Characterized by pain, numbness, tingling, swelling, or muscle weakness in the feet and/or hands, neuropathy, also known as peripheral neuropathy or PN, can make walking and standing difficult and may cause debilitating pain.

While treatments may include antidepressants and pain medications, practicing self-care is key to managing symptoms. Gentle yoga stretching, breathing, and stress management techniques can help.

Understanding Peripheral Neuropathy (PN)

Peripheral neuropathy occurs when the peripheral nerves, located outside of the brain and spinal cord are damaged. ​​This can affect your ability to feel sensations or control movement in your feet, legs, arms and hands.

Symptoms:

The symptoms of PN can vary depending on the kind of nerve affected, but generally include one or more of the following:

• Gradual onset of numbness, prickling, or tingling in the feet or hands. These sensations can spread upward into the legs and arms.
• Sharp, jabbing, throbbing or burning pain
• Extreme sensitivity to touch
• Pain during activities that shouldn't cause pain, such as pain in the feet when putting weight on them or when they're under a blanket.
• Lack of coordination and falling
• Muscle weakness
• Feeling as if you're wearing gloves or socks when you're not
• Inability to move if motor nerves are affected
• Heat intolerance
• Excessive sweating or not being able to sweat
• Bowel, bladder or digestive problems
• Drops in blood pressure, causing dizziness or lightheadedness

Causes:

In healthy people, the peripheral nerves communicate with the central nervous system (the brain and spinal cord). However, when peripheral nerves are damaged, they have difficulty sending or receiving messages to and from the brain. Type 2 diabetes is the most common cause of PN, but other causes include autoimmune diseases, infections (such as shingles), surgery, and cancer treatments.

Treatments:

If you suspect you have peripheral neuropathy, it is important to first consult your health care practitioner to determine the underlying cause. In addition to medication, your physician will may also recommend making lifestyle changes which is where yoga can help.

Easing Peripheral Neuropathy Pain with Yoga

Yoga is a particularly beneficial complementary therapy for individuals with peripheral neuropathy. It is a gentle, accessible, and holistic practice that addresses the physical, mental, and emotional effects of PN. Specifically, yoga helps--

• relieve pain
• improve flexibility
• increase mobility
• reduce muscle tension
• lessen feelings of anxiety and depression
• improve sleep
• improve blood glucose levels, especially for people with diabetic neuropathy
  

Specific yoga poses can be used to target neuropathy-affected areas to relieve pain and discomfort. Just as valuable, pranayama (breathing) and yoga nidra (yogic rest) practices reduce anxiety and depression which are common when dealing with

chronic pain.

Since it’s most common to have PN in your feet, below are several gentle, chair yoga poses sequence that can help reduce pain and discomfort. You will need a sturdy chair and yoga strap.

*Remember, always to first consult your health care provider before

beginning a new exercise routine.

8 Yoga Poses to Combat PN Pain

Foot and ankle strengthening exercises are an essential component of a comprehensive exercise program for individuals with PN in their feet. The feet and ankles play a crucial role in maintaining balance and stability. The first three exercises aim to improve foot and ankle muscle strength, flexibility, as well as proprioception (the ability to know where your body is in space) which can enhance overall foot function and reduce your fall risk.

Toe Warm Ups

1. Keep the ball and sole of each foot on the floor. On an inhale, lift and spread the toes of both feet wide. On an exhale, release your toes to the floor. Repeat five times.
2. Next, inhale to curl your toes under, as if picking up a marble with your toes. Exhale, relax, and release the toes. Repeat five times.
3. When you are finished, pause to notice any sensations in your toes.
   

Seated Heel Lifts

1. Inhale, lift both heels up and press the balls of your feet into the floor. Exhale, lower the heels.
2. Next, lift your toes and forefoot on an inhale, keeping your heels on the floor. You’ll feel a gentle stretch in the calves and a tightening in the shins and ankles.
3. Repeat, alternating lifting your heels and then your toes, four more times.

Ankle Rotations

1. Extend one foot out in front of you, heel off the floor.
2. Breathing steadily, circle the ankle slowly four times in each direction.
3. Repeat with the opposite foot.
4. Shake out both feet. Pause to notice any sensations of warmth or tingling.

The next stretch is an excellent exercise for reducing tension and increasing flexibility in your legs.

Seated Hamstring Stretch

1. Sitting tall in a chair, loop a yoga strap around the ball of your left foot.
2. Holding each end of the strap in a separate hand, use the strap to raise your left foot off the floor. Maintain a slight bend in your knee. Do not lock the knee.
3. Using the strap for guidance, circle your extended leg five times in each direction. Don’t worry about how big the circles are -- move within your available range of motion.
4. Bringing the leg to stillness, use the strap to draw your toes towards your face. You want to feel a gentle stretch in the back of your thigh. Hold the stretch for three breaths.
5. Release your foot to the floor and remove the strap. Repeat on the right.

One of the symptoms of PN is reduced circulation in the legs. The next two movements improving blood flow to the feet by engaging and strengthening the calf and lower leg muscles. These poses also enhance balance and stability, both of which can be compromised when you suffer from neuropathy.

Mountain Pose Heel Raises

1. Stand tall behind a chair with your hands resting on the back of the chair for balance.
2. On an inhale, raise your heels off the ground and rise up onto the balls of your feet. Pause here for one count. Then, slowly exhale your heels back to the floor.
3. Keeping your left hand on the chair, lift your heels again, floating your right arm forward and overhead. Pause here for one count. Then exhale your arm and heels back down.
4. Repeat lifting your left arm. Alternate arms twice more.

Warrior I Chair Push Ups (Calf Stretch)

1. Holding the back of the chair with both hands, step your left leg back about three feet. Both feet should be flat on the floor. Angle your left foot slightly outward.
2. Without bending your knees, bend your elbows to bring your upper body towards the chair. Keep your elbows close to your ribs and stop when you begin to feel a gentle stretch in your left calf.
3. Stay here for three counts. Then straighten your arms. Repeat three times.
4. Step forward and pause for a breath. Repeat on the right.

Standing Downward Facing Dog

1. Holding the back of the chair, walk both feet back three to four feet to create an inverted L-shape with your body.
2. Bend your knees slightly and bring your ears between your upper arms, gazing downward.
3. Stay here for three breaths. Feel free to experiment with shifting your hips from side-to-side and bending and straightening your knees.
4. Lift your head, look towards the chair, and walk in towards the chair until standing again.

Mindful breathing exercises, such as deep, diaphragmatic breathing, reduce stress and anxiety levels. Stress can exacerbate PN symptoms which makes stress management an essential component of managing neuropathy pain. The following breath practice can be done seated or lying in bed.

Bamboo Ratio Breathing

1. Sit comfortably, with your head, neck, and torso aligned vertically. As you exhale, release tension from your body. Breathing through your nose, establish a quiet, smooth, steady breath pattern, inhaling for a count of four and exhaling for four.
2. Next, visualize your spine as a stalk of bamboo. As you inhale, imagine your breath rising up the center of the bamboo stalk, from your tailbone to the crown of your head. Picture your breath cascading down the center of the bamboo as you exhale. Do this for three breaths, visualizing the breath moving up and down the spine.
3. After three breaths, lengthen your exhale to a count of five. Repeat this for two more breaths.
4. Lengthen the exhale by a count of one so you are inhaling for four and exhaling for six for two cycles of breath.
5. Continue lengthening the inhale after two cycles of breath until you’ve reached a 4:8 inhale to exhale ratio. Stay with the 4:8 breath pattern for five more breaths.
6. When you are ready, gradually start to reduce the length of your exhale, breathing in for 4 and exhaling for 7, and so on until you return to a 4:4 breath pattern.
7. Release the counting and allow the breath to resume to its normal rhythm. Take time to observe the effects of this practice.
   

Living with PN presents a great challenge. Incorporating gentle yoga poses that improve circulation, flexibility, balance, and stress management can empower you take charge and manage symptoms.

For more foot exercises, read Foot Fitness: Strength and Mobility for Aging Feet and visit Wisdom Tree Yoga’s On Demand Video Library for accessible home practice videos.

Be well!

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