If you've lost sensation in a hand or foot due to nerve injury, you'll notice that most of the information available focuses on muscle. Muscle wasting, muscle strengthening, preventing atrophy, stimulating a weak limb. Page after page of content. Then you look for something about the numbness, the part that actually bothers you most, and there is very little content available.

I want to address that gap, because there is real evidence that electrical stimulation improves sensory recovery. There is also, as far as I am aware, no evidence that any device you can buy and use at home will bring feeling back to a numb hand. Those two statements sit together and seem to be opposing; the difference between them is worth understanding before anyone sells you anything.

We see many people with foot drop, but the cause can vary a great deal and the treatment approach consequently will need to be personalised to the situation. One person has broken a leg; another has dislocated a knee or is recovering from a hip replacement or lumbar spine surgery, and now the foot on that side will not lift. They are catching their toe on every kerb. They have discovered foot drop stimulators online, watched the videos of people walking along a corridor without a brace, and they want to know how to get one.

The videos are genuine. The devices do what they appear to do. But almost every person in those videos has had a stroke, and that difference is not a minor detail. It decides whether that type of device can work for you at all.

I want to explain what a foot drop stimulator is actually doing, why it may do nothing whatsoever for a peroneal nerve injury, and what does matter in the first few months after that kind of injury.

Someone has damaged a nerve. Perhaps because of a fracture, perhaps a fall, perhaps a complication of surgery they were told would be routine. They have read that electrical stimulation can help prevent muscle wasting. They have bought a device, often an inexpensive TENS unit, sometimes a consumer muscle stimulator. They have put the pads on, turned the intensity up as far as it will go, and nothing has happened. No contraction. No twitch. Nothing at all.

Then, usually near the end of the call, comes the question, and it is nearly always some version of this:

Could I have made it worse?

If you have a nerve injury, whether at the spine or further out in a limb, at some point, someone may send you for a nerve conduction study. You will lie on a couch while a neurophysiologist delivers small electrical pulses to your skin and, a little later, puts a fine needle into one or two muscles. A few weeks after that, a report lands with your consultant. It is dense, full of numbers and abbreviations, and it is written for one clinician to read to another. Almost nobody explains it to the person whose nerve it describes. Just this morning, I read a note from a client who said, "I had a nerve conduction test, which indicated severe injury to the nerves." You might wonder, like me, what severe means, and what do I do about it?

Creatine monohydrate is the most studied supplement in sport, with a safety record few products can match. From time to time, someone living with a spinal cord injury, or a therapist working with neurological clients, asks me about it: if it builds muscle and improves performance in athletes, would it help someone rebuilding strength after a neurological injury? It is an interesting question.

This article works through what the research shows, its limitations, and what that means in practice. The short version is that the evidence in healthy and older adults is strong, the evidence in neurological rehabilitation is thin and mixed.

One point before we begin. Creatine is a food supplement, not a medicine, and nothing here is individual medical advice. If you have kidney problems, take other medication, or have a complex medical picture, speak to your doctor or a dietitian before starting anything. With that said, let us look at the evidence.

For some people, the obstacle to standing up is not weakness. It is the opposite problem: legs that are too stiff, too tense, or too unpredictable to cooperate. You go to move and the leg pushes out straight when you wanted it to bend, or a spasm arrives at the worst possible moment, or simply getting your feet into a sensible position feels like a negotiation. This is spasticity, and for a great many people, after an incomplete spinal cord injury or stroke, it is the single thing standing between them and a useful sit-to-stand.

We have written before about spasticity after spinal cord injury and the limits of medication. This article looks at a more specific question: when spasticity is the thing blocking a functional goal like standing, what can electrical stimulation do about it, and how do the pieces fit together?