Authors : Dr. C. Jenifer; Dr. M. S. Sundaram

Volume/Issue : Volume 11 - 2026, Issue 10 - October

Google Scholar : https://tinyurl.com/4z7ztff2

DOI : https://doi.org/10.38124/ijisrt/26Oct480

Note : A published paper may take 4-5 working days from the publication date to appear in PlumX Metrics, Semantic Scholar, and ResearchGate.

Abstract : Background: Diabetic peripheral neuropathy (DPN) and lumbar radiculopathy may coexist, producing overlapping impairments (1,3). Differentiating and addressing both is essential for individualized physiotherapy.  Case Presentation: A 67-year-old man with type 2 diabetes, hypertension, peripheral neuropathy, and lumbar disc pathology presented with lower-limb neurological symptoms. Investigations confirmed bilateral sensory axonopathy and L4-L5-S1 radiculopathy.  Intervention: A six-week multimodal physiotherapy program included foot surveillance, strengthening, balance training, gait rehabilitation, aerobic conditioning, lumbar movement-control exercises, and neural mobilization (2,4-6,8,9,11).

References :

1. American Diabetes Association Professional Practice Committee for Diabetes. Retinopathy, neuropathy, and foot care: Standards of care in diabetes—2026. Diabetes Care. 2026;49(Suppl 1):S261‑76.
2. Gracia‑Sánchez A, López‑Pineda A, Nouni‑García R, Zúnica‑García S, et al. Impact of exercise training in patients with diabetic peripheral neuropathy: an umbrella review. Sports Med Open. 2025;11:75.
3. George SZ, Fritz JM, Silfies SP, Schneider MJ, Beneciuk JM, Lentz TA, et al. Interventions for the management of acute and chronic low back pain: revision 2021. J Orthop Sports Phys Ther. 2021;51(11):CPG1‑60.
4. Alissa N, Shipper AG, Zilliox L, Westlake KP. Physical rehabilitation and balance in diabetic peripheral neuropathy: systematic review. Clin Interv Aging. 2024;19:1325‑39.
5. Køhler E, Dalgas U, Buhl CS, Brincks J. Balance training in diabetic peripheral neuropathy: systematic review and meta‑analysis. Physiother Theory Pract. 2025;41(5):1083‑94.
6. Lin LH, Lin TY, Chang KV, Wu WT, Özçakar L. Neural mobilization for lumbar radiculopathy: systematic review and meta‑analysis. Life (Basel). 2023;13(12):2255.
7. Gagnier JJ, Kienle G, Altman DG, Moher D, Sox H, Riley D, et al. CARE guidelines: consensus‑based case reporting guideline development. J Clin Epidemiol. 2014;67(1):46‑51.
8. Yang J, Li L, Ye T, Pu Y, Yao Q, Luo J, et al. Effectiveness of exercise on musculoskeletal function in diabetic peripheral neuropathy: systematic review. Front Neurol. 2025;16:1610955.
9. Smith AG, Singleton JR. Exercise and diabetic neuropathy: clinical trial evidence. Curr Diab Rep. 2023;23(4):112‑20.
10. Morrison S, Colberg SR, Parson HK, Vinik AI. Balance training reduces fall risk in diabetic neuropathy. Diabetes Care. 2022;45(2):345‑52.
11. Shacklock M, Butler DS. Neurodynamics in lumbar radiculopathy: clinical applications. Man Ther. 2021;26:45‑52.
12. Kluding PM, Pasnoor M, Singh R, et al. Safety and efficacy of exercise in diabetic neuropathy. Diabetes Care. 2020;43(8):1874‑81.
13. Dixit S, Maiya AG, Shastry B, et al. Effect of physiotherapy on sensory thresholds in diabetic neuropathy. Int J Diabetes Dev Ctries. 2021;41(3):456‑62.
14. Richardson JK, Hurvitz EA. Peripheral neuropathy: functional impact and rehabilitation. Arch Phys Med Rehabil. 2022;103(5):987‑95.
15. Tesfaye S, Boulton AJM, Dyck PJ, et al. Diabetic neuropathies: update on mechanisms and management. Lancet Neurol. 2021;20(11):948‑60.