How to Exercise With Chronic Inflammatory Demyelinating Polyradiculoneuropathy (CIDP)

Regular exercise has benefits when you have chronic inflammatory demyelinating polyradiculoneuropathy (CIDP). But this autoimmune condition also presents unique challenges for physical activity, since it can cause symptoms like weakness, fatigue, numbness or tingling, and trouble with balance and walking. Overdoing it on exercise can leave you feeling worse.

But with the help of the right experts — such as a physical therapist specializing in neurological disorders — it’s possible to find a personalized exercise program to meet your needs. “Exercise can be modified to meet variable functional levels and will continue to be beneficial regardless of [symptom] severity,” says Katelyn Kimble, DPT, a physical therapist in the department of neurology at WashU Medicine in St. Louis.

Here, experts share their advice on how to safely be active with CIDP, so you can work with your body rather than against it.

Benefits of Exercise for CIDP

• Improve or regain muscle strength (if your CIPD treatments are successful) or slow the loss of muscle function (if your treatments aren’t successful)
• Reduce stiffness
• Improve your balance
• Improve your mood and sleep
• Support your heart and lung health to protect against other diseases like diabetes (which can further impact your nerves) and heart disease

Challenges of Exercise With CIDP

Despite the valuable perks, it isn’t always easy to be active with CIDP. Muscle weakness, sensory changes like numbness, tingling, or trouble balancing, and getting fatigued more quickly can all make sustained movement feel tougher.

Your individual challenges may depend on the severity of your CIDP. “Symptoms and changes in mobility are based on the severity of nerve damage, symptom management, and response to medical treatment,” Kimble says. “Therefore, some patients will have a greater difficulty with exercise compared to others.”

That doesn’t mean exercise has to be off the table, though. By working with a PT who understands your symptoms and circumstances, you can find an activity program that meets you where you’re at and helps you get stronger.

How to Exercise With CIDP

You’re a good candidate for a general exercise program if your CIDP is in remission or if you’ve reached a point of recovery where you have relatively few restrictions on your mobility, Kimble says. If you’re in the midst of a flare, rehab guided by a physical therapist may be more appropriate. Your neurologist and physical therapist can help you decide what’s right for you.

If you’re ready to lace up your sneakers, you’ll want to keep some CIDP-specific considerations in mind. Here’s what you need to know to get set up for success.

Work With a Physical Therapist

Choose the Right Types of Activity

• Aerobic Exercises Walking, riding a stationary or recumbent bicycle, and water-based exercises are all good choices. If balance or gait issues make walking difficult, your PT can recommend modifications like taking frequent breaks or using assistive devices like a walker or orthotics. They may also suggest starting walking indoors (where there are fewer tripping hazards) and moving outside as you feel steadier.
• Resistance Exercises Bodyweight exercises or lifting light weights help you get stronger, especially when you gradually increase the intensity. The key is starting with light weights and avoiding going too hard, since fatiguing your weakened muscles and nerves can slow your recovery rather than support it.
• Mobility Exercises Stretches that gently work your calves, hamstrings, hip flexors, chest muscles, forearms, and hand muscles will reduce stiffness and help you improve your posture. You’ll see the biggest benefits when you hold a stretch for 30 to 60 seconds, taking care not to extend stretches to the point of discomfort.
• Balance Exercises Sometimes called proprioception training, your PT can share appropriate activities to improve your gait and reduce your risk of falling.

Manage Fatigue

You may already be struggling with low energy, and exercising too hard or for too long could make that issue worse. “It is important to avoid pushing past fatigue because a patient with CIDP may take longer to recover from overexertion and has the potential to worsen inflammation, symptoms, and debility,” Kimble says. As you get stronger, you’ll gradually be able to go a little further or a little longer.

Safety and Red Flags

Again, pushing yourself too hard during exercise can potentially worsen your symptoms or slow your recovery. So it’s important to pay close attention to your body and let your care team know if anything starts to seem amiss.

According to Kimble, you should stop exercising, rest, and reevaluate your activity plan if:

• Your symptoms get worse with exercise
• You’re finding that you need to push past pain or fatigue to complete your workout
• You have muscle soreness for 24 hours or more

An exercise plan also isn’t appropriate for people who are medically unstable, having an uncontrolled flare, or are noticing a rapid worsening of symptoms, she adds. Be sure to clear any precautions with your physician before you start PT.

Seek immediate emergency medical attention for more general exercise-related red flags, too, including chest pain, significant shortness of breath, racing heart, or dizziness or lightheadedness.

The Takeaway

• Exercising with CIDP can come with challenges, especially when symptoms make movement feel harder.
• But with guidance from the right experts, especially a physical therapist, and a personalized, low-impact plan, staying active can improve your strength, mobility, energy, and overall quality of life.
• The key is learning to work with your body instead of against it. Over time, many people find that the right routine helps them feel stronger, steadier, and more confident in what they can do.