Accelerated PN , possibly from PT?

I just wanted to thank all of you for sharing your experiences with PT and neuropathy. I struggle with feeling like I’m not doing “enough,” even though I know and discussed with my PT why it’s important for my body and nervous system specifically to grade exposure to activity. But I still always felt like I was “weird” or slow. So it’s great to be reminded that what works for me and my body is what’s best, and that there are others who’ve benefited from a similar strategy. Thank you.

I had abrupt neuropathy (radiculopathy) symptoms upon the large rupture of a herniated lumbar disc. I saw an Orthopedist, had MRI testing, and was sent to PT within a week. The PT emphasized and re-emphasized the role of the brain in pain management. He said the pain signals come up to the brain as an “explosion”, the brain can’t differentiate/pinpoint the location, just interprets it as “PAIN”. The PT said it’s important not to open “pain pathways”, as the brain will focus on the “explosion” and accelerate your sense of pain. Sounded weird to me, but I decided to trust him and then/now I primarily use visualization and calculated fury to beat back any opening of a pain pathway. When I’m woken up by severe lower leg pain (sledge hammer hitting it type), my most successful visualization is to fiercely envision a blow torch of fire blasting back down that pathway, driving the signals back. Five minutes of that and the pain is gone. I’ve also imagined little friendly aliens with phasers blasting my calf muscles. I tried “relaxing at the beach” visualizations, it that didn’t work for me.
The PT emphasized- this is not true pain from a true cause, it’s your brain’s interpretation of the explosion of false signals coming up.

Any pressure on the bottom of my feet such as from walking on hard surfaces or exercising aggravates the nerve pain. Consistent with the other posts above, I'm working with my physical therapist to advance my activity extremely slowly. For example, I started with walking outside only 6 minutes every other day. Even that much aggravated the nerve pain in my feet at night. So, I'm holding at that level until my tolerance improves.

I had abrupt neuropathy (radiculopathy) symptoms upon the large rupture of a herniated lumbar disc. I saw an Orthopedist, had MRI testing, and was sent to PT within a week. The PT emphasized and re-emphasized the role of the brain in pain management. He said the pain signals come up to the brain as an “explosion”, the brain can’t differentiate/pinpoint the location, just interprets it as “PAIN”. The PT said it’s important not to open “pain pathways”, as the brain will focus on the “explosion” and accelerate your sense of pain. Sounded weird to me, but I decided to trust him and then/now I primarily use visualization and calculated fury to beat back any opening of a pain pathway. When I’m woken up by severe lower leg pain (sledge hammer hitting it type), my most successful visualization is to fiercely envision a blow torch of fire blasting back down that pathway, driving the signals back. Five minutes of that and the pain is gone. I’ve also imagined little friendly aliens with phasers blasting my calf muscles. I tried “relaxing at the beach” visualizations, it that didn’t work for me.
The PT emphasized- this is not true pain from a true cause, it’s your brain’s interpretation of the explosion of false signals coming up.

For me, I learned that overuse during PT (or any other activity) contributes to fatigue and that my PN requires me extra time to recover. My therapist agreed that we needed to work on eliminating the “day after” effect if PT, as it should be more seamless while helping us build strength and brain/muscle memory. She would modify the activities or reps to help my PN. Open communication is key - we start each session with reviewing how I felt after the prior session. One thing that does not work for me under any terms are exercises that stress my toes. I can stand on heels, but trying to be a ballerina on toes or pushing weights with them leave extra painful and numbing effects for many days, so we’ve had to come up with a different way of helping engage that part of the foot. We’re all different, but if you find that an activity or exercise leaves you worse off vs better, please let your therapist know as there may be a more suitable exercise.

Thanks for sharing your experience. My PT hasn’t suggested anything like that since I don’t have a lot of pain, just numbness. She mostly concentrates on balance since my feet are numb. I am flummoxed by the nerve tingling, the cold then sensory numbness that follows. This now happens even at rest when I flex my foot or toes. It makes you reluctant to even move. I’m experiencing it sitting down on the front porch while writing this response.

Walk...walk.... walk Dr says that's the most important
thin.

I had abrupt neuropathy (radiculopathy) symptoms upon the large rupture of a herniated lumbar disc. I saw an Orthopedist, had MRI testing, and was sent to PT within a week. The PT emphasized and re-emphasized the role of the brain in pain management. He said the pain signals come up to the brain as an “explosion”, the brain can’t differentiate/pinpoint the location, just interprets it as “PAIN”. The PT said it’s important not to open “pain pathways”, as the brain will focus on the “explosion” and accelerate your sense of pain. Sounded weird to me, but I decided to trust him and then/now I primarily use visualization and calculated fury to beat back any opening of a pain pathway. When I’m woken up by severe lower leg pain (sledge hammer hitting it type), my most successful visualization is to fiercely envision a blow torch of fire blasting back down that pathway, driving the signals back. Five minutes of that and the pain is gone. I’ve also imagined little friendly aliens with phasers blasting my calf muscles. I tried “relaxing at the beach” visualizations, it that didn’t work for me.
The PT emphasized- this is not true pain from a true cause, it’s your brain’s interpretation of the explosion of false signals coming up.