Accelerated PN , possibly from PT?

As a retired PT, it seems unlikely that the PT accelerated your neuropathy but if you are up on your feet more doing "weight bearing exercises" this may have aggravated your PN. Have you discussed water exercises with your PT? It may be beneficial and the water may have a calming and "tamping down" effect on the PN.

Hi @cherbear2cubs
I do not think it is the PT but the movement and the shoes, because of their size. If you foot has to much room, your toes could be pushed into the end, squished, and now the nerves are awake and unhappy. I have done this from not tying my shoes tight enough, my toes hurt, by nerves are disgruntled, and then I need to call them down. I do this with a foot myofascial massage trying to make the nerves happier, by allowing them to move. Not a cure, a treatment, I do repeat the error of my ways, with causing my neuropathy to flair. So I do the massage often.

@paul14 - I just noticed your post and I actually felt that my PN did stabilize to some small degree during PT. Key word is small. I went 2 days a week for about 3 or 4 years until the Medicare ran out, generally in June of each year and then in Jan, I would start back up. I did see a difference when not in PT. I'm having knee issues and I am a candidate for replacement, but docs will not do it due to my potential of falling from neuropathy in both feet causing poor balance. So, knee pain at this point keeping me away from PT but in general, I'd say it helped. I may try to go one day a week starting in October, fortunately, my therapist will work with me. Ed

The other day I aggravated my neuropathy to a new level, I called my PT, an amazing, brilliant PT, and asked if she had any ideas as my usual efforts were not working. She suggested a "shock wave" treatment. Wow, did it work! I just thought you should all know there are options. This did not cure my neuropathy, the pain level just went from a seven to one, it also helped my feet in general feel so much better. I will have the treatment again, and again... I will still do everything else to keep the neuropathy in check, I am so appreciative to have this treatment work for me.

My understanding is that symptoms coming from spinal issues are more accurately diagnosed as "radiculopathy" and coded that way on your MD billing, but hardly anyone has heard that term or understands what it means, so outside the MD office, we all use "neuropathy" as people have heard of that. We with radiculopathy don't have "nerve disease" as determined by an EMG, but share many of the same "neuropathy" symptoms of pain, sensory changes, and weakness.
I had spinal surgery 5 years ago to relieve the spinal stenosis caused by the herniated disc and spondylothesis, which spectacularly reduced my sciatic pain and really gave me back my life, but I do continue with the "neuro" symptoms. Everybody has a terrible story about a terrible surgical outcome for their cousin's sister-in-law's best friend, but it worked for me (done at a major teaching hospital with the head of the spinal dept).

Can you pls provide more details on your "shock wave" treatment, if you don't mind?

Hi @rayma, There is another discussion o the shockwave therapy that you might want to read through here:
--- Shockwave or Softwave Therapy for Neuropathy Pain?: https://connect.mayoclinic.org/discussion/neuropathy-treatment/

There is also another discussion on shockwave therapy in the Bones, Joints & Muscles Group here:
--- Shockwave therapy for tendinopathy?: https://connect.mayoclinic.org/discussion/shockwave-therapy-for-tendinopathy/

@centre and @artscaping, thank you for pointing out the differences between radiculopathy and peripheral neuropathy.

For the sake of others in this discussion, I found this information to be clarifying:

Radiculopathy falls under the larger umbrella of neuropathy. The symptoms of peripheral neuropathy overlap with radiculopathy and include pain, weakness, numbness, and tingling.

From Johns Hopkins https://www.hopkinsmedicine.org/health/conditions-and-diseases/radiculopathy#:~:text=Radiculopathy%20Versus%20Neuropathy&text=Peripheral%20neuropathy%20is%20the%20damage,in%20the%20wrist%20and%20hand.
"Radiculopathy symptoms may overlap with those of peripheral neuropathy, making it difficult to pinpoint the source of the problem. Peripheral neuropathy is the damage of the peripheral nervous system... . Radiculopathy is the pinching of the nerves at the root, which sometimes can also produce pain, weakness and numbness .... Consult a spine specialist for an accurate diagnosis."

@centre I appreciate your use of quotation marks around some of the phrases in your post, such as explosion and pathways, to underline that these are visualizations that can be helpful for some people to manage chronic pain.
When I had frozen shoulder, I learned the difference between acute and chronic pain, and the role the brain plays when dealing with chronic pain. It was explained to me when I had frozen shoulder that chronic pain I had was no longer due to my original injury. I, too, had to trust my PT that I could safely do the exercises she recommended to help with my recovery.

Here's a good article on the difference between acute and chronic pain.
- Acute vs. Chronic Pain https://my.clevelandclinic.org/health/articles/12051-acute-vs-chronic-pain

@rayma Hi,

Sorry for the delay. I felt like crap yesterday, and brain fog would have been an improvement. @johnbishop, thank you provided excellent links explaining the treatment. I also had myofascial release massage and that should improve my issues, I am still recovering from the intensity of that. I do as much proactive physical efforts, knowing they are treatments. I also just finished an IVig treatment (for other health issue), and am in a newer happier place. I still have the neuropathy, but it is the background, not in my every thought making life miserable. I have not recovered from . I will try to answer your questions. Also, appointment days for doctors such up a minimal of 5 to 6 hours due to travel.

Jfn

Glad to hear it!

RayAMontesino