Sadra Medical Journal

Mechanistic Insights into the Effectiveness of Physiotherapy for Peripheral Neuropathy: A Narrative Review

Document Type : Review Article

Authors

Marzieh Mohamadi 1
Farahnaz Emami 1
Mohammad-Mahdi Zarnegar 2
Neda Tavakoli 2
Mahshad Nassiri 2
Homeira Parizad 2

1 Department of Physical Therapy, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Iran

2 Student Research Committee, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Iran

https://doi.org/10.30476/smsj.2026.107738.1661
Abstract
Treating peripheral neuropathy is challenging; understanding the underlying mechanism may facilitate the selection of the most effective treatments. This article reviewed the underlying mechanism of physical approaches used to treat various types of peripheral neuropathy. The PubMed, ScienceDirect, and Google Scholar databases were searched. After screening 161 articles and excluding those that were not relevant, 36 studies, including randomized and non-randomized clinical trials as well as systematic reviews, were selected for inclusion. To facilitate analysis, the studies were categorized into three groups based on the underlying condition: (1) chemotherapy-induced peripheral neuropathy, (2) diabetic peripheral neuropathy, and (3) other types of peripheral neuropathy. In the first group, various physiotherapy interventions and exercise modalities were examined. The second group focused specifically on evaluating the effects of various exercise modalities. The third group investigated aerobic and progressive resistance exercises, as well as illusory touch therapy. This enabled the assessment of different rehabilitation interventions studied within each peripheral neuropathy subgroup. This narrative review demonstrated that mechanisms such as neuroprotection, nerve regeneration, anti-inflammatory effects, glycemic control, improvement of vascular function, pain modulation, muscle activation, and neuroplasticity played crucial roles in the effectiveness of these interventions.

Keywords

Peripheral Nervous System Diseases
Diabetic Neuropathies
Nerve Fibers
Mechanisms of Action
Treatment Outcome
Physical Therapy Modalities
Exercise
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Sadra Medical Journal
Volume 14, Issue 2
Spring 2026
Pages 500-517

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