I have read elsewhere that neuropathic pain should not prevent us from exercising . . . and of course we need to exercise, and that walking is a good one (duh! I used to be a backpacker and mountaineer!)

But now I find that after I walk, or even at the end of a busy day . . . my foot pain seems more intense, and my numbness seems to be worse. I have begun to give my feel cold soaks and I massage them every night when I moisturize and check them over for any injuries. But evenings seem to be when I need pain relief the most.

However, I do not wish to become entirely sedentary, and I have things I want to do! How can I tell what is neuropathic, harmless pain, from what might be pain from an activity that might make my symptoms worse?

I have numbness of the front of both feet. I walk slowly and do not feel any pain.

I've had sensory PN for over 20 years with the worst being in my lower legs and feet. Despite everything, I have continued my exercise of walking. I don't do much - a mile or two - but I do it regularly and I strongly feel that this is what has kept going all these years. Just DO it!

What pain meds, if any, are you using to manage your pain? I'm beginning to find that the more I walk the less my symptoms. I take Tramadol for the PN pain.

I recently quit smoking and that's led to a decrease in both PN and RLS symptoms. I'm taking less medication than I have for a very long time which makes *me* happy. But I won't give up my pain med and I won't tolerate a very high level of pain from my feet. After all, this is going to be a life-long thing or so I'm told so why should I put up with any more pain than I absolutely have to?

If increased exercise means increased pain it's kind of difficult to convince oneself that walking in spite of the pain is a good thing. I was always taught that pain is the body's way of telling you something is wrong. Don't ignore it and don't push through it. Permanent damage could result. So, where does that leave PN sufferers? I think we each have to do what feels right and works for each one of us.

What does your doctor say about all this?

(ETA: There seems to a be a glitch in posting in that when I hit post or whatever it's called, it mangled part of my post and lost another part of it altogether.)

i try to walk as many days as possible. i also find that my feet are very sore and more painful after walking or standing for more than 15 minutes for that matter with an increase in numbness often. i keep doing it though unless im sick injured or in too much pain. i look at it as its not real what i am feeling it is how my brain is interpreting the messages from the damaged nerves or the lack of messages. not working through pain for injuries to me is something else entirely than working through pn pain.

to walk or any other kind of exercise as much as possible. You have to help your vascular system flush out whatever's 'settled' and enable new juices to get into those nooks and crannies to help heal what's damaged. Also, if new nerves are growing? You gotta give them something to do besides ZAP or ZEEP! You have to program them! They want to know their job!
It is very hard to find the right way for YOU! though. It's taken me a lot of rounds of PT for the PN and for broken bones etc. to find the right combination of 'tricks' that work for me. Truly, more than I care to recall overall. MOVING is plain old important!
As for finding out what is good vs. bad exercise pain? Well, that is why I advocate finding good therapists...Of Course I've gone thru a few before finding the right place with the right people who can work with me, understand my PN issues [and other problems] and can devise a HOME PROGRAM that can help me do it all on my own.
Knowing what is good vs bad is tricky? I've found my own 'barometer' is either I'm soo hurting I do not think I can drive home on my own safely...to finding out that X times five reps all at once is too much in the pay-back-pain factor the next day...and that doing X times five reps scattered during the PT session and switching off onto other equally 'exciting' tasks in between helps keep the pain down immensely. I call it 'little bits'. That what I do AT PT I then do at home is useful too..in that I can do those reps of '5' spread out thru the day...I have found that I can creep up on the reps and build my strength up more slowly, but effectively w/far less pain. We all TRY TOO HARD at times. This is a situation where you have to be far more slow and steady than the tortoises. But, just keep on going. It all adds up.
The most annoying part of all this PN is that I really have to PLAN! I've got to plan where I go and for how long..... and plot out how I go and shop or do anything else in terms of moving through any building etc. But, I've found the 'plotting' has saved me a lot of frustrations in the long run. I tho, have learned my current limits - even tho I push them? I am careful to have access to some sort of help in the process. Should I get STUCK! And I have at times. Tales for another time?
Hope this helps! Keep on keeping on... - j

My neuro recommended adding a good podiatrist who understands PN to my team. [For obvious foot care, and to address shoes, support, etc.] Is that someone who I might enlist to prescribe some PT? I had thought that PT might be a good start, but was unsure if Medicare pays for PN therapy. I guess even if it cost me, I might find it beneficial, as I happen to be the one who has to get around on my own, now, aren't I?

SHOULD do it? That he's trying to pass it off on a podiatrist is well, shabby to me. My own neuro just raised eyebrows the first time I had asked? And then just filled out the order. Apparently that is one of those very low things on their mental agendas... And all but one of my PT orders have been done by my neuro.
The only other one was thru my Podiatrist? It must have been the first one he'd ever written in ages as I had to tell him what to write....Most bizarre experience. But, at the same time, he was super contiensious in the follow-up with the therapists.
Does this help? Hugs etc. - j

We have a local podiatrist who specializes in PN. . . I am considering scheduling an appointment. If i learn nothing else, I probably need to hear the drill on foot care for neuropathies. . . and probably be sure there are no other issues going on. At 56 that might not be such a bad idea. . . .

There can be many things going on in your feet, that may
complicate PN or imitate it.

I have a very good podiatrist.
Things to NOT like in one are:

1) do not fall for the foot bath routine. refuse it. They do this to make money, and it does not help you at all, and often the baths contain organisms...I got plantar's warts from one once.

2) Don't fall for cutting. Just about every podiatrist will suggest cutting something. Some are big on cutting others less so.

But do get Xrays and perhaps orthotics. My podiatrist recommended certain shoes for me. Example:
Large toe box, or 1/2 size larger, or firm sole vs flexible sole.

You need to find out the status of your sesamoid bones, and whether you have spurs and where they are located.
I have a spur under a toenail, and also on both heels.
The heels are silent now, but did flare up once a while back.

Tarsal tunnel is a problem and would be aggravated by swelling of the feet.

So yes, I think you should get an opinion. Try to find a good podiatrist who will answer your questions easily. Any resistance-- you leave. They can be difficult to find so ask around or get your doctor to make a suggestion.
I had one poor experience with one, and unfortunately learned a painful lesson.