Walking and Balance Issues with Neuropathy

Today's post is the first of three articles this week, from footpaincenter.com (see link below) the blog of Dr. Marc Spitz, who has been featured on this blog before and has extensive experience of neuropathic foot problems. He has his own Foot Pain Center in California and although advertising is strongly discouraged on this blog (in the interests of objectivity), there is no arguing with Dr Spitz's information which can be very helpful for many neuropathy sufferers. If you wish to follow up on his site or any of the products he mentions, please copy and paste the link below.

Why People with Peripheral Neuropathy Have Walking and Balance Problems

Posted on May 2, 2012

Studies have shown that over 70% of people with peripheral neuropathy experience problems with walking and balance. There are many reasons why neuropathy sufferers have balance difficulties. By definition, peripheral neuropathy is a condition whereby the nerves in the feet are damaged. Essentially there are three bodily components to good balance: feet, inner ear and eyes. If any one of these structures malfunctions, the end result will inevitably lead to poor balance. Today I will focus of the feet as a key element on proper balance.

Sensory nerves-You are what you feel
Sensory nerves supply feeling to the feet. When one looses the ability to feel his/her feet, balance can be severely affected. The brain and spinal cord, which are the computers of the central nervous system, are not properly communicating with the lower extremities. The brain sends signals to the feet, which allow the feet to adjust to a variety of factors. As we move from one surface to another – for example from a hard cement sidewalk to an uneven grassy lawn – the brain will allow us to compensate for these changes. If people have lost feeling in their feet, they lose this ability and are more prone to unsteadiness and falling.

No one likes to experience pain! Yet pain is an important protective mechanism for our bodies. For examples, if we sprain our ankle, the brain sends pain signals and our natural reaction is to avoid putting pressure on this area. People with nerve damage often lose this ability, which is referred to as loss of protective sensation.

Odd Sensations Contribute to Balance Problems Peripheral Neuropathy patients at the Foot Pain Center describe these sensations in many ways – the feeling of walking on sandpaper, cardboard, rocks, marbles or pins are just a few. When people have the sensation of walking on rocks or marbles, it does interfere with the normal walking pattern. A person who experiences these sensations is distracted when walking and cannot effectively concentrate on the normal heel-to-toe gait.

Loss of Proprioception: Ability to Know Where Your Feet are Positioned Relative to the Ground
Proprioception is often referred to as the sixth sense. Our brain sends out impulses and allows us to sense where a particular body part is situated without visually seeing it. A test that has been previously described is called the proprioception sensation test. This test consists of having a patient sit in an examination chair with eyes closed. The examiner moves a body part, usually the great toe in an upward or downward position. A person with adequate proprioceptive ability can differentiate the different positions of the toe.
It is extremely important for good balance to be able to sense where your feet are situated at all times. Picture an astronaut floating around in his space vehicle. Without the sensation of “being grounded” it is most difficult to remain orientated to your surroundings. The same holds true for a person with peripheral neuropathy. If this person does not feel where his/her feet are relative to the ground, unsteadiness and imbalance will occur.

Improving balance
Improving balance requires various approaches depending on the cause of the balance problems. Here are some tips for improving balance:

• Exercise keeps the foot and leg muscles strong-and prevents muscle atrophy. A daily work-out doing some type of exercise is beneficial. There are a number of home programs such as Improve Your Balance Now DVD –can help improve the function of the feet, eyes and inner ear. Regular exercise such as walking can help strengthen the muscles of the feet and legs.
• Enroll in a Tai Chi, yoga or Pilates class-these disciplines emphasize balance
• Wear proper shoes-a good walking shoe with a built-in medial arch can ease foot fatigue
• Use a walking aid such as a cane, walker or walking poles. These devices can improve balance and confidence when walking. A new device called the U-step Walker is revolutionary in that it emits a laser light on the ground that actually assists in both stability and gait training.

http://www.footpaincenter.com/blog/?m=201205