Perhaps the most frustrating, but real issue surrounding patients who suffer from peripheral neuropathy and many types of chronic pain is that more often than not, there are often multiple underlying causes.
As you know, life is an accumulation of experiences—sometimes, unfortunately, including trauma and illnesses.
All of these things have consequences, some of which will not show up for many years. You probably also know that things that are very easy to ignore at 25 now become impossible to ignore at 65 and beyond.
One of the issues that concerns me while treating many neuropathy patients is when clinicians and patients focus exclusively on trying to find the “one” cause of their pain, burning, tingling numbness or other neuropathy symptoms.
The reason for this is quite simple. Most commonly, patients develop peripheral neuropathy as the result of multiple underlying causes.
For example, a common scenario is an overweight smoker who had a history of back surgery. Perhaps they are overweight or pre-diabetic, or have used some medications (commonly statins) known to cause neuropathy. These are some of the many multiple underlying causes we find in patient histories every day.
The reality is, all these things are risk factors for the development of chronic pain, and often peripheral neuropathy.
So, unless all these multiple underlying causes are addressed, the patient is unlikely to significantly improve.
Worse yet is when doctors and other caregivers are not familiar with this all-too-common scenario.
We honestly believe this is the reason why so many patients receive symptomatic prescriptions, yet no constructive advice on how to manage, let alone possibly beat, their peripheral neuropathy.
So the best advice we can give you is to try and understand everything that may be contributing to your current situation.
Also understand how very important it is NOT to delay proper treatment. The longer the delay, the more difficult peripheral neuropathy and chronic pain becomes to manage.
We find this is also why the biggest neuropathy treatment successes come when implementation of EARLY effective pain & neuropathy treatment, including neurostimulation (NDGen(R)), manual and massage therapy, laser (LLLT/LED) therapy, can have a profound impact on our patients’ outcomes, no matter what the multiple underlying cause(s) might turn out to be.
Learn so much more about treatment options, products and service at https://NeuropathyDR.com
One of the more common but sometimes under diagnosed components of some forms of peripheral neuropathy is loss of balance. Patients will often say “I don’t have neuropathy; I only walk like I’ve had a few drinks”. This is why it is so crucial to address balance and neuropathy treatment.
In the clinic, we call this “gait” changes. Of course, there are many neurologic disorders that can cause you to walk abnormally or to lose your balance.
But this loss of balance occurs frequently in peripheral neuropathy and sometimes its the very first things patients notice. This is primarily due to changes in sensation in your feet to touch, as well as position sense, or what doctors call proprioception.
One of the most important things to recognize is that left untreated, this problem often gets worse. It requires not only treatment for the neuropathy component but also rehabilitation to help retrain balance and coordination, wherever this is possible.
There are some very simple steps they can be taken almost immediately to prevent catastrophic falls and help balance and neuropathy treatment.
The first thing is to make sure that proper footwear is worn at all times. Secondly, remove common hazards around the household such as objects upon stairs, rugs without non-slip backing or pads, spilled liquids on the floor etc.
Be especially careful in kitchens and bathrooms. Once neuropathy treatment has begun, we’ll instruct you in a series of exercises to help retrain your nervous system.
This is only possible when adequate balance and neuropathy treatment has been able to improve sensation to the soles of your feet, and position sense to your toes and ankles and knees.
This is why getting care early can go along way towards helping possible neuropathy recovery, but also set the stage for a return to a more active lifestyle.
Remember, the sooner you act, the sooner you improve.
Please, do not wait for your situation to really deteriorate before seeking active balance and neuropathy treatment intervention.
Good treatment for many of the more common forms of neuropathy is now available!
All you have to do is ask!!!
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An entrapment neuropathy occurs when a nerve is wedged or “pinched” against a bone, inflamed muscle, or other structure…
Most people have heard of carpal tunnel syndrome (CTS). What you might not know is that carpal tunnel syndrome is only one of a family of ailments in the upper limbs known as entrapment neuropathies. The other entrapment neuropathies are not as well-known in the mainstream as CTS, and so people who suffer from nerve symptoms in their forearms and hands frequently jump to conclusions. We are here to help set the record straight!
Diagnosis for compression neuropathies is usually straight forward…
An entrapment neuropathy, also called nerve compression syndrome, occurs when a nerve is wedged or “pinched” against a bone, inflamed muscle, or other internal mechanism in your arm. Aside from the median nerve (the one associated with CTS) there are two main nerves that help to control your arm and hand: the radial nerve and the ulnar nerve. Both are susceptible to compression, and the results can be painful!
Entrapment occurs under a number of conditions, most commonly:
- When there is an injury originating at your neck or a disease of the cervical spine
- When your elbow has been injured due to fractures or improper use
- When your wrist has been injured due to fractures or Guyon canal alignment problems
- Rarely, an aneurysm or thrombosis in your arteries
- Factors commonly associated with peripheral neuropathy, such as diabetes, rheumatism, alcoholism, or infection
Your radial nerve runs the length of your arm, and is responsible for both movement and sensation. Radial neuropathy usually occurs at the back of the elbow, and can present itself with many of the common symptoms of neuropathy such as tingling, loss of sensation, weakness and reduced muscle control (in this case, often difficulty in turning your palm upwards with your elbow extended).
A number of palsies affect the radial nerve, such as:
- “Saturday night palsy” where your radial nerve is compressed in your upper arm by falling asleep in a position where pressure is exerted on it by either furniture or a bed partner
- “Crutch palsy”, where your nerve is pinched by poorly-fitted crutches
- Tarsal Tunnel at the foot and Cubital Tunnel at the elbow.
Two main conditions affect the ulnar nerve: Guyon’s canal syndrome and cubital tunnel syndrome. Guyon’s canal syndrome is almost exactly the same in symptoms as carpal tunnel syndrome (pain and tingling in the palm and first three fingers), but involves a completely different nerve. Guyon’s canal syndrome is caused by pressure on your wrists, often by resting them at a desk or workstation, and is frequently experienced by cyclists due to pressure from the handlebars.
Nearly everyone has experienced cubital tunnel syndrome: it’s the “dead arm” sensation we’ve all felt when we wake up after sleeping on top of our arm! Sleeping with your arm folded up compresses the ulnar nerve at your shoulder, causing it to effectively “cut off” feeling to your arm. As you probably know from experience, this sensation is unsettling but temporary.
Diagnosis for all compression neuropathies is fairly straight forward. First, we will examine your arms for signs of neuropathy, and will likely ask you to perform several demonstrations of dexterity. If we suspect you may have an underlying condition, nerve (EMG/NCVs) or blood tests may be recommended. To pinpoint the specific location of a compression, we may also suggest MRI or x-ray.
Similar to carpal tunnel syndrome, most cases of compression neuropathy are mild. Treatment for these mild cases and commonly ice, rest, and a change in habits of motion or stress that are causing the symptoms. For more severe cases, possibly anti-inflammatories, and in extreme cases, a surgical solution is sometimes justified.
If you suffer from a compression neuropathy or have questions about this or any other kind of neuropathy, let us help! Contact us by calling the number at the top of the page and we can answer your questions.
Don’t wait! The sooner and accurate diagnosis is made, the more options for treatment you will have.
Do you or someone you know suffer from CTS? Join the conversation HERE!
Lets Make The Most Accurate Diagnosis First. We have been teaching patients and professionals this for many years. Here is one example why.
Recently, I had the opportunity to read an article written about pain & neuropathy treatment. This article was written directly for patients.
Now maybe you even saw this yourself. It has been widely publicized as a “neuropathy treatment solution” in a bottle.
As I read through the article I couldn’t help but think of the patients I’ve seen in my clinic that have been diagnosed with peripheral neuropathy, or another named condition when in fact they have also have another serious underlying health problem.
Unfortunately, this is not at all uncommon. I recently had this discussion with another doctor who repeated the same thing to me.
The fact of the matter is not every patient with a diagnosis or cause of their pain has had it fully explored and when possible confirmed. Far too often, the problem turns out to be something different than what they believed.
Treating patients with pain and neuropathy requires great skill, with much time dedicated to proper assessment and evaluation.
So often, pain, including peripheral neuropathy accompanies other medical conditions. Unless your Doctors are thorough, you can spend months and sometimes years chasing the wrong thing! This is happening more and more with all the Social Media “cures” and practices being promoted.
And that is why it is very important before beginning any extended program of care, it is crucial to most accurately understand what may be causing your symptoms.
Too often, patients with peripheral neuropathy have impaired sensation, and judgment affected by medication. This is one of the things that make self-treatment and home care without supervision potentially dangerous.
Be aware, there are also drug/diet supplement interactions, which can be potentially dangerous. A common one is Coumadin and Co Q10. Then there is the potential interaction with acetyl l Carnitine with thyroid, HIV and many chemotherapy drugs.
Choose your Doctor carefully. Stay away from fads, quick fixes or “magic treatment” pills or supplements.
When in doubt seek out our help before engaging any any questionable treatment. You can Call us anytime @ 781-659-7989.
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“Why Do I Feel so Lousy With Weather Changes?” This is one of things we hear very often from pain and neuropathy patients, “While do I still feel so lousy?”
Sometimes, it’s easy to put your finger on the reason why. For example you fail to eat properly. You over exercise. You under exercise. But lately you’ve been eating better and drinking lots of water but sometimes, you feel lousy for seemingly no reason at all.
It could be, that you are suffering from what we call “denervation hypersensitivity”.
Now, that sounds like a mouth full. And at first glance it is!
You see your body is very sensitive to environmental changes. These could include things such as air pressure, temperature, humidity, and other environmental changes. Much more so with nerve irritation due to injury, arthritis or neuropathy.
Is it sunny and warm or hot and humid today?
The reason for this is that when nerves are damaged they become hypersensitive to environmental changes. This is not an old wives tale.
A very common scenario is when an approaching storm seemingly increases your level of pain and discomfort oftentimes dramatically.
It is a well-known phenomenon that anybody familiar with neuropathy treatment, arthritic pain, or patients that suffer from neuropathy and probably many forms of chronic pain..
Some of my patients even joke that they have become walking barometers. Now there’s nothing you can do to change the weather. However there are some things you can do to make yourself more comfortable. Number one, make sure you maintain as even environmental temperature and humidity level as you possibly can in your home and car.
Number two, keep yourself away from draft exposure. Even on relatively warm days, you need to make sure that you’re protected from wind and drafts.
Lastly, armed with this knowledge plan on extra treatment at home or maybe even in the clinic during times of flare-up
The most important thing of all though?
Recognize that your body while suffering from pain and neuropathy is very sensitive and take steps to protect it.
This is one of the reasons, we advocate every neuropathy treatment patient owns their own homecare kit which can give you invaluable relief during the times of flare-up, during the middle the night, weekends, and even for breakthrough pain.
Tell us how your neuropathy treatments are effected by the environment HERE!