If you’ve been diagnosed with peripheral neuropathy, there’s a good chance you’ve had an EMG. Maybe a nerve conduction study too. And while those tests have their place, there’s something important they don’t measure, and most patients never find out it was missing.

They don’t tell you how much sensation you’ve actually lost.

What Standard Neuropathy Testing Leaves Out

The EMG is primarily a motor test. It measures how well your muscles are responding to nerve signals. That’s useful information, but it only tells part of the story.

What it can’t tell you is how well you’re feeling your feet. Not in a general sense, but specifically. How much hot and cold are you detecting? What about light touch, sharp sensation, or vibration? These are different fiber types, and they degrade at different rates as neuropathy progresses. Without measuring them, you’re missing a significant piece of the picture.

There’s no device you can simply hook someone up to that spits out a sensation score. So at Nexus Neuro, we use the Toronto Clinical Scoring System, a standardized clinical tool designed specifically to measure sensory loss in neuropathy patients.

What the Toronto Clinical Scoring System Tells Us

The Toronto Clinical Scoring System gives us something most neuropathy patients have never had: a real number.

It tells us what stage of neuropathy you’re in, and the exact percentage of sensation loss across the relevant fiber types. That information directly shapes your care. It tells Dr. Schulke which treatments are appropriate, what intensity makes sense, and what a realistic recovery timeline looks like. Without it, any treatment plan is built on incomplete data.

And because the test is non-invasive, there are no needles involved. Patients who have dreaded repeat testing after an EMG are often relieved to hear that.

The Balance Question That Changes Everything

Here’s where the assessment goes a step further.

Many neuropathy patients also struggle with balance problems. The instinctive assumption is that it’s all connected, that if the feet aren’t working properly, the balance must be suffering too. And sometimes that’s true.

But not always.

Balance problems can originate in two very different places. The first is the peripheral nervous system, meaning your feet simply aren’t sending accurate signals to your brain about where you are in space. The second is the central nervous system, specifically the control centers within the brain itself.

These are not the same problem. And they don’t have the same solution.

Knowing which one is driving your balance issues isn’t just interesting information. It determines your entire treatment protocol. At Nexus Neuro, distinguishing between those two causes is a core part of the initial assessment, and it’s something that rarely gets addressed in a standard neurology workup.

What This Means for You

If you’ve been living with neuropathy symptoms and feel like you still don’t have a clear picture of what’s actually happening in your body, that’s not unusual. It’s one of the most common frustrations patients bring to us.

You deserve more than a diagnosis. You deserve to know what stage you’re in, what you’ve lost, what’s driving your symptoms, and what can actually be done about it.

That’s what a thorough neuropathy assessment looks like at Nexus Neuro.

Ready to get real answers? Call us at 317-884-8824 or visit nexusneurohealth.com to schedule your consultation.