Symptoms, Causes, Treatment & Therapies, Diet & Cure
“Neuropathy” means “disease of nerve.”
The term “peripheral” means that the disease is occurring to nerve tissue outside the brain and spinal cord. This includes injury of nerves to muscles (motor nerves), nerves from the skin (sensory nerves), and/or nerves to the gut and other internal organs (autonomic nerves).
Peripheral neuropathy is a very broad topic that demands classification for purposes of diagnosis, evaluation, and treatment. An initial distinction may be made between focal and generalized peripheral neuropathies.
A focal neuropathy means only one or, at most, a few nerves are injured. Pain, numbness, and weakness are confined to a single limb or a small region of the trunk or head. Focal neuropathies are typically caused by compression or trauma. Carpal tunnel syndrome, a common syndrome characterized by nighttime numbness and tingling in the hand, is an example of a focal neuropathy. Compression of a major forearm nerve called the median nerve causes this syndrome.
Generalized neuropathies present as pain, numbness, tingling, and, sometimes, weakness that affect both sides of the body. The feet and toes are commonly affected early in the course of a generalized neuropathy. As discussed in the “Causes of Peripheral Neuropathy” section, generalized neuropathies are often associated with general medical problems. Generalized neuropathies are also called polyneuropathies. I will use these terms interchangeably in Neuropathy 101.
A physician may also classify a neuropathy as being predominantly “axonal” or “demyelinating.” These are technical terms that refer to the microscopic component of the nerve that is being damaged. All nerves that supply muscles and the skin are comprised of microscopic fibers that carry the (electrical) information along the nerve. You may understand this by thinking of all the individual wires inside the main cable that goes to your computer printer. Within these fibers are cores called axons; these are analogous to the copper inside the wires. Most axons are ensheathed in fatty tissue called myelin. Myelin is required for the rapid transmission of signals along the axons. Myelin is analogous to the rubber insulation around wires. Whether a neuropathy is axonal or demyelinating has implications for medical work-up and treatment options. Nerve conduction studies (NCS) are required to distinguish between these two types of neuropathies. Axonal neuropathies are more common than demyelinationg neuropathies. In order to simplify the subsequent discussion of peripheral neuropathy, I will not distinguish axonal from demyelinating neuropathies; the discussion will apply to both types.
SIGNS & SYMPTOMS
Peripheral neuropathies present as pain, numbness, tingling, and, sometimes, weakness. The initial symptoms generally depend on the nature of the underlying damage to the nerve.
Tingling and Other Spontaneous Sensations
Odd spontaneous sensations are often the initial symptom of a peripheral neuropathy. Patients with polyneuropathies often describe the sensation that a thin layer or film is surrounding their toes or the soles of their feet. It may also feel as though something is stuck between the toes. A pins-and-needles sensation may also occur in the feet.
Pain
Pain from a peripheral neuropathy is called neuropathic pain. Burning sensations are very common. Aching or stabbing pain may also occur. Electric shock sensations may go up or down the legs and feet.
Altered Sensations
Tactile sensations are often altered in body regions affected by peripheral neuropathy. Commonly, this manifests as increased sensitivity to pressure. For example, when a patient with polyneuropathy steps on a small pebble, it may feel like a sharp piece of glass is cutting into the sole of their foot. Also, the feet may feel swollen or bound up. Even very light sensations, like bedsheets being drawn across the feet, may cause severe discomfort.
Numbness
Impaired sensation is a feature of almost all peripheral neuropathies. Patients may be unaware of these problems because pain in the affected body region overrides any appreciation of the numbness. Only when the physician applies light touches or a vibrating tuning fork or the sharp end of a pin to the skin does it become clear to everyone that sensation is impaired.
An unfortunate paradox of peripheral neuropathy is that the numbest areas of the body also tend to be the most painful.
Balance Problems
In moderate-to- severe polyneuropathies, balance may be affected. In these cases, sensory fibers that carry information about joint position to the brain have degenerated. This type of sensory information normally allows us to do such things as touch the tip of the nose with a fingertip with closed eyes. We are unconscious of this type of sensation from our limbs.
If a neuropathy leads to impairment of joint position in the legs, the person becomes more dependent on vision for balance. It is for this reason that neuropathy patients have the toughest time with balance when their vision is limited—when, for example, they are shampooing their hair in the shower or walking in the dark.
Weakness
Weakness may occur with any peripheral neuropathy. The region of weakness depends on the type of neuropathy. In polyneuropathies, weakness is usually worst at the ankles and toes.
Urinary, Sweating and Gastrointestinal Problems
Sometimes the nerves to blood vessels, gut, and bladder are diseased in a peripheral neuropathy. Autonomic neuropathy is a more specific name for this type of peripheral neuropathy.
When the nerve supply to blood vessels is diseased, the blood vessels cannot constrict in response to standing to maintain adequate blood pressure. Without this response, the blood pools in dependent body regions and the brain does not receive enough blood flow. This manifests as lightheadedness. The patient must sit or lie down for relief.
When the nerves to the bladder are affected, it may be difficult to fully empty the bladder.
When the nerves to the gut are affected, patients may have either constipation or, sometimes, diarrhea. Patients may feel full even after eating small food portions.
When the nerves to the sweat glands are affected, the pattern and frequency of sweating may be affected.
INCIDENCE & CAUSES
Causes of peripheral neuropathy include:
- Medical problems such as diabetes
- Genetic
- Nutritional deficiencies
- Toxins
- Compression/ trauma
- Infiltration by tumor
A few of these causes are discussed below. In about 30 percent of patients, a specific cause of neuropathy cannot be found—even after an exhaustive search. These neuropathies are called idiopathic. Probably, complex metabolic and genetic factors contribute to idiopathic neuropathies.
Medical Problems
Many different medical problems lead to peripheral neuropathies. It is therefore important that physicians take a careful medical history when assessing patients for neuropathy. Medical problems that may be associated with neuropathy include: 1) metabolic diseases such as diabetes mellitus; 2) autoimmune diseases such as lupus erthymatosis; 3) organ failure; 4) endocrine (hormonal) diseases such as hypothyroidism; 5) infections such as Lyme disease, HIV, and leprosy. (Until quite recently leprosy was the leading cause of polyneuropathy in the world.)
Diabetic peripheral neuropathy is the most common polyneuropathy in the United States and the world. It is estimated that there are 15-20 million cases of diabetic polyneuropathy in the United States. Given the size of this problem, it is odd that more people do not know about it. Diabetic polyneuropathy contributes to the incidence of lower limb amputations in diabetic patients because diabetics are less likely to perceive a wound in their feet or legs.
An autoimmune disease is one in which the body’s immune system attacks body tissues. Neuropathies may occur in patients with multi-system autoimmune diseases such as lupus erythematosis in which the skin, joints, and kidneys may also be affected. Sometimes an autoimmune disease may be directed selectively against nerves. A dramatic example of this is Guillain-Barré syndrome. People who have direct experience with this type of polyneuropathy will never forget it. It is characterized by a very rapid decline in strength. Sometimes patients, though alert, become completely paralyzed and need a breathing machine. With intensive care, most patients make a good recovery. This disease has inspired more than one medical student into chosing a career in intensive care medicine or neurology!
Nutritional Deficiencies
Deficiencies of certain vitamins and minerals (including the B vitamins, vitamin E, and copper) can cause a peripheral neuropathy.
Alcoholic patients may become deficient in thiamine (a B vitamin) if they do not eat well. This deficiency is thought to contribute to alcoholic polyneuropathy.
In Western societies, B12 deficiency is the most common vitamin deficiency leading to neuropathy. When it is severe, patients may have very poor balance. Anemia is also a feature of B12 deficiency.
Genetic Neuropathies
Mutations in a number of genes (sections of DNA) may lead to a peripheral neuropathy. Sometimes, as many as 50 percent of family members have it. Sometimes only a single family member has it. Genetic neuropathies tend to present early in life and progress very slowly over time. There are certain clinical clues such as the appearance of the feet that would make a physician suspect a genetic neuropathy.
Currently there are no cures and only a few specific treatments for the genetic neuropathies. Genetic disease is a rapidly evolving part of medicine, and there is hope that better therapies are on the horizon.
Toxins
A wide array of industrial chemicals including solvents and heavy metals, including arsenic and lead, can cause neuropathy. Industrial workers who develop symptoms of a neuropathy should bring a list of their chemical exposures to their physicians.
In people who do not have significant occupational exposures to chemicals, the most likely culprit for causing a toxic neuropathy is a pharmaceutical drug. Certain chemotherapeutic drugs are notorious for causing peripheral neuropathies.
If the toxin can be identified and removed, the peripheral neuropathy typically stabilizes and then improves.
Idiopathic Peripheral Neuropathy
It is frustrating for both the patient and physician when a specific cause for a neuropathy cannot be found. Most idiopathic neuropathies progress over time, albeit very gradually. Usually sensory symptoms predominate over motor deficits (weakness). Over time, balance may be affected. Even after many years, however, many patients with idiopathic neuropathies usually do not have significant limb weakness.
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HOW IS PERIPHERAL NEUROPATHY DIAGNOSED?
As with any medical problem, the proper diagnosis of a peripheral neuropathy
requires that a physician take a history and perform a physical examination. The history must include a review of any currently prescribed medications because some medications can cause a peripheral neuropathy. The physician will also inquire about any relatives that may also have similar symptoms. If they do, there is an increased chance that the patient has a genetic peripheral neuropathy.
In cases in which the cause of the neuropathy is not obvious, bloodwork and potentially an analysis of urine is necessary to help make the specific neuropathy diagnosis.
The physician may also order electrodiagnostic testing. Nerve conduction studies (NCS) require electrical stimulation of the nerves. Responses are recorded on a machine. An electromyogram (EMG) may also be ordered. This test involves the placement of fine needle electrodes into muscles. With the needle inserted, the patient is asked to move the limb. The resulting electrical activity from the muscle is then amplified and displayed for the physician. These tests are very safe but uncomfortable. Some patients do not mind the test in the least; others run for the door after the first nerve is stimulated! It is very helpful for patients to be mentally prepared beforehand that the test involves electrical stimulation and needle placement. Oral pain relievers may be taken prior to the test and do not affect the test results.
WHAT TREATMENTS ARE AVAILABLE?
Treatment for peripheral neuropathy includes:
- Therapies to repair nerves
- Therapies for pain relief
- Therapies to improve function
Therapies to Repair Nerves
The best way to repair the nerves is to identify and treat the underlying disease process causing nerve injury.
Treatment of focal neuropathies may involve surgery to remove pressure on the nerve. Sometimes, as in the case of mild blunt trauma to the nerves, a “tincture of time” is all that is needed.
For polyneuropathies, the job of identifying the root cause of the neuropathy becomes important. To do this, your physician may order various laboratory tests. If the underlying disease can be identified and treated, the neuropathy usually stabilizes and symptoms may improve.
For example, the best way to treat a diabetic polyneuropathy is to optimize blood sugar levels. The best way to treat an alcoholic polyneuropathy is abstinence and proper nutrition. Autoimmune neuropathies may respond to steroids or intravenous immunoglobulin therapy.
When an underlying cause cannot be found (i.e., the idiopathic neuropathies) , the therapeutic options to heal the nerve are, unfortunately, limited. Studies of chemical factors and drugs that can directly regenerate nerve endings have been disappointing.
Therapies for Pain Relief
For all types of neuropathies, there are many options available to reduce pain and discomfort.
A number of drugs specifically target neuropathic pain. These medications generally affect the electrical and chemical activity of nerve fibers both in the peripheral and central nervous system. Some drugs suppress the rapid electrical discharges of nerves. Oral medications can target pain throughout the body. Unfortunately, these medications may also impair brain function, causing sleepiness or foggy thinking.
Even with aggressive management, persistent and bothersome neuropathic pain is a frequent problem. This is can be a source of tremendous frustration for neuropathy patients. Because relatives and loved ones are often not familiar with either neuropathy or neuropathic pain, patients feel additionally isolated. Pain is the most common impetus behind neuropathy patients seeking help from their physicians; it is the most common reason patients attend support groups. Without a doubt, there is an enormous need for more effective oral pain treatments that have fewer cognitive side effects.
For some patients, topical pain relieving medications are effective. These medications only have a local effect and do not get absorbed significantly into the bloodstream. Because of this, there are no cognitive side effects with these medications. The main options in this category are topical anesthetics (similar to the numbing medications given by dentists) and chili pepper extract (capsaicin). As one would imagine, the capsaicin creams cause burning sensations when applied. After repeated applications, however, neuropathic pain is mitigated. Topical medications tend to work best for neuropathies in which symptoms are restricted to small regions of the body (e.g., just the feet or toes).
An exercise program is often beneficial for alleviating chronic pain and for promoting general well being. For patients with polyneuropathy, exercises need to be chosen that limit the impact on the soles of the feet. Swimming is an excellent exercise. It is a terrific aerobic exercise that involves many muscle groups without putting much strain on the joints. Other options include bicycling. Other low impact exercises include Tai Chi and Yoga. It is recommended that you discuss an exercise program with your physician.
Other therapies aimed at pain relief include massage therapy, acupuncture, and electrical stimulation.
There are many other devices and nutritional supplements marketed to patients with neuropathic pain. A few have demonstrated benefit in clinical trials, but most of these devices and supplements are experimental. Before spending large amounts of money on any such treatment, I would recommend discussing it with your physician.
Therapies to Improve Function
If significant weakness is present, braces or splints may become necessary. In addition to helping mobility and function, these aids protect the full range of motion of joints. Without them, some neuropathies may result in joint contractures (very stiff joints).
In severe neuropathies, canes, walkers, or even wheelchairs may be necessary for patients to maintain mobility.
Neuropathy - Prevention & Curing Protocol
This Neuropathy Prevention and/or Curing Protocol is for people who are ready to take the full responsibility for their own health.
"The person who says it cannot be done should not interrupt the person doing it."
Chinese Proverb.
The protocol incorporates lifestyle change, and implements healthy diet, body cleansing, exercises and different traditional and natural therapies. Protocol contains links to other pages that give detail explanation for each part of this program. Please, follow the links, to fully understand all the words. Remember: There is always something that can be done! The first thing to do is to change your mood. If you are depressed, if you are unhappy, you can not be healthy.
Advice: start with the Laughing Cure
Laughing provides us with the natural inner massage, and through change of mood it can account for up to 30% of cure!
The Neuropathy Cause
To understand The Neuropathy Prevention and Curing Protocol, you should first get familiar with the Neuropathy Cause. Now, I assume that you know something about what is causing Neuropathy, so we can continue with the Neuropathy program.
Neuropathy Diet
Let's start with most simple part of this program: Neuropathy diet. When it comes to diet, it is very important to avoid eating Toxins and Foods that Kill. Please follow those links and learn what are The Toxins I am talking about and what are those " Foods that Kill". Now, important part of your diet should also be Water Cure. Please, become familiar with Water Cure. Your Diet should contain: Foods That Heal, Vegetable juices, Fats that Heal, Unrefined Sea Salt. Also, try to understand food tolerance. You can not find the right Neuropathy diet, unless you fully understand and learn about food tolerance.
Take some time to implement and learn all what you have read here, and then continue reading further.
Body Cleansing (Neuropathy)
Now, let's start with body cleansing. Body cleansing is extremely important part of every prevention and curing program. You are guessing: "Dietary changes you made are also a form of cleansing." But, most people need more then this, especially when it comes to liver health. Body Cleansing is even important for children. Our internal organs can hold a lot toxins, and sometimes, it is impossible to get those toxins out, without doing cleansing. Our liver can contain hundreds of intrahepatic stones. Those stones will block bile flow, and affect the bases of your health, your digestion. Another problem are parasites. You must learn as much as possible about parasites. And, don't forget also dental toxins.
Let start with cleansing program. You are suppose to do cleansing in this order:
1. Bowel cleanse with parasite cleanse
2. Dental cleanup (if you can afford it)
3. Kidney Cleanse and
4. Liver cleanse.
Body Cleansing for Adults:
1. Bowel cleanse and Parasite cleanse !
2. Dental cleanup - dental work may be one cofactor of your disease: amalgam, root canal, nickel crowns, cavitations (pocket inside jaw bone left after extraction of the wisdom and molar teeth )
3. Kidney cleanse
4. Liver cleanse and Gallbladder cleanse -liver flush!
Make sure you visit those pages and get more info. Dental cleanup can take many years. If you have a lot of dental metal, do not rush to replace it all at once. Bowel cleanse should be done at least once a year. Liver cleanse is a procedure that, for best results, should be repeated at least 6 - 10 times, every 2 or 3 weeks. Kidney cleanse is simple and cheap, many herbs can be used to cleanse kidneys. If you have no kidney stones, even Water Cure could be enough!
Body Cleansing for kids:
1. Parasites cleanse
2. Dental cleanup .. Kids older then 8 may need dental cleanup (amalgam) and liver cleanse:
3. Liver Cleanse - flush
Physical Activity (Neuropathy)
Physical Activity helps cleansing, it brings balance and relieves stress. Psycho-physical activities will help you balance your body and will help you relief accumulated stress. You will have to find a form of exercise that suit you. I will just give you a few examples:
Mini Trampoline jumping - rebounding!
Meditation
Walk or jog in the nature : Forest, Mountain , river / sea / lake side, beach ... fishing, photo-safari, rowing, riding, golf, ...
Tai Chi, Chi Gong, Meditation ...
Yoga - Hatha, Meditation, Chinese Yoga ...
Martial Arts: Karate, Judo, Kung Fu, Teakwood, Budokai, Uechi, Aikido ...
Dancing, Aerobics, Gymnastics, Stretching ...
Swimming in non-chlorinated water ! ( Best in minerals rich water - Ocean ! )
Weight lifting, ....
Do not exhaust yourself !
Do not exercise with full stomach ! (You may take a walk!)
Do not hurt yourself !
Sweating (Neuropathy)
Sweating is powerful way to cleanse your body from accumulated toxins.
examples:
- exercise with a lot of clothes
- Sauna
- drink warm tea in a hot room ...
- eat CAYENNE pepper! ...
It is known that some modern industrial toxins and pesticides can leave your body only through sweat glands!
Psychotherapy and Spiritual Therapy
Human body is not just this what we can se. There is more to it. To treat other level of us, to treat soul and to treat mind and unconscious parts of us, Hellinger's therapy is suggested.