♪ Bob and Brad, ♪
♪ The two most famous physical therapists on the internet ♪
- Hi, I'm Bob Schrupp, Physical Therapist.
- Brad Heineck, Physical Therapist.
- And together, we are the most famous physical therapist
on the internet. - In our opinion,
of course, Bob. - Yes, they are.
Okay, today Brad you want
to talk about peripheral neuropathy?
- Yes, to me, your peripheral neuropathy is
one of those terms that just kind of sounds overwhelming
and scary. - Yeah, right.
- And you hear that- - (indistinct)
- Yep, as a matter of fact, I had a patient who had that
and she was just-
She got so anxious about it, she was nervous,
"Oh my God, I got peripheral neuropathy,"
so I had to sit her down and talk to her
about what it really meant and she felt better about it,
and things went much smoother after that.
So peripheral neuropathy, peripheral referring to,
in this case-
- You see the extremities. - Right.
- The arms or the legs. - The arms or the legs
- And typically below the knees and below-
- [Both] The elbows.
- Oftentimes, the feet and the hands
and neuropathy is a nervous system,
apathy saying there's a problem,
or lesion, or- - Right.
- Illness in the nervous system-
- Something with the nervous is going on.
- Right. - Right.
- It just means, so you got problems in likely in your hands
or your feet and the symptoms are typically numbness,
tingling, sometimes just pain, achiness-
- Could have burning sensations
- Burning sensations, all of those are symptoms
that may be- - Right.
- All under this category.
- Whenever you get nerves involved,
you can get kind of strained sensations involved.
- Right. - You could get feelings of
feeling hot and cold- - Yeah, exactly.
- Temperature changes. - So the next question is
for the therapist or the physicians is,
why are you getting these symptoms?
- Right. - Okay?
And we're just gonna go through kind of briefly,
in a sense- - Yeah, sometimes,
not to throw another term in here,
but sometimes it could be a radiculopathy
and not really even the peripheral neuropathy.
- Right, yeah, now we're getting a little technical.
- Let's just give you explanation
of some of the reasons why you might be getting
some nerve sensations. - Right.
So if you're getting-
Let's talk about your feet
'cause that's probably more common with a lot of this.
You look at the nerves that come out of your lower back
right here, L5 or L4.
Those nerves come down and through your pelvis
and down your leg and down to your feet.
If one of these nerves is being pinched from stenosis,
or a bulging disc, or whatever it may be,
that could cause these symptoms.
- Right. - So technically,
you could have peripheral neuropathy from a bulging disc.
- Right. - Okay?
Or from stenosis, meaning that it's getting pinched up
in here, mechanical problem.
- Again, it would probably be called
a radiculopathy not a peripheral,
but it could be mistaken then.
- Exactly. - People might say,
"I've got peripheral neuropathy,"
and they think it is from diabetes or something like that
and actuality it might be from your back.
- Right, exactly. - So-
- So that's the next point,
a real common reason for peripheral neuropathy is
diabetics. - Diabetes.
- Yep. - Right.
- And you'll get those same symptoms,
and that you're not going to change
with any exercises or physical therapy.
- Right. - You know-
- That's up to your doctor and you with medications
and possibly maybe changes in diet,
eventually, but- - Right.
Oftentimes, these people have it
and that's the way it is. - Right.
- So then as therapists, we know that
when you have numbness, tingling, your sensation
in your feet is bad,
your balance- - Balance is gonna be bad.
- And you become a higher risk for falls.
- So you try to compensate by, you know,
using the things that you do still have intact
and enhancing those. - Right.
- Did you say Brad? - Right.
So your vision is- - Right.
- A very important part of your balance.
You might need just a cane might be enough.
- Right, you might need some type
of gate aid- - Right.
- To help you with your balance
because you're at that high risk for falling.
Strength, you wanna make sure everything
that you have is strong,
the muscles that are still there
or that are still working- - Right.
- Are maybe even a little stronger
than normal. - Right.
- So they can compensate for some of the weaker muscles.
- And you're probably gonna need to go
to a therapist for that so we could assess
your muscle groups and maybe there was one muscle group
that is weak and needs specific strengthening.
- And sometimes with peripheral neuropathy,
you can get a foot drop. - Sure.
- And then in that case, you might need to use a brace
or something like that to compensate for.
- Exactly, it's a good point, Bob.
- This is, you know, complicated stuff
and it is where you do need to have
the assessment of a doctor
or physical therapist. - Right.
But there are a lot of people
that have peripheral neuropathy
and it's not severe and you can live a normal life
with it for a number of years. - Right, and again,
I think the point we're trying
to make here is you wanna make sure
it is something that's not treatable,
that it is not coming from a source of, you know,
the spine that maybe we could treat
and actually make it go away. - Right.
- Same with the, you know,
if you get a pinching in the neck of a nerve
it can send numbness and tingling into the hand
that really isn't a peripheral neuropathy
so much as maybe again a radiculopathy.
- Right, right. - So-
- So I don't know if we've made it clear
or more confusing Bob, but- (laughs)
- (indistinct) one of my instructors used to say.
- Yeah, so we did have one
of our viewers requested this
and I think more than one actually saw,
there you go we're helping to reach out
for more education for all. - There we go,
consider it better myself.