360 Physical Medicine

360 Physical Medicine Striving to give patients the lives they want and deserve by removing physical barriers and allowing He and his family had a critical decision to make.

At a very young age Dr. Inshan knew his mission in life was to help people, but he wasn’t sure how. Throughout his adolescence he was very passionate about sports. It wasn’t until 10th grade when he was in a serious car accident that changed his entire life. Doctors instructed him to get surgery and told him that there was no way his activity level would be the same. Dr. Inshan was in chronic pain

, having herniated numerous disks throughout his spine. Do they opt for invasive surgery or take a more conservative approach to treatment? Dr. Inshan and his family determined that a conservative approach to treatment was the best course of action. Dr. Inshan went through 12 months of consistent chiropractic care and physical therapy. Thanks to the great work of the doctors, he made a phenomenal recovery. By 11th grade he was back to enjoying the life he had prior to the accident. Dr. Inshan continues to receive regular spinal adjustments to maintain the integrity of his spine and joints and is now relatively pain free! Because of the incredible results he obtained through consistent chiropractic care Dr. Inshan was ultimately inspired to become the amazing doctor that he is today. His internal driving force to help others live life to their full potential stems from the results and relationships he built with his own personal doctors as a young adult who needed the type of care that he now provides!

06/02/2026

Many people with neuropathy notice the same pattern:

The burning is worse at night.The tingling is worse at night.The electrical sensations are worse at night.

And they immediately assume their nerves are deteriorating as the day goes on.

But that may not be what’s happening.

Your body runs on a circadian rhythm, an internal biological clock that influences everything from hormone production to body temperature to how your nervous system processes pain.

For many people, pain sensitivity naturally rises later in the day and into the evening.

Most healthy individuals never notice it.

But when nerves are already irritated, vulnerable, or struggling to function properly, even normal changes in pain processing can become much more noticeable.

That’s one reason neuropathy symptoms often feel more intense at night.

What can you do?

• Protect your sleep schedule

• Avoid large swings in blood sugar, especially in the evening

• Stay physically active during the day

• Limit alcohol before bed

• Pay attention to patterns rather than judging your condition based on one difficult night

A rough night can feel alarming. But understanding why it happens is often the first step toward responding more effectively.

06/01/2026

One of the most common things we hear from people with neuropathy is:

“my feet are so much worse at night.”

And sometimes they are.

But for many people, part of what’s happening is that the world finally gets quiet.

During the day, your brain is constantly processing movement, conversations, sounds, tasks, and thousands of other sensory inputs.

At night, those distractions disappear.

The TV goes off.

The house gets quiet.

You get into bed.

And suddenly the burning, tingling, numbness, buzzing, or electrical sensations become much harder to ignore.

That doesn’t mean neuropathy is “all in your head.”

It means that symptom perception can be influenced by attention, environment, sleep quality, stress, positioning, blood sugar fluctuations, and many other factors that change throughout the day.

This is why understanding neuropathy requires looking beyond the symptom itself.

The goal isn’t just to ask why symptoms feel louder at night.

The goal is to understand the factors contributing to those symptoms in the first place.

If you’ve ever felt like your neuropathy becomes impossible to ignore the moment you lay down, you’re not alone.

What symptom bothers you most at night?

Neuropathy can involve many different factors, which is why patients often find themselves under the care of multiple pr...
05/31/2026

Neuropathy can involve many different factors, which is why patients often find themselves under the care of multiple providers.

Primary care physicians.

Neurologists.

Endocrinologists.

Vascular specialists.

Podiatrists.

Physical medicine and rehabilitation providers.

Each serves an important role.

That is why we encourage our patients to maintain regular follow-up with their physicians and specialists and to remain engaged in the care plans they have established together.

Our role is not to replace those relationships.

Our role is to contribute where appropriate, support function, and work within a broader healthcare team focused on the patient’s long-term well-being.

We believe patients benefit when healthcare is thoughtful, coordinated, and centered around preserving mobility, independence, and quality of life.

Every provider brings a different perspective.

Every perspective has value.

And patients deserve the benefit of all of them.

05/31/2026

Why does neuropathy seem worse at night?

Many people assume their nerves are suddenly getting worse after sunset.

The reality is often more complicated.

In this week’s video, I break down why nighttime symptoms happen and what they may be telling you.

Watch here: https://youtu.be/pAPYDv3zp2E?si=QVcKHD9poiMH5pVp

05/28/2026

I can’t tell you how many people sit across from me exhausted because every test came back “fine”…

But their body clearly doesn’t feel fine.

They’re still burning at night.
Still losing sleep.
Still afraid of falling.
Still feeling their world slowly getting smaller.

And after enough appointments, many start wondering if maybe it’s all in their head.

It’s not.

The tests have a role.
MRIs, EMGs, vascular studies, bloodwork… they matter.

But most of them are designed to look for major damage, major loss, major disease.

They don’t always explain why a nerve is struggling to function before things become severe.

That’s the part many patients feel nobody talks about.

Because there’s a big difference between:
“Nothing life-threatening showed up”
and
“Your nervous system is functioning well.”

Those are not the same conversation.

That gap between what the tests say and what you feel every single day…

That’s where we spend our time looking deeper.

05/26/2026

Neuropathy rarely begins where people feel it.

The burning, numbness, tingling, and balance changes are often the final expression of problems that have been developing upstream for years.

Poor metabolic health.
Circulation deficits.
Inflammation.
Sleep disruption.
Nutrient depletion.
Loss of repair capacity.

The nerve is not existing separately from the rest of the body. It is responding to the environment it’s being forced to survive in.

That’s why so many people plateau when the entire focus is placed on the nerve itself.

Because by the time symptoms appear, the body has usually been compensating quietly for a long time.

The real question is not:
“How do we cover the symptoms up?”

It’s:
“What changed in the body that allowed the nerve to start failing in the first place?”

05/22/2026

A lot of people with neuropathy tell me:

“Honestly… it doesn’t hurt as much anymore.”

And at first, they think that means things are improving.

But sometimes the reason it hurts less…
is because the nerves are losing the ability to feel normally in the first place.

That’s the part most people never get told.

Neuropathy does not always become more painful as it progresses.
Sometimes it becomes more numb.
More unstable.
More disconnected.

That’s why we take changes in sensation seriously here, even when people think they’re “getting better.”

05/21/2026

A lot of people with neuropathy spend years chasing symptom relief without realizing the environment around the nerves is still working against recovery.

If blood sugar remains unstable…
if blood pressure stays elevated…
if metabolic health continues declining in the background…

the nervous system is constantly fighting uphill.

That’s why some people try treatment after treatment and still feel like nothing truly holds.

Neuropathy is not just about the symptoms you feel in the feet.
It’s also about the internal environment those nerves are living in every single day.

This is also why being properly managed by your primary care physician or specialist matters so much.
Because when diabetes, blood pressure, cholesterol, and overall metabolic health are better controlled, the body is no longer fighting the same level of ongoing stress in the background.

Before the body can truly stabilize, the foundation has to matter too.

Get managed.
Get stable.
Then we can actually get to work.

05/20/2026

A lot of people with neuropathy are trying to make decisions without ever really understanding what may be driving the problem underneath.

That’s the part I take seriously.

Helping people understand:
What are we actually trying to accomplish here?

Are we only trying to make symptoms easier to live with?
Or are we also trying to change where this is heading over time?

Because once people understand the difference, the conversation changes.

05/19/2026

One of the hardest conversations I have is when patients tell me:

“I wish I would’ve taken this seriously earlier.”

Because in the beginning, neuropathy usually does not feel catastrophic.

It feels annoying.
A little burning.
A little numbness.
Maybe balance feels a little off sometimes.

And then enough time passes that people start changing how they live around it.

They stop traveling.
They stop trusting their footing.
They start worrying about falling.

That’s why I take early symptoms seriously.

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Orlando, FL
32821

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