, it is difficult to measure. Most patients are now familiar with having medical staff to rate their level using the one through ten scale.

Treatment for patients with nerve damage can be quite complex, yet doctors encourage that they get early diagnosis and treatment. Prompt treatment and program compliance generally bring good results. Deferring care may lead to permanent, non-reversible nerve loss. It seems logical that these patients would seek answers toward eradicating those early morning complaints of numbness, tingling and painful throbbing, interrupting a sound night of sleep. Therapists are able to provide these patients with a customized home exercise program that does demand daily practice and ongoing reassessment to measure gains and advance the treatment program.

Christine Harness has worked in the field of Occupational Therapy throughout her adult life, both in and outside of the Kern River Valley. She has helped countless individuals to maintain or regain their independence. Christine believes that enjoying and taking satisfaction in one’s day-to-day activities is the key to a meaningful life.

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