RECOMMENDATIONS FOR PEOPLE WITH PERIPHERAL NEUROPATHY

Following a healthy diet

A healthy diet, that is rich in fruits, vegetables and whole foods has a positive effect on any chronic medical condition, as it ensures an optimal supply of nutrients and vitamins. Patients with peripheral neuropathy should eliminate or reduce their intake of processed and sugary foods, as these increase inflammation and can aggravate pain. Alcohol should also be consumed in moderation.

Engaging in physical activity

Regular exercise and physical activity helps control blood sugar, increases blood circulation, improves sleep and mood and, in combination with a healthy diet, reduces body weight. If the patient has the support of a physiotherapist or an occupational therapist, it is recommended that they should do the exercises they prescribe at home.

Giving up smoking

Smoking has harmful effects on vessels and blood circulation, which can increase the risk of foot problems that, in severe cases, can lead to limb amputations.

Checking the condition of the feet

Daily checking of the feet is recommended to detect wounds, sores or any other changes. Therefore, the feet should be checked in their entirety (top, sides, soles, heels and between the toes) and washed every day with lukewarm water and mild soap. In addition, the use of cream, petroleum jelly, lanolin or oil is recommended on dry skin.

Performing massages

Massage of the hands and feet is recommended, either by the patient or by a professional. Physical therapy aids circulation and the delivery of nutrients to nerve cells, which can relieve pain and stiffness.

Avoiding pressure

Patients should take care to avoid prolonged pressure on the limbs, as this can aggravate the damage to the affected nerves. Thus, it is not recommended to keep the knees crossed or to lean on the elbows for a long time.

Having a multidisciplinary panel of trusted health care providers

The patient’s regular doctor may prescribe drugs to relieve the symptoms and pain of the disease. However, other professionals can also help to improve the patient’s overall well-being:

• A psychologist specialising in chronic pain management can help affected individuals to develop coping skills and neutralise negative emotions, such as frustration, sadness or anger.
• A podiatrist can provide foot care.
• A physiotherapist can provide exercise programmes to improve flexibility and mobility of the affected areas.
• An orthopaedic specialist can treat motor system problems and advise on hand or foot orthotics, a cane, walker or wheelchair to improve the patient’s mobility.
• An occupational therapist can help implement adaptive devices and improve the work or home environment.

Wearing appropriate footwear

Patients with peripheral neuropathy should consider the following recommendations when choosing footwear:

• The use of comfortable socks and shoes is recommended, avoiding tight-fitting shoes and garments on the feet and legs, as these can aggravate numbness and pain in the lower extremities.
• Avoid wearing open shoes to improve balance and gait. Therefore, those affected should wear shoes or trainers that ensure good foot support, preferably above instep height and with non-slip soles.
• In cold weather, gloves and warm socks are recommended.

Attending a support group

Gaining support from people in the same situation is an enriching experience. These forums are used to share experiences, give recommendations and create a sense of togetherness, all of which benefits the patient.

Following alternative therapies

In some patients, relaxation and breathing techniques (yoga, tai chi, meditation, acupuncture, guided visualisation) are physically and emotionally beneficial, helping to strengthen and stretch the muscles and combat anxiety.

Improving sleep quality

Sleep disturbances or insomnia are often a side effect of neuropathic pain. Pain can interfere with sleep in many ways: due to the discomfort caused by the ailment itself, reduced activity linked to the sensation of pain, depressive states, the use of pain-mitigating drugs, etc. Some recommendations for improving sleep disorders include:

• Sharing insomnia problems with the doctor, who may prescribe medication to aid sleep or assess whether the patient’s medications or doses are interfering with their sleep.
• Reducing caffeine and alcohol consumption.
• Giving up smoking.
• Doing regular exercise.
• Limiting or omitting naps.
• Maintaining regular schedules.
• Ensuring a suitable temperature in the bedroom that is neither too hot nor too cold.
• Assessing whether the bed is sufficiently comfortable (firmness of the mattress, height and consistency of the pillow).
• Avoiding screens for a while before going to bed to give the mind time to relax.

Adapting the home

Due to the fact that patients with peripheral neuropathy experience sensory and/or motor difficulties that may affect their balance, coordination and strength, it is important to ensure safety at home. Some suggestions include:

• Keeping all rooms, hallways and stairways well lit.
• Installing handrails on both sides of the stairs.
• Covering stair treads with a non-slip material.
• Removing all tripping and slipping hazards, such as carpets and general clutter.
• Avoiding furniture with wheels, such as tables or chairs, as well as furniture with sharp edges, points or corners.
• Wear shoes at all times when moving around the house to protect your feet from potential injury.
• Wiping up spilled water or liquids immediately to prevent slipping
• When driving, making sure that you can fully feel the brake, accelerator and steering wheel pedals and that you are able to move the foot quickly from the accelerator pedal to the brake.
• Not keeping any small pets at home.

In the bathroom:

• Installing handrails in the bath or shower and next to the toilet.
• Installing handrails in the bath or shower and next to the toilet
• Checking the water temperature with your elbow before stepping into the bath.