April 2, 2020

Physical Therapy for Lower Extremity Neuropathy


Imagine Physical Therapy

Read Time

5 minutes

Facts About Neuropathy

    Neuropathy can be a broad term used to describe a variety of symptoms such as foot pain, numbness, tingling, burning, lack of sensation, etc. and is commonly associated with diabetes.  It has been discovered that roughly 50% of people with a diagnosis of diabetes will develop neuropathy at some point in their lives1.  Neuropathy can also be chemotherapy-induced or caused by other injuries.  Regardless of the cause, neuropathy, as well as the pain, imbalance, tightness, and weakness that can come with it, can be treated and improved with physical therapy. 

Effect of PT on Neuropathy

    Oftentimes, the numbness/tingling/burning or other nerve-related symptoms people diagnosed with neuropathy experience can be a result of tight muscles.  The nerves that innervate your lower leg and feet exit your low back and run down the entirety of your leg. At any point along that chain, tight muscles in your low back, buttocks, hamstring, calf, or feet can actually put tension or pressure on a nerve and reproduce those neuropathy symptoms that can be felt in the feet.  A combination of hands-on therapy as well as stretching and strengthening exercises have been proven to be more effective than just exercise alone in relieving pain and improving flexibility, strength, and function2.  Here at Imagine Physical Therapy, we utilize a number of hands-on techniques including dry needling, ultrasound, electrical stimulation, cupping, massage, and joint mobilization/manipulation that have all been proven through evidence-based research to get you better faster3,4.  Balance is also a major deficit in people with neuropathy, which has been shown to significantly improve with a progressive balance training and strengthening program5,6 that will be a part of your treatment in physical therapy.

Practical Advice

    Patients with neuropathy will benefit from physical therapy, especially one that combines manual therapy with an extensive exercise routine.  At Imagine Physical Therapy we will perform a comprehensive and detailed evaluation to determine your deficits and develop a plan based on the best evidence to improve your balance, strength, flexibility, and pain.  In doing so, we will get you back to whatever you need, want, and love to do.  

For all of your physical therapy questions, concerns, or to schedule an appointment, contact our team at Imagine Physical Therapy today!


  1. Hicks CW, Selvin E. Epidemiology of peripheral neuropathy and lower extremity disease in diabetes. Curr Diab Rep. 2019;19(10):86-99.
  2. Renan-Ordine R, Alburquerque-Sendin F, Rodrigues de Souza DP, Cleland JA, Fernandez-de-las-Penas C.  Effectiveness of myofascial trigger point manual therapy combined with a self-stretching protocol for the management of plantar heel pain: a randomized controlled trial.  J Orthop Sports Phys Ther. 2011;41(2):43-50.
  3. Dunning J, Butts R, Henry N, Mourad F,Brannon A, Rodriguez H, et al. Electrical dry needling as an adjunct to exercise, manual therapy and ultrasound for plantar fasciitis: a multicenter randomized clinical trial. PLoSONE. 2018;13(10).
  4. Stein, Cinara, Eibel, Bruna, Sbruzzi, Graciele, Lago, Pedro D., & Plentz, Rodrigo D. M.. (2013). Electrical stimulation and electromagnetic field use in patients with diabetic neuropathy: systematic review and meta-analysis. Brazilian Journal of Physical Therapy, 17(2):93-104.
  5. Akbari M, Jafari H, Moshashaee A, Forugh B.  Do diabetic neuropathy patients benefit from balance training? J Rehabil Res Dev. 2012;49(2):333-338.
  6. Ites KI, Anderson EJ, Cahill ML, Kearney JA, Post EC, Gilchrist LS.  Balance interventions for diabetic peripheral neuropathy: a systematic review. J Geriatr Phys Ther. 2011;34:109-116.