What is paresthesia? It’s a sensation of tingling, numbness, or “pins and needles,” which is a common symptom that patients may experience due to various underlying causes. Whilst we have several strategies to manage neuropathic pain, paresthesia can be more troublesome to manage for some clinicians. Physiotherapists play a crucial role in helping patients manage and alleviate paresthesia symptoms. In this blog post, we’ll explore the causes of paresthesia and discuss effective treatment strategies that you can use to help your patients.
Understanding the Cause:
Paresthesia can arise from a range of factors, including nerve compression (carpal tunnel syndrome), poor blood circulation (Raynaud’s syndrome), metabolic disorders (vitamin B12 deficiency), or nerve damage (diabetic peripheral neuropathy). By identifying the underlying cause, you can tailor treatment plans to address the root issue while alleviating the accompanying symptoms.
Manual Therapy Techniques:
You can employ various manual therapy techniques to alleviate paresthesia symptoms. Soft tissue mobilisation, joint mobilisation, and nerve gliding exercises can help reduce nerve compression, release tension, and improve overall mobility and function. These techniques aim to restore proper nerve conduction and reduce paresthesia sensations.
Therapeutic Exercises:
Exercise plays a pivotal role in the rehabilitation process for individuals with paresthesia. You can design specific therapeutic exercises to address muscle imbalances, improve posture, and enhance flexibility and strength. Additionally, targeted exercises can promote nerve regeneration and enhance nerve function, reducing paresthesia symptoms over time.
Neuromuscular Re-education:
Neuromuscular re-education techniques focus on retraining the nervous system to restore normal sensation and movement. You can incorporate sensory reintegration exercises, proprioceptive training, and balance exercises to enhance the body’s ability to interpret and respond to sensory input accurately.
Education and Lifestyle Modifications:
Empowering patients with knowledge about their condition is essential. You can explain ergonomic principles, postural corrections, and self-care strategies to manage paresthesia symptoms effectively. Lifestyle modifications, such as maintaining a healthy weight, managing chronic conditions, and avoiding repetitive motions or positions that exacerbate symptoms, can also contribute to long-term symptom relief.
Medication:
Certain medications, such as anticonvulsants or antidepressants, can help stabilise nerve impulses and reduce abnormal nerve firing, which may contribute to paresthesia. This option can be particularly useful for patients that are struggling to manage their symptoms. Examples include gabapentin, pregabalin, amitriptyline, or duloxetine. These medications can help manage chronic pain and decrease paresthesia sensations. If you feel your patient would benefit from medication, consider making a referral to the patient’s usual doctor.