Why peripheral neuropathy can steal your balance

Summer in Bluffton and Hilton Head has a certain rhythm. Some folks are out early walking before the sun turns the parking lot into a cast-iron skillet. Some are headed to the outlets, some are making their neighborhood loop, and some are still convinced this is the summer their tennis game, golf swing or pickleball reflexes are coming all the way back.

Then, somewhere along the way, a few people start noticing something odd. They are not exactly dizzy, but they are not exactly steady either. They feel a little wobbly. A little unsure. A little less confident on their feet than they used to be. That is one of the sneaky things about peripheral neuropathy.

A lot of people think neuropathy only means pain, burning, tingling or numbness. And yes, it can absolutely cause those symptoms. But peripheral neuropathy can also affect the nerves that help tell your brain where your feet are and what the ground feels like. When that signal gets fuzzy, balance can get fuzzy right along with it. Common symptoms include numbness, tingling, burning, loss of sensation, lack of coordination and, sometimes, falls.

Here is the part many people do not know: Not everyone with neuropathy loses balance right away. People with small-fiber neuropathy often complain of burning, pins-and-needles sensations, electric-type pain or sensitivity to temperature changes. Small-fiber neuropathy usually does not cause major balance problems by itself because it typically does not involve the large sensory fibers that carry balance information to the brain.

Balance problems become more common when the large sensory fibers are involved. Those fibers help carry vibration and position sense. They are a big part of how your brain knows where your feet are positioned. As neuropathy progresses, people may have more trouble walking on uneven surfaces or in the dark because their feet are not sending clear information to the brain.

That is why patients say things like:

“It feels like I’m walking on marshmallows.”

Or rubber.

Or foam.

Or like they have thick socks bunched up under their feet even when they are barefoot.

A golfer may say, “I just do not feel steady over the ball anymore.” A tennis player may start favoring one foot. Someone walking around Bluffton or Hilton Head may notice they are looking down at their feet more, walking more slowly or feeling awkward on stairs, grass, sand or even a driveway that suddenly feels steeper than it used to.

At first, people blame age, bad shoes, a stiff back or just “one of those things.” Then they realize the problem may be starting from the ground up. Neuropathy also tends to creep in quietly. It often starts gradually, and many people brush off the early symptoms until their balance begins to change. Summer in the Lowcountry is too good to spend staring at the ground and negotiating with your toes.

If you have numbness, tingling or burning, or if your feet feel like they are walking on marshmallows, your body may be trying to tell you something. It may be time to get evaluated for peripheral neuropathy. Start early, before a small problem turns into a bigger one.

Dr. Kenneth Horup, DC is a Chiropractic Physician at Discover Specific Chiropractic, Certified in Neuropathy.