Peripheral Neuropathy: 4 Exercises to Improve Balance and Sensory Awareness

Feeling pain, tingling, numbness, or weakness in your hands or feet may be a sign of peripheral neuropathy. More than 20 million Americans are diagnosed with peripheral neuropathy, making it a common condition that contributes to impaired mobility, altered balance, and increased fall risk.

The goal of managing peripheral neuropathy should be to maintain and restore the function of your peripheral nervous system and optimize movement and balance to ensure a sufficient level of function.  

This article will go into a few of the most effective exercises and techniques for improving foot awareness and balance in those with peripheral neuropathy. All of these recommendations can be performed on a daily basis. 

4 Exercises to Improve Peripheral Neuropathy

1. Foot Exercises for Sensory Stimulation

Bringing in sensory stimulation and strengthening the nerves in the bottom of the feet is important for overall movement function. Foot sensory stimulation can be in the form of textured insoles or socks, vibration platforms and rollers, and barefoot stimulation. These products can be used throughout the day or integrated in 30-minute doses.

When going barefoot or using sensory-based products, always perform a foot check before and after to ensure the foot skin is clean and intact.

2. Improve Balance with Forward Lean Exercise

This simple exercise connects our postural muscles to our feet.

1. Start by standing barefoot on a clean surface, placing your feet shoulder-width apart. 
2. Keeping your body tall and straight, gently shift or lean the body weight forward until you feel your feet engage with your toes pushing down into the floor. 
3. After you feel the toes engage, resume your starting position and relax your feet. 
4. Repeat the forward lean 10 times.

If balance is a concern, you can stand next to a wall and gently place one hand on the wall.  

3. Sensory Training: Sit, Stand, and Turn

This exercise trains all the sensory input systems that are needed for balance, including the visual, vestibular, proprioceptive, and tactile.   

1. Start by sitting in a chair with your feet flat on the ground. If you can, perform this exercise barefoot to increase foot stimulation 
2. Stand up from the chair and turn in a full circle in one direction, then sit back down. When turning, go as slowly as you feel comfortable.
3. Repeat by standing up, turning in a full circle in the other direction, and sitting back down.
4. Repeat 5 times in each direction.  

4. Eye Movement Exercises 

You can practice these eye movement exercises sitting in a chair or standing to increase the challenge. 

1. For the first eye movement exercise, hold a pen in one hand directly in front of you and with the arm straight out. 
2. Slowly move the pen side to side or in Figure 8 and track it with your eyes only. Try to keep your head still so only your eyes are moving.   
3. Perform for 10 seconds with the pen in one hand and then repeat holding the pen in the other hand.
4. The second eye movement exercise is called a saccade. To do this exercise, you want to keep your head still, shift only the eyes, and look all the way to the right and then all the way to the left. 
5. Repeat back and forth, right to left, for 10 seconds. Then rest for 10 seconds and repeat for another 10 seconds.
6. The final eye movement exercise is targeted at strengthening the peripheral vision. In a seated or standing position, focus your gaze across the room and stare at one object in the distance. While keeping your eyes locked on this object, start to notice other objects in the room in your peripheral vision.
7. Do not turn your head or shift your gaze when noticing the objects in the peripheral vision. 
8. Perform for 30 seconds.

Practice Consistently to Improve Peripheral Neuropathy

When we perform these exercises consistently, they can improve body awareness and postural perception when standing and walking. Our feet, posture, vestibular, and visual system all play an important role in maintaining balance. For those with peripheral neuropathy and decreased sensation in the feet, training all these input systems is important to ensuring movement longevity.