| What We Treat
Peripheral Neuropathy
Numb feet change how you balance, and balance responds to training even when the sensation does not recover.
Overview
What It Is
Peripheral neuropathy is damage to the nerves outside the brain and spinal cord, usually affecting the longest nerves first — hence feet before hands. It produces numbness, burning, tingling and sometimes weakness. Sensation may not recover, but balance and walking depend on more than sensation alone, and the systems that remain can be trained to compensate.
Trainable Even If Sensation Is Not
Balance depends on more than sensation. The vestibular and visual systems can be trained to compensate for what is lost.
Symptoms
How It Tends to Feel
These are the features that point towards this diagnosis rather than another:
Glove and Stocking Numbness
Symmetrical, starting in the toes and progressing upwards over time.
Burning or Shooting Pain
Often worse at night, and out of proportion to any obvious cause.
Unsteadiness
Markedly worse in the dark or with eyes closed, because vision is compensating.
Loss of Fine Control
Difficulty with buttons, coins and keys.
Weakness
Foot drop or difficulty pushing off in more advanced cases.
Skin Changes
Dry skin, and unnoticed injuries because protective sensation is lost.
Causes & Risk Factors
What Drives It
The usual contributors, in rough order of how often they turn out to matter:
Diabetes
The commonest cause in the UK by a wide margin.
Alcohol and Nutritional Deficiency
Particularly vitamin B12, which is treatable if identified.
Chemotherapy
A recognised and often dose-limiting side effect.
Other Medical Causes
Thyroid disease, kidney disease and inflammatory conditions all feature.
How We Can Help You
Treatment & Management
Treatment is built around what the assessment finds, but generally follows this shape:
When to Seek Help
Red Flags — Don’t Ignore These
Most presentations are straightforward. These features are the exceptions, and warrant prompt assessment:
⚠ Seek Medical Advice If You Notice
- Rapidly progressive weakness, particularly if it is ascending — seek urgent medical assessment
- Any foot ulcer, wound or area of redness that is not healing
- New bladder or bowel changes
- Falls causing injury
If any of these apply, contact your GP or seek urgent medical care rather than waiting for a physiotherapy appointment.
Common Questions
Frequently Asked Questions
Will the feeling come back?
Sometimes, where the cause is treatable — B12 deficiency in particular. Often it does not. But balance and walking can improve considerably regardless, because they rely on more than sensation.
Why am I worse in the dark?
Because vision has been compensating for the lost sensation without you realising. Remove it and the deficit shows. This is exactly what balance training targets.
Is exercise safe with numb feet?
Yes, with sensible precautions: supportive footwear, checking your feet daily, and starting balance work with something to hold.
Not Sure If This Is What You Have?
An assessment will tell you what is actually going on and what to do about it. I see everyone myself, and you will leave with a plan rather than a leaflet.
Book Your Initial AssessmentThis page is for general information only and isn’t a substitute for individual medical advice. If you’re experiencing any of the warning signs above, contact your GP or seek emergency medical care as appropriate.