Utilizing laser, LED therapy, and electroanalgesics has been shown to have a tremendous success rate
From the moment I graduated I have treated neuropathology. I have discovered, however, that many patients do not know chiropractors treat neuropathy. Only a small percentage of people truly understand what chiropractors do and that we treat more than back pain. Our goal is to educate the public that treating conditions such as degenerative disc disease and idiopathic peripheral neuropathy are the essence of what we do.
To treat idiopathic peripheral neuropathy doctors must understand its symptoms, which include numbness or altered sensations, such as feeling like a bunched sock is under the toes. Idiopathic (the underlying cause of nerve damage is unknown) peripheral neuropathy (damage to the nerves in the legs and arms) typically begins in the longest nerves first, usually in the toes and feet. These can be debilitating to the patient.
This condition can have significant symptoms, yet some patients notice no symptoms at all. The Cleveland Clinic estimates that 25 to 30 percent of Americans will be affected by peripheral neuropathy. They estimate 30 to 40 percent of peripheral neuropathy cases are idiopathic in nature.
Utilizing laser, LED therapy, and electroanalgesics has been shown to have a tremendous success rate—some studies show up to a 90 percent success rate, especially when you supplement the patients with nitric oxide.
The basics of peripheral neuropathy
Symptoms of peripheral neuropathy can include numbness, tingling, pain, and oversensitivity to touch. Strange altered sensations may be present. Patients describe the feeling they have as a sock bunched under their toes even though they are not wearing a sock.
Others report it feels as if they are walking on leather or rocks or have something wrapped around their feet. Sometimes a stimulus that normally is not painful is perceived as painful, such as a sheet touching a foot.
Some people do not notice any symptoms at all. These patients do not realize they have lost sensation in their feet as the loss has been so gradual that it seems normal. They have no abnormal or strange sensations in their feet, but may lose balance gradually or develop a painless sore on their foot that normally would be expected to be painful.
Peripheral neuropathy can lead to loss of balance, weakness, hammer toes, and foot deformity, which may require the use of a cane, walker, or foot braces, if severe. The condition typically worsens as a person ages.
Loss of sensation in the feet can be serious. A person can develop a foot sore they do not feel, even if it becomes severely infected. This can lead to amputation of toes or legs and, in rare cases, death.
The loss of balance associated with peripheral neuropathy also is very serious, as it puts a person at higher risk of falls. Falls can have catastrophic consequences. This is why diagnosis and treatment protocols are so important.
Falls are the most common cause of injury in elderly adults (age 65 and older). As many as one third of elderly adults fall each year and the risk of falling triples if you have a neurologic disorder such as peripheral neuropathy.
Twenty to 30 percent of older people who fall suffer moderate to severe injuries, such as hip fractures and head traumas. These injuries can be life-altering and even deadly. According to the Centers for Disease Control and Prevention, falls kill more than 18,000 older adults each year.
Why we fall
Balance is the ability to maintain the body’s center of mass over its base of support. A properly functioning balance system allows humans to see clearly while moving, identify orientation with respect to gravity, determine direction and speed of movement, and make automatic postural adjustments to maintain posture and stability in various conditions and activities.
Balance depends on the coordination of input from multiple sensory systems:
Visual: Provides information on the verticality of the body and spatial location relative to objects.
Proprioception: Provides information from skin (touch) and joints (pressure and vibratory senses).
Vestibular: Our sense organs that provide information on direction, motion, equilibrium, and spatial orientation.
Our bodies need to integrate this sensory input and translate that into motor output to the eye and body muscles. Maintaining balance depends on information received by the brain from three peripheral sources: eyes, muscles and joints, and vestibular organs. All three of these sources send information to the brain in the form of nerve impulses from special nerve endings called sensory receptors.
Peripheral neuropathy is a disorder of the motor, sensory, and autonomic nerves. So, in addition to aging, peripheral neuropathy patients are at a greater risk of falling because numbness, decreased sensitivity to touch, and muscle weakness can have significant adverse effects on their balance.
Evaluation and diagnosis
To diagnose a peripheral neuropathy as idiopathic, you must first evaluate for treatable causes of peripheral neuropathy:
An electromyography (EMG) test can evaluate for a demyelinating peripheral neuropathy.
Blood work that includes hemoglobin A1C to evaluate for pre-diabetes; a vitamin B12 blood test (with the goal being a number greater than 400); a thyroid-stimulating hormone (TSH) test to rule out hypothyroidism; and a serum protein electrophoresis test are all advised.
If the peripheral neuropathy is idiopathic, all of these lab tests will be normal.
Excessive alcohol use, based on patient history, also can determine peripheral neuropathy.
Monitor feet for any sores or cuts, and give care vigilantly if a wound is discovered.
Here are several suggestions to prevent and treat peripheral neuropathy:
Use medications to help neuropathic pain. These include Neurontin (Gabapentin), Lyrica (Pregabalin) and Cymbalta (Duloxetine). These medications only help with pain; they do not correct numbness or balance problems and do not slow the progression of neuropathy as we age. They also carry the risk of dizziness, which can increase fall risk even further.
Shun excess vitamin B6. Doses greater than 100 mg per day are toxic to the nerves and actually cause nerve damage.
Avoid falls—eliminate throw rugs, have a night light, or use a cane or walker for safety. Most falls occur inside the home.
Don’t smoke; limit alcohol intake.
Apply laser treatment, which may help temporarily with pain, but does not fix numbness or cure neuropathy.
Take available supplements, such as alpha lipoic acid, although they are uncertain to be of benefit.
Exercise is a must! Regular exercise, such as walking, improves circulation, helps control weight, and helps maintain balance. Strengthening exercises for the back, legs, and core improve balance.
A 2012 study of balance disorders in diabetic peripheral neuropathy patients showed that patients could achieve better balance and stability through progressive balance training. The study recommended that training be gradual and persistent so as to have long-term effects on the patient. Clinical studies also have shown that Tai Chi helps stabilize gait, improve balance, and reduce falls among people with peripheral neuropathy.
Idiopathic peripheral neuropathy is very frustrating when it is found in a patient who is otherwise healthy. Knowledge about the condition is important. Ruling out treatable causes of peripheral neuropathy is imperative. Knowing that peripheral neuropathy increases the risk of falls can lead a person to be more careful and help prevent a fall. Medication treatment can help with neuropathic pain symptoms, but as chiropractors we know treating the symptoms alone will not be a cure.
We must detect the regions of kinesiopathology subluxations, while treating these pathophysiologies with chiropractic care to remove the nerve interference, with laser to assist in stimulating the cells and with electroanalgesics to reduce symptoms while healing nerves and increasing circulation. This, combined with proper nutrition and supplementation, actually positions chiropractors and the chiropractic profession to be the leaders in both disc and neuropathy treatment.
Neuropathy is a term used to describe nerve damage. It can occur as the result of a variety of medical conditions. However the most common cause of neuropathy is diabetes. The complication develops secondary to poor blood circulation that compromises the supply of nutrients and oxygen to the distal parts of the body. Without a sufficient, reliable blood supply, the nervous tissues in the feet and hands are prone to developing peripheral neuropathy which presents itself in the form of tactile sensory disturbances.
Unfortunately, doctors have yet to find a way to reverse the effects of neuropathy. This is because nervous tissue does not repair itself, unlike the other tissues in our bodies. So any damage they sustain is likely to be irreparable. For that reason, anyone who suffers from neuropathy should observe the necessary steps in order to prevent the complication from worsening. For individuals with diabetes, the most effective step would be to maintain blood glucose levels to cease the further development of neuropathy.
Conventional Methods for Managing Neuropathy
While neuropathy can’t be reversed, there are a variety of management methods that medical professionals suggest in order to help alleviate the pain and discomfort that the complication might cause. These methods target only the symptoms, and simply help make day to day life a little more bearable for those who suffer from the sensory issues that neuropathy might cause.
For the most part, neuropathy is managed with medications that aim to mitigate pain. Over the counter pain killers are often the first treatment option, however they’re not usually the most ideal for long-term use. This is because chronic use of pain medication can have significant effects on the liver and kidney. What’s more, advanced cases of neuropathy often come hand in hand with pain that’s too severe for simple OTCs pain management medications to resolve.
Some other methods for treating neuropathy involve the use of topical creams. The most effective is capsaicin which works to alleviate pain by reducing a chemical in the nerves that is responsible for transmitting pain signals. In part, capsaicin also helps by dampening the pain receptors in the areas over which the cream is applied.
More aggressive treatments for neuropathy include antidepressants, SNRIs, spinal cord stimulators, and sodium channel blocker. These work in different ways to reduce pain and are prescribed only after extensive analysis by doctors and specialists. Figuring out which of these treatments will work best often depends on the type and severity of the pain experienced, as neuropathies can be slightly different from person to person.
Aside from these aforementioned treatments, new studies suggest that laser treatment can also be an effective solution against neuropathic pain. But is it really as beneficial as these new findings suggest?
How Does Laser Treatment for Neuropathy Work?
In medicine, lasers have long been used for a variety of purposes. Many different types of surgery involve the use of lasers to cut precise incisions along delicate parts of the body, such as the eyes. Aside from this, studies have found that the therapeutic use of low level lasers on neuropathy can help target the pain and discomfort that the condition might cause.
The most popular form of laser therapy used for neuropathic pain is cold laser treatment. The method works by stimulating blood circulation around the affected areas. This is beneficial because of the lack of blood supply around the distal parts of the body, as a result of increased glucose levels.
In doing this, the nerve fibers that have been damaged can receive sufficient nutrition and oxygen, thus helping repair and optimize their functionality. The end result is decreased neuropathic pain and discomfort.
The process is painless and works to relieve other symptoms associated with diabetic neuropathy as well, including inflammation and wound healing. Depending on the extent of the complication, it may be necessary to receive laser treatment multiple times in a week.
What Do Studies Say?
Laser treatment for neuropathy is fairly new, so we’re only just beginning to understand how it works and whether it truly provides relief from neuropathic pain. However, despite the lack of in-depth understanding regarding the treatment, existing studies point to the same conclusion – that laser treatment might be effective, especially when used appropriately.
The issue that most studies found is that while the treatment itself is a promising solution against neuropathic disturbance, a uniform method of administration has yet to be established. Without a structured treatment method, the extent of the benefits that the modality could provide widely varies from study to study.
According to research published in 2017, low level laser therapy can improve sensory function in individuals with peripheral neuropathy however, the variations in laser treatment regimens and the lack of a specific treatment protocol could have an effect on the efficacy of the treatment.
Another study measured pain management by way of the Michigan Neuropathy Screening Instrument – a standardized test that quantifies the level of pain experienced by an individual. Based on their findings, low level laser therapy was found to significantly reduce pain in individuals with Type 2 Diabetes. This was the same result collected from a study conducted in 2011.
Based on all of this research, it’s easy to see that laser light treatment can be a promising method for neuropathic pain relief. It is hoped that further research will help LLLT become an accredited medical treatment so that more health care professionals will make it accessible to individuals seeking relief from neuropathic pain.
Who Provides Laser Treatment for Neuropathy?
While most of us would expect that neurologists and neurosurgeons would be the best equipped to administer laser treatment for peripheral neuropathies, that’s not actually the case. In fact, it’s rare that you will find a licensed medical doctor prescribing this form of treatment because it’s considered an alternative medicine. That is, laser treatments have yet to be accepted in the medical field as a sound, reliable management for neuropathy.
Currently, laser treatments for neuropathies can be provided by chiropractors or pain management clinics. Keep in mind that because of the limited research on laser treatment, it’s not covered by any sort of insurance. As it can be quite expensive – ranging from $125 to $175 USD per session – it might not be practical for a lot of individuals.
Low Level Laser Treatment at Home
While the use of medical lasers at home isn’t recommended, there are FDA-cleared devices that can be safely and effectively used in the comfort and privacy of your own space. These lasers cost quite a pretty penny, so it would be wise to undergo a few clinic-based treatments first to find out whether or not the therapy actually provides you any relief.
If you’re certain that LLLT is right for you, then there are a variety of low level lasers that you can purchase in order to treat the pain yourself. The biggest consideration you need to make is the level of power you will need to make the most of your purchase. A class 1 laser will only be able to excite a small number of cells over a given area, while a class 4 laser can excite anywhere from 100 to 1,000 times the coverage of a class 1.
While you might be thinking that more power means better results, that isn’t always the case. This is especially true if your neuropathy presents only as tingling or numbness without pain. It also pays to consider the fact that lasers that fall within the 3 and 4 classes come with their own safety protocol because they can become hazardous in the wrong hands. Often, retailers will request some sort of proof of your condition or a clearance from a certified laser therapy provider before they can sell you higher class lasers.
Of course, there are non-FDA class 3 and 4 lasers that you can purchase without all the red tape. However it is assumed that any device that fails to get clearance from the FDA might have some sort of functionality or safety issues, so you will have to make that purchase at your own risk.
Peripheral neuropathy can be a major drawback for your functionality and independence and may even have some heavy emotional and psychological effects. However there are ways that you can treat the condition.
Aside from talking to your doctor about possible medication alternatives, consider discussing the potential of LLLT for neuropathy. While this particular treatment is fairly new in the industry, countless studies and anecdotal sources have testified for its efficacy. Plus, there really isn’t anything to lose if you want to give it a shot – especially if that means giving yourself a chance at a pain-free life.
Treatment for neuropathy
Peripheral Neuropathy, or the numbness and pain caused by nerve damage in the hands and feet, can be caused by many factors.
When the blood supply to the nerve is affected, the nerve fibers that are responsible for pain conduction are damaged and can cause a loss of sensation and create burning and tingling for the patient. This can occur in the hands and arms, but most commonly it is seen in the feet and legs.
Most treatments currently in use for neuropathy are geared towards treating the symptoms and not to cure the problem. These treatments help lessen the symptoms to make the disease more manageable for the patient; however, they usually involve prescription medications that mask the disease rather than treating it.
Recent research has shown that Cold Laser Therapy can help treat the underlying causes of neuropathy and help with symptom management.
HOW DOES LASER THERAPY WORK?
Cold Laser Therapy helps by actually stimulating microcirculation around the nerve fibers, which increases blood flow to the nerves and helps to heal and reduce neuropathic pain.
Laser light energy penetrates the skin and stimulates increased oxygen on a cellular level. This increase in microcirculation around the nerve has been shown to help regenerate fibers and help heal peripheral nerves. Cold Laser Therapy is painless and has been proven to decrease neuropathy, decrease inflammation and aide in the healing of wounds and tendons.
Peripheral neuropathy is a frustrating, life impairing condition which is all too often inaccurately diagnosed and only treated with medications. Fortunately, with the recent advances in neurologic treatment technologies, relief is available for many neuropathy sufferers.
SIGNS OF PERIPHERAL NEUROPATHY
Five Signs of Peripheral Neuropathy
Burning or freezing sensations
Prickling or tingling sensations
COMMON CAUSES OF PERIPHERAL NEUROPATHY
Diabetes Type 1 or Type 2
Nerve Entrapment Syndromes
Nerve Compression due to Disc Protrusion or Stenosis
Metabolic Syndromes such as Thyroid Imbalances
Nutritional Deficiencies like low B12, Folic Acid, or Minerals
Auto-immunity due to Food Sensitivities
Impaired Gut or Liver or Kidney Function
BEST TREATMENT FOR PERIPHERAL NEUROPATHY
Providing that the damage is not too severe, the goal of treatment is to create an environment that allows the nerves to regenerate. Stated simply, our nerves need fuel and activation to repair. The fuel is oxygen and glucose; activation is use.
To get oxygen to nerves we need to breathe properly and have healthy vascular function. Many peripheral neuropathy sufferers have blood sugar dysregulation.
Class IV Laser is the most powerful non-drug tool for speeding nerve regeneration. Class IV Laser has been quickly gaining popularity in the United States since its FDA approval in 2001. Near infrared (820 nm wavelength) light supplies energy to the body without tissue damaging heat. Near infrared light penetrates the skin and is absorbed by the mitochondria of our cells. This energizes the mitochondria, allowing increased production of ATP (fuel for our cells). This in turn accelerates healing of damaged nerves and surrounding tissues. Class IV Laser has a similar effect on our cells as sunlight does on plants, and is a key component of our safe pain-free treatment procedures.