Tuesday, 18 October 2016

Neuropathy Patients Hate Exercise But They Mustn't Avoid It

Today's short post from journals.lww.com (see link below) is a response from a doctor to a question most of us with neuropathy hope the answer to, will be a resounding "No". Unfortunately, the answer is yes to the question as to whether exercise helps with neuropathy. So we need to be prepared to put our bodies through yet more pain and discomfort for their benefit in the long run. The key is, making exercise something that is so obviously valuable that we can't ignore it and making it as pleasurable as possible. You can groan all you want (I do too) but the fact is that neuropathy weakens our muscles and joints to such an extent that it makes the pain considerably worse, never mind the fact that we can't do simple tasks any more. Read the article and think about your best strategy but don't overdo it and listen to your body when it tells you that you're doing just that.

Departments: Ask the Experts
You Ask. We Answer:

Is exercise helpful for peripheral neuropathy?
Ensrud, Erik MD
Neurology Now: October/November 2016 - Volume 12 - Issue 5 - p 31 doi: 10.1097/01.NNN.0000503487.82934.2d
Q Is exercise helpful for PERIPHERAL NEUROPATHY?


Yes, as long as you aren't overdoing it. The same benefits that anyone gets from exercise—improved cardiovascular function, increased mobility, a boost in mood—are realized by people with peripheral neuropathy, regardless of its cause. People with neuropathy may also experience an improvement in function and quality of life, as well as a decrease in pain.


Peripheral neuropathy is a general term for a group of diseases that affects motor and sensory nerves outside the brain and spinal cord. There are different types of neuropathy, and each has different causes and effects. Focal neuropathy, for instance, usually affects just one nerve or group of nerves. A common example is carpal tunnel syndrome, which involves nerve damage in the wrist. Any exercise that involves repetitive motion directly on the joint, such as playing tennis or texting or typing for hours on end, could aggravate the condition. Proximal neuropathy can reduce muscle strength in the legs and hips, so patients with this type of neuropathy might try riding a recumbent bike to avoid putting too much force on a compromised leg or hip joint.


When people think of exercise, they often think of the intense workout regimens of Olympic athletes like Michael Phelps and Katie Ledecky. But for most people, intense exercise is counterproductive. For people with neuropathy in particular, overstressed muscles may not recover as well because of existing nerve problems. A good rule of thumb during exercise is the talk test: If you can maintain a conversation without becoming breathless while exercising, you are likely at the right exertion level.


If physical activity feels like a chore or is inconvenient, you'll eventually stop doing it. Decide what you like to do—swimming, biking, walking, dancing, yoga, tai chi—and how you like to do it—with friends, at home, in nature, as part of a class—and you're more likely to stick with it. The goal is to create a positive association with exercise so you do it more often. Consider an activity tracker, which logs your steps every day; seeing the steps add up can be very motivating for some people.


Before beginning any exercise program, talk to your doctor. You want to be sure you don't have any conditions that may affect the type of exercise you can do or how long you can safely do it. Once you get the all-clear, start out with five to 20 minutes of exercise three times a week. As your fitness improves, gradually add minutes, distance, or intensity. A good way to start is by walking around a large indoor shopping mall or store. The surface is level, the temperature is comfortable, you can use a shopping cart for stability, and it's free—unless, of course, you buy things.

Dr. Ensrud is director of neuromuscular disease rehabilitation at St. Luke's Rehabilitation Institute in Spokane, WA. He is also a member of the American Academy of Neurology.

© 2016 American Academy of Neurology


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