Patient Safety: Living With Peripheral Neuropathy

Peripheral neuropathy refers to any condition that causes damage to the peripheral nervous system. Often, the symptoms progress slowly and insidiously. So, by the time patients notice issues, significant impairment may have already occurred. 

Because the peripheral nerves control everything from a patient’s ability to walk, digest, sweat, and more, these impairments impact many aspects of daily life. The condition can also significantly affect safety in older people. Here’s what your patients and their caregivers need to know about living with peripheral neuropathy and enhancing their safety.

Impacts of Life With Neuropathy

Peripheral neuropathy is an umbrella term encompassing various symptoms and conditions associated with nerve damage. It may cause:

• Autonomic nerve damage
• Sensory nerve damage
• Motor nerve damage

Damage to the autonomic nerves can lead to heat intolerance, perspiration impairments, and digestive issues. It may also cause orthostatic hypotension or sudden changes in blood pressure resulting from patient movement and repositioning. 

Sensory nerve damage contributes to loss of sensation and inability to sense heat, cold, vibrations, and more. It may also result in pain and discomfort as nerves randomly fire. Finally, motor nerve damage causes muscle atrophy, muscle cramping, lack of coordination, and weakness. 

Whether we’re talking autonomic, sensory or motor nerve issues, safety remains the common denominator. For this reason, your patients and their loved ones need to stay proactive about addressing potential hazards. 

Autonomic Nerve Damage and Orthostatic Hypotension

Damage to the autonomic nerves can impact patients in many different ways. But orthostatic hypotension represents one of the most significant issues when it comes to safety. Why? Because sudden changes in blood pressure can cause fainting, weakness, lightheadedness, visual changes, and challenges related to sitting or standing for too long.

There are many ways to support patients facing these challenges. They include using an abdominal binder and compression stockings to regulate blood pressure. Patients should also consider sleeping with their heads elevated roughly four inches. They should avoid heat and opt for frequent small meals rather than large ones. 

When moving from one bodily position to another, patients should transition slowly, pausing as needed. Learning about counter maneuvers that help individuals before changing positions is also a useful tactic. These motions may include straightening and bending the knees, wiggling the feet, marching in place, squeezing the glutes, or squeezing the thighs together. 

Sensory Nerve Damage and Impairments

Many individuals suffering from peripheral neuropathy experience sensory impairments. These impairments may have a significant impact on a patient’s ability to walk because their legs lack enough sensation to feel for movement and positioning. 

Those dealing with sensory loss should use a handheld mirror several times per day to examine their feet, heels, and ankles. During these sessions, they should look for injuries, areas of broken skin, or infections that they may not feel due to neuropathy. 

Conversely, some patients report living with neuropathic pain that makes it too painful to walk, sleep, or complete other activities. Primary care physicians or neurologists may prescribe pain medication to help patients with symptoms. Cognitive behavioral therapy and physical therapy may also help. A growing body of information indicates proper nutritional support coupled with laser light therapy (LLT) is also essential to managing or even reversing some neuropathic symptoms. 

Motor Nerve Damage and Weakness

Peripheral neuropathy may also lead to weakness. Depending on which body parts are impacted, there are various ways to mitigate this symptom. For example, hand and finger-related weakness should be formally evaluated by an occupational therapist. Based on this evaluation, they may recommend wearing a hand or wrist orthosis. 

Foot and ankle weakness comes with obvious physical symptoms. These may include “foot drop,” a condition that occurs when the muscles of the feet aren’t strong enough to properly lift up and move. Other people may experience ankle rolling or foot slapping. These symptoms represent serious fall hazards that must be addressed and may require orthotic intervention or physical therapy. 

Fall Hazards and Peripheral Neuropathy

As people age, fall dangers increase exponentially, and peripheral neuropathy exacerbates this trend. What are some additional ways that physicians and caregivers can help patients avoid preventable falls? They may include using a gait aid such as trekking poles, a single-end cane, or a front- or four-wheeled walker. 
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Rugs, clutter, and potential trip hazards should be cleared from living spaces. Installing motion detector lights and night lights is also essential to keeping patients safe when moving around at night. Individuals with neuropathy should always sit when dressing or bathing, and bathrooms and kitchens should be arranged so that frequently used items are easily accessible at waist or shoulder level. 

The bathroom also requires additional safety features, such as a shower chair, tub transfer bench, and grab bars. For patients who find sitting or standing from a toilet difficult, consider installing a comfort-height toilet or a safety frame. 

Safety and Living With Peripheral Neuropathy

Patients living with peripheral neuropathy and their caregivers should be proactive when it comes to safety and fall risks associated with impairments and disabilities. Simple strategies like installing shower grab bars, using a shower chair, and removing rugs and clutter can guard against life-threatening falls. Orthotics may help with ankle rolling and other forms of weakness caused by the condition. 

Patients should receive assessment and counseling to educate them about the latest developments in managing neuropathy symptoms. Many health professionals now offer the NeuropaCalm Care Program coupled with nutritional support to achieve better outcomes. Help your patients by providing these proven therapies at your facility. Contact us today to bring NeuropaCalm to your clinic or facility. ​