Can Acupuncture Work For Neuropathy

Another long but extremely useful article from pain-topics.org (see link below) today. It discusses a new study trying to determine once and for all, the usefulness of acupuncture in relieving chronic pain. It's a long-running argument, with many people swearing by the effectiveness of acupuncture and many others putting down any benefits to a placebo effect. The layman might reasonably think that acupuncture might have beneficial effects on nerve damage - it just seems logical, especially when you think that the needles are placed on acupuncture points along the main nerve pathways. However, whether that's more wishful thinking than fact is discussed here. One thing is sure; if you go ahead with acupuncture (which more often than not will not be covered by your insurance) then you should always go to someone who knows what they're doing; preferably someone who also has a doctor's qualification.

 

Acupuncture Aids Chronic Pain – Sort Of

Thursday, September 13, 2012

The largest and most rigorous study to date, employing a meticulous data meta-analysis, provides evidence that acupuncture is more than just an elaborate placebo for treating chronic pain. However, placebo effects do appear to play a considerable role and the contribution of the type and quality of acupuncture itself may be of relatively minor consequence. So, the debate over the value of acupuncture in chronic pain management seems unsettled.

Writing in an advance online edition of the Archives of Internal Medicine, Andrew J. Vickers, DPhil, of Memorial Sloan-Kettering Cancer Center, New York, and colleagues used data from previously published randomized controlled trials (RCTs) encompassing nearly 18,000 patients from the United States, United Kingdom, Germany, Spain, and Sweden [Vickers et al. 2012]. Going beyond the usual rigors of meta-analysis, the authors acquired individual patient data from 29 high quality randomized controlled trials (RCTs) comparing acupuncture with either sham (placebo) acupuncture or no acupunture (ie, usual care) in 3 chronic pain conditions: back and neck (musculoskeletal) pain, osteoarthritis, and chronic headache.

Patients in all RCTs had access to analgesics and other standard treatments for their pain, so either true acupuncture or sham acupuncture was an add-on therapy. Sham acupuncture, representing a placebo-control condition, included needles inserted superficially or at non-acupuncture points, devices with needles that retracted into the handle rather than penetrating the skin, or non-needle approaches such as deactivated electrical stimulation or detuned laser.

Results of this study, funded by the U.S. Natonal Center for Complementary and Alternative Medicine (NCCAM), suggest beneficial effects of accupuncture. After adjustments to eliminate biases unduly favoring acupuncture, the following standardized effect sizes were reported:

1. Patients receiving acupuncture had less pain, with effect sizes of 0.23 (95% CI, 0.13-0.33), 0.16 (95% CI, 0.07-0.25), and 0.15 (95% CI, 0.07-0.24) Standard Deviations (SD) in comparison with sham acupuncture controls for back and neck (musculoskeletal) pain, osteoarthritis, and chronic headache, respectively.
2. Standardized effect sizes for acupuncture in comparison to no acupuncture controls (ie, usual care) were 0.55 (95% CI, 0.51-0.58), 0.57 (95% CI, 0.50-0.64), and 0.42 (95% CI, 0.37-0.46) SD for back and neck (musculoskeletal) pain, osteoarthritis, and chronic headache, respectively.

These results were robust to a variety of sensitivity analyses, including those accounting for possible publication bias and weaknesses in some of the included trials. The statistically significant effects of true versus sham acupuncture in the first analysis above indicate that acupuncture is more than merely a placebo; however, the researchers concede that the effect sizes, representing differences between the two approaches, are relatively small.

The authors conclude that factors in addition to the specific effects of needling are important contributors to the therapeutic efficacy of acupuncture. Additionally, even though effect sizes for acupuncture compared with usual care in relieving pain are only moderate, the researchers advise that acupuncture is effective for the treatment of chronic pain and is therefore a “reasonable referral option.”

COMMENTARY:
According to background information in the Vickers et al. article, an estimated 3 million adults in the United States alone receive acupuncture treatment each year. Yet, they add that the lack of an accepted biological mechanism to explain the physiological effects of this therapy, and its provenance in theories and practices outside of traditional medicine, still make acupuncture highly controversial.

In a commentary accompanying the Vickers et al. article, Andrew L. Avins, MD, MPH — of Kaiser-Permanente, Northern California Division of Research, Oakland — notes that the debate over acupuncture as a bona fide therapy for pain is ongoing [Avins 2012]. To date, at least 60 meta-analyses addressing unresolved questions surrounding acupuncture have been conducted without reaching definitive answers.

Research and arguments on both sides of the debate have been presented in various Pain-Topics UPDATES [here]. In the most recent UPDATE on this topic [here], Edzard Ernst, MD, PhD and others discuss broad-scale reviews of the scientific literature on acupuncture, finding that evidence in its favor for a variety of pain conditions is equivocal, inconsistent, or inconclusive in many cases.

This meta-analysis by Vickers et al. was indisputably thorough and rigorous, involving dozens of scientists from multiple countries over a period of years. Their extensive search uncovered 955 studies for consideration, attesting to the extent and diversity of research on acupuncture, but also to the inferior quality of so much of the research. The research team identified only 31 high quality studies meeting their stringent inclusion criteria and were able to obtain individual data records for 29 of those to perform their very exacting meta-analyses. That is, they did their own calculations of outcome results, not relying on those of the original study authors.

The findings of the meta-analysis are scientifically and clinically important; however, the authors acknowledge the following regarding the effects of acupuncture found in their data:

“…an important part of these total effects is not due to issues considered to be crucial by most acupuncturists, such as the correct location of points and depth of needling. Several lines of argument suggest that acupuncture (whether real or sham) is associated with more potent placebo or context effects than other interventions. Yet, many clinicians would feel uncomfortable in providing or referring patients to acupuncture if it were merely a potent placebo. Similarly, it is questionable whether national or private health insurance should reimburse therapies that do not have specific effects.

Our finding that acupuncture has effects over and above those of sham acupuncture is therefore of major importance for clinical practice. Even though on average these effects are small, the clinical decision made by physicians and patients is not between true and sham acupuncture but between a referral to an acupuncturist or avoiding such a referral. The total effects of acupuncture, as experienced by the patient in routine practice, include both the specific effects associated with correct needle insertion according to acupuncture theory, nonspecific physiologic effects of needling, and nonspecific psychological (placebo) effects related to the patient's belief that treatment will be effective.”

Also, it should be emphasized, as noted earlier, that acupuncture did not exert effects in isolation from “usual medical care,” since in all cases acupuncture (or sham acupuncture) was add-on therapy. So, effects of acupuncture, though modest, were beyond and above those typically achievable by pharmacotherapy or other traditional treatments for chronic pain.

However, it is difficult to assess just what those added benefits of acupuncture might be and their clinical impact. Effect sizes were presented in the meta-analysis as standard deviation units (essentially Cohen’s d scores). For example, the favorable effect=0.57 SD of acupuncture for osteoarthritis would denote an improvement of roughly a 1/2 standard deviation on the end-point measurement scale used to assess pain, functionality, or something else.

Vickers and colleagues note that, in deriving effect sizes, their meta-analysis combined different end points, such as pain and function, measured at different times. Despite this variation, they claim that their results were stable; for example, effect sizes generally did not change when analyses were restricted to only pain end points and measured at specific follow-up times (eg, 2 to 3 months after randomization). However, as Avins notes in his commentary, these standardized effect sizes can be problematic when trying to assign absolute measures of improvement.

Vickers et al. believe that their overall observed estimate of roughly 0.50 SD favoring acupuncture over usual care is of clear clinical importance, but Avins observes that this is difficult to substantiate. The clinical relevance of this would vary with the outcome being assessed (eg, pain, functionality, mood, etc.), how it is being measured, and the standard deviation. For example, given a hypothetical average baseline osteoarthritis pain score of 60mm on a 0-to-100mm VAS and a standard deviation of 20mm, acupuncture might exert an 18% improvement of about 11mm (0.57 effect size X 20mm) and patients would still have moderate pain measuring 49mm on the VAS. A recent UPDATE [here] discussed research finding that 12mm denotes the Minimum Clinically Significant Difference (MCSD) in a VAS score that is perceived by patients as being of any consequence. So, from a patient’s perspective, would this sort of benefit be sufficient to justify the time, inconvenience, and expense of acupuncture?

Another disquieting aspect is the admitted placebo aspect of acupuncture. Although Avins argues in his commentary that placebo-based mechanisms have a place in pain management practice, he also recognizes that in traditional medicine new therapies must clearly show superiority over placebo to gain regulatory approval. In the Vickers et al. meta-analysis, acupuncture compared with sham/placebo demonstrated statistically significant improvements but only small effect sizes (0.15 to 0.23 SD) that might not be considered of clinical significance. If acupuncture were judged according to the same stringent criteria as a pharmacotherapy would it be approved by regulatory agencies?

Unfortunately, the Vickers et al. meta-analysis does not examine sham/placebo acupuncture compared with usual care, so the differential effects attributable to acupuncture alone, devoid of the placebo component, cannot be calculated. Still, Avins argues for an appreciation of placebo effects, writing…

“Perhaps the recognition that some patients find benefit in CAM therapies (many of which may, indeed, operate primarily through placebo mechanisms) should force us to examine our perceptions of placebo effects and question why so many of us feel threatened by their existence. …. At the end of the day, our patients seek our help to feel better and lead longer and more enjoyable lives. It's ideal to understand the mechanism of action, which carries the potential for developing more and better interventions. But the ultimate question is: does this intervention work (or, more completely, do its benefits outweigh its risks and justify its cost)?”

Through their meta-analysis, Vickers and colleagues reveal evidence that benefits of acupuncture, while modest, may provide advantages going beyond usual care for patients with diverse types of chronic pain. At the same time, considerable therapeutic effects may be due to factors such as a patient’s belief that treatment will be helpful, as well as placebo and other context effects, while a much smaller acupuncture-specific component may or may not involve such issues as specific needling points and the type or depth of needling. All of this may be unsatisfactory to what Avins calls “the quack-hunter community” who continue to argue against the validity of CAM therapies that rely more on placebo or other nonspecific effects than validated biological mechanisms of action.

REFERENCES:
> Avins AL. Needling the Status Quo: Comment on “Acupuncture for Chronic Pain.” Arch Intern Med. 2012(Sep); 172(11):1-2 [abstract here].
> Vickers AJ, Cronin AM, Maschino AC, et al. Acupuncture for Chronic Pain: Individual Patient Data Meta-analysis. Arch Intern Med. 2012(Sep);172(11):1-10 [abstract here].

http://updates.pain-topics.org/2012/09/acupuncture-aids-chronic-pain-sort-of.html

Can Avoiding Dairy Help With Neuropathy Vid

The third video clip from Dr John Hayes Jr this week, looks at why it may be sensible to cut down on or eliminate dairy products in your diet. You may not make a direct connection between nerve pain and diet but if you have neuropathy,  it is worth watching this clip and then thinking about your dietary choices (especially if you're in a diabetes risk group).


Episode 7 – Why Avoid Dairy? Part 1 of 2
Thursday, April 25th, 2013 Posted by John Hayes Jr

Dr. Hayes explains why consuming dairy is not ideal for anyone, especially those suffering from peripheral neuropathy and chronic pain.

http://beatingneuropathy.tv/2013/04/episode-7/

Can Massage Help With Neuropathy Symptoms

Today's post from  cancertherapyadvisor.com (see link below) is directed towards neuropathy patients who have nerve damage thanks to chemotherapy treatment but there is no reason at all to suggest that this form of treatment and the study thereof, can't also apply to all neuropathy patients suffering with the same symptoms. This is the key to researching neuropathy on the internet - you should never ignore articles ostensibly directed towards a particular disease when it comes to nerve damage. Once you have neuropathy, all treatment information is useful. That said, the conclusions of this study are pretty thin and although massage seems a very attractive treatment to most neuropathy sufferers, there's very little evidence to suggest that it really can reduce symptoms to any great extent. However, massage certainly may help you feel better and along with acupuncture, may well be worth a try if your medications aren't producing the goods (as most of them don't).

Massage Therapy May Reduce Chemo-induced Peripheral Neuropathy

Jason Hoffman, PharmD, RPh 

September 19, 2016

 

Massage therapy may reduce peripheral neuropathy symptoms among patients receiving neurotoxic chemotherapy, according to a study presented at the 2016 Palliative Care in Oncology Symposium.¹

Chemotherapy-induced peripheral neuropathy (CIPN) is known to negatively affect quality of life and can necessitate dose reductions of anticancer drugs. There is, however, no consensus of an effective strategy to improve CIPN. For the present study, researchers evaluated massage therapy as primary prevention and as a treatment option for CIPN.

For this prospective study, investigators enrolled 62 patients receiving cytotoxic chemotherapy. All participants underwent 2 massage therapy sessions; CIPN was measured using a validated survey instrument at baseline, after the first session, and after the second session.

Nearly all patients reported at least 2 CIPN-related symptoms. The most common symptoms were numbness and tingling of feet, numbness and tingling of feet, feeling weak all over, trouble walking, and joint pain or muscle cramps.

After the first massage therapy session, between 52% and 100% of patients reported improvement in CIPN-related symptom categories. Improvement in CIPN-related symptoms, with the exception of vestibulocochlear symptoms, continued from the first session to the second session of massage therapy.

Among the 25 patients initially prescribed analgesics, 56% had no progression of CIPN-related symptoms following the first session of massage therapy. After the second session, 38% of the 13 presenting patients reported no progression of symptoms, and 31% reported complete symptom resolution. Nearly one-third had symptom progression.

The findings suggest that clinicians should consider incorporating massage therapy as an approach to improving CIPN.
                          
Reference

1. Menendez AG, Cobb R, Carvajal AR, et al. Effectiveness of massage therapy (MT) as a treatment strategy and preventive modality for chemotherapy-induced peripheral neuropathy (CIPN) symptoms. Poster presented at: 2016 Palliative Care in Oncology Symposium; September 9-10, 2016; San Francisco, CA.
2.  
3.   http://www.cancertherapyadvisor.com/side-effect-management/massage-therapy-chemotherapy-peripheral-neuropathy-treatment/article/523534/

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Can Osteopaths Improve Nerve Pain Symptoms

Today's post from health.clevelandclinic.org (see link below) is both helpful and should maybe carry a health warning to people with long-term neuropathy. We're all looking for ways of reducing the symptoms without resorting to bucketloads of pills but whether, as suggested here, an osteopath is the answer, is an important question. Typically, osteopaths treat joint and muscular pain but more and more nerve pain patients find their way to the osteopath, having unsuccessfully tried just about everything else. As the article suggests; both acupuncture and massage are genuine ways of relieving  inflammatory pain with out medications. Similarly, diet and exercise are important components of treating nerve pain and possibly most importantly, most neuropathy patients are begging for doctors to treat them holistically (looking at the whole body and history of the patient before treatment). However, purely because of an osteopath's specialisation and concentration on muscles and joints, that may not be the best way forward for people with nerve damage - in fact it may make matters worse. Many doctors are dismissive of osteopaths and rightly or wrongly, you should still consult them as to whether visiting an osteopath will help you or not. Try to get your doctor to explain to you why they are anti osteopath if that's the case and armed with that information, you may be able to make a better decision for your own body.

You Can Manage Your Pain Without Medications
Contributor: William Welches, DO, PhD 

 Diet, exercise and gentle ‘manual medicine’ can help 

Too often, we treat pain with medications. Unfortunately, many pain medications have bad side effects. They also can be addictive. As a pain management physician, I encourage patients struggling with pain to consider all of their alternatives before resigning themselves to long-term medication use.

Many of my patients are able to achieve significant relief of pain throughout their body (back, neck, shoulder, knees, chest and more) with osteopathic manipulation therapy (OMT) and acupuncture. Both are in-office procedures and typically are gentle.

In OMT, the physician uses his or her hands to manipulate patients’ bodies into proper alignment as a way to ease pain. Such “manual medicine” is the hallmark of osteopathic physicians.

OMT generally is covered by insurance. Acupuncture, the strategic placement of very thin needles to stimulate nerves and relieve pain, is not always covered.
 
Diet and exercise

Osteopathic physicians are trained to be holistic in their approach to patients. They try to treat the whole patient, not just one part of the body. As part of my holistic approach to pain, I strongly encourage my patients to improve their diet and exercise. These two acts alone can achieve positive results without medication.

I often suggest an anti-inflammatory diet. This can be a big change from the typical American diet. An anti-inflammatory diet involves eating a lot of vegetables (corn and potatoes don’t count) and fish. The diet includes some fruit and limited amounts of dairy and whole grains and very little red meat, flour or sugar. It is 80 percent to 90 percent vegan.

Following it is a challenge, but it is well worth it. Some patients start to feel much better in as little as two weeks. They have substantial pain relief. They also see lower blood pressure and lower lipid, cholesterol and blood sugar levels. All this without bad side effects.

With these approaches, I have seen patients overcome disabling pain and resume an active life without medications. If you think you might benefit from these steps, consider seeking a referral to a physician who specializes in a holistic approach to pain management.

https://health.clevelandclinic.org/2014/09/you-can-manage-your-pain-without-medications/

Can Essential Oils Help With Nerve Pain

The title alone of today's post from healthyfocus.org (see link below) may put you off reading it unless you have some sort of faith in alternative treatments for neuropathy. But consider this; medical science currently provides treatments which either don't work, or are limited, or have side effects worse that the nerve problem itself - is it not worth at least considering that there may be alternative treatments which may work for you? Believe me, I'm with the doubters but have studied neuropathy for long enough to realise that some things really do work for some and not for others and that includes non-chemical treatments. This article provides a good overview of the subject and gives helpful hints as to how to use the oils in question. It may be worth not dismissing out of hand - worth a read.

Essential Oils for Neuropathy
Wellness By Angela Deckard / June 12, 2015

Chances are, you either suffer from neuropathy yourself or may know someone with this disorder. Neuropathy is a painful condition that occurs when there is damage to the peripheral nervous system.

The peripheral nervous system connects the nerves from the central nervous system (brain and spinal cord) to the rest of the body, including the internal organs, skin, muscles, hands, feet, legs, mouth, and face.

These are responsible for sending messages about physical sensations back to your brain. However, when these nerves have suffered significant damage or are destroyed, these nerves may no longer do their job, resulting in a disorder called neuropathy.

This means that you may not feel physical pain when something is hurting you or your brain may send pain signals when you have not suffered injury. There are three different nerve groups and neuropathy can affect one or all three:

Sensory nerves, connected to your skin, which receive messages such as pain, heat, or touch.
Motor nerves, connected to your muscles, which dictate how they move.
Autonomic nerves, connected to your internal organs, which control such functions as heart rate, blood pressure, bladder function, and digestion.

Despite the grim nature of this disorder, there are many treatments, such as the use of essential oils, which can alleviate these painful symptoms and make living with neuropathy more manageable.



Symptoms
 
The symptoms of neuropathy may limit a person’s activities and decrease their ability to live a normal life. These symptoms may include:

Tingling in the hands and feet, which may eventually extend to the arms and legs
Numbness in the hands and feet
​Sharp, stabbing pains or a burning sensation
​A decrease in motor function such as dropping things from your hands
Lack of coordination and falling down
​Extreme sensitivity to touch
​Muscle weakness or heavy feeling limbs

If the autonomic nerves are affected, you may experience the following symptoms:

Digestive and bladder problems
A heat intolerance or a change in sweating patterns
Change in blood pressure which may result in a feeling of being light headed or dizziness

Causes

Neuropathy is a common disorder that can occur due to a number of factors, which include:

Hereditary: People who have a family history of neuropathy have a higher risk of developing the disorder.
Diabetes: Diabetes is one of the #1 factors contributing to the development of neuropathy, affecting over half of diabetes sufferers. This is the result of unregulated blood sugar levels, obesity, and high blood pressure in the diabetes patients over the age of 40.
​Autoimmune diseases: Disorders affecting the immune system such as lupus or rheumatoid arthritis are known to contribute to the development of neuropathy.
​Disease: Other diseases such as liver disease, kidney disease, hypothyroidism, and connective tissue disorders may lead to the development of neuropathy.​
​Alcoholism: People with severe alcoholism are at a higher risk for developing neuropathy as alcohol can have a toxic effect on nerve tissue.
Medications: Taking certain medications may result in developing neuropathy. These drugs may include medications that treat cancer, seizures, blood pressure, and blood pressure.
​Toxins: Exposure to insecticides, solvents, and toxic chemicals can result in nerve damage. Exposure to heavy metals such as mercury and led can also contribute to the disorder.
Infections: Certain viruses and bacterial infections can cause neuropathy, which include Lyme disease, herpes simplex, hepatitis C, leprosy, chicken pox, shingles, Epstein-Barr virus, and HIV.
​Vitamin deficiencies: Lacking vitamins E, B1, B6, and B12 may cause neuropathy. These vitamins are vital to nerve health and functioning.
Injury: Suffering physical injury is the most common way people damage their nerves. This may be the result of car accidents, falls, sports injuries, and fractures. Carpal tunnel syndrome is a form of neuropathy, which is the result of placing increased pressure on the nerves of the wrist from repeated motions such as typing.
Tumors: The development of tumors can create pressure on surrounding nerves, causing damage.


Treatment with Essential Oils

Many find that living with neuropathy isn’t really living at all. They may limit their activities because they are scared they may fall, injure themselves, or may simply find it too painful to participate in activities they once enjoyed.

Fortunately, there are natural and non-invasive treatments that can help control the symptoms of neuropathy, dramatically increasing the quality of life for those suffering from neuropathy.

Essential oils address many problems associated with neuropathy, such as pain management, circulation, energy, sleep disorders, stress, anxiety, depression, and overall mood.

Research has found that several essential oils are effective in alleviating the pains associated with nerve damage

Peppermint

Peppermint essential oil increases circulation and provides nervous system support. It is also a pain reliever, controls muscle spasms, improves respiration, and relieves flatulence. 

Black pepper

Black pepper is an antiviral essential oil that provides nervous system support, increases circulation and is a known pain reliever. This powerful essential oil also gives skin a healthy ruddy glow, aids in digestion and relieves flatulence.

Geranium Rose

Geranium rose provides circulatory support, increasing sluggish circulation. This antimicrobial essential oil is also a pain reliever, anti-inflammatory, balances hormones, stops bleeding, and can be used as an astringent.

Eucalyptus

Eucalyptus oil is an antiseptic, antimicrobial, and antibacterial, anti-inflammatory oil that offers a host of benefits such as relieving muscle spasms and improving respiration.

Rosemary

Rosemary increases circulation, relaxes muscle fibers, and removes lactic acid. This incredible essential oil is an antifungal, antimicrobial, anti-rheumatic that also suppresses muscle spasms, improves respiration, and is a mild pain reliever. 

Spruce

Spruce essential oil that improves circulation, stimulates the immune system, and promotes muscle repair. This essential oil relieves muscle spasms, helps clear cell receptor sites, and is an anti-inflammatory, antiparasitic, and antiseptic.

Frankincense

Frankincense stimulates the immune systems and relaxes the muscles. This essential oil also is an antiseptic that improves respiration, clears up mucus, and works as antidepressant and sedative. 

Blue Tansy

Blue tansy is an anti-inflammatory and a pain reliever. It also relieves itch, helps clear cell receptor sites and clears excess debris from soft tissues to help improve oxygenation.

Lavender

Lavender is a pain reliever and anti-inflammatory. This hardworking essential oil is also an antidepressant and helps to reduce the damaging effects of stress on the body.

Rosewood

Rosewood is a pain reliever and increase immune system function. Rosewood essential oil an anti-inflammatory and an antibacterial that works overtime to increase mood by working as an antidepressant and stress reliever.

Roman Chamomile

Roman chamomile is a pain reliever that soothes achy muscles. This essential oil is also mood booster and promotes relaxation.
Helichrysum

Helichrysum essential oil is an anti-inflammatory that is a known pain reliever. It also helps to relieve muscle spasms and helps to calm the nerves.

How to Use Essential Oils

There are many ways you can apply essential oils to help relieve the symptoms of neuropathy:

Massage: Mix 10 to 12 drops of essential oil with one ounce of carrier oil. The most recommended carrier oil for this method is coconut oil as it is clear, and light, and does not oxidize. Massage the mixture onto the effected area.
Bath: Mix 4 to 8 drops of essential oil with one teaspoon of carrier oil. Once again, coconut oil is the recommended carrier oil. To relieve achy muscles, add Epsom salt. Fill the tub with warm water and immerse yourself for duration of 15 minutes, making sure to massage the affected areas.
Compress: Fill a container with water. Use warm water to inspire relaxation and increase circulation or use water to energize and relieve inflammation. Add 3 to 5 drops of essential to the container and then stir. Soak a washcloth in the container of water, wring, then apply to the affected area.

Some recommended oils are listed in the table below. These are reasonably priced oils that are good brands who make therapeutic grade oil.

 http://healthyfocus.org/essential-oils-for-neuropathy/

Can Massage And Other Natural Treatments Help Neuropathy Vid

Today's post from beforeitsnews.com (see link below) is a personal post including video tips from someone who's father has neuropathy problems. This person is studying massage techniques and is using them to try to help the father with his neuropathic symptoms. It's not a bad idea at all but like the author, it's probably best to have some idea of what you're doing before you begin. Massage can be extremely soothing and relaxing for people with foot and leg pain and getting a friend or family member to massage your feet and legs can really help but it's advisable to use You Tube videos (or others) to help you improve your technique before you start. Begin gently and work up; one thing a neuropathy patient will not appreciate is a full-on sports massage attack on their limbs. Ask the patient for their reactions at each stage.

Peripheral Neuropathy: Massage, Stretching And Natural Remedies Can Help (Video).
Wednesday, July 2, 2014 11:54
 
Today I want to talk about a condition called Peripheral Neuropathy which is a result of nerve damage, often causes weakness, numbness and pain, usually in your hands and feet, but it may also occur in other areas of your body, I’m interested in this condition because both my parents experience the symptoms of this condition. People generally describe the pain of peripheral neuropathy as tingling or burning, while they may compare the loss of sensation to the feeling of wearing a thin stocking or glove. Both of my parents have described the pain as tingling, pins and needles, and numbness.




The pain was getting worse on my father so I decided to do some research. At first I was really scared that it was a sign of prediabetes. I told my dad that I had this tea called Gymnema Sylvestre which I bought as a weight loss aid. I wrote a story on it…I will post the link below. Anyways, I remember reading that this herb helps with type 1 and type 2 diabetes. Even though my father hasn’t been diagnosed with diabetes I thought it would be a good idea for him to drink a couple of cups a day…if anything it will help you lose weight and what’s the harm in that, right? My dad has said that this tea helps him feel a bit better and he’s being drinking it for a while now.

Learn more about Gymnema Sylvestre: http://bit.ly/Lk4hLK

I also read that A study of over 1,200 people shows acetyl-L-carnitine relieves numbness and pain, and helps repair nerves. Your liver, kidney, and brain make all the ALC you need when you’re young and healthy. When you exercise regularly, you’re likely to have more of it. But sometimes you don’t have enough when you’re older or sick, even if you exercise a lot (instituteofnaturalhealing).


 
Also, one of the best things that has helped my father is massage. I’m in massage school right now so I have just finished learning how to do a basic Swedish massage. Lately, I have been giving my father weekly massages focusing mostly on his left leg and the top of his foot where it mostly hurts. His symptoms have been improving but they aren’t entirely gone. Since I want my father and my whole family to feel peachy keen I did some more research. I think it might by the entrapment of the tibial nerve. Below is a video showing some stretches to help with the tibial nerve:




Finding the Tibial Nerve:


If anyone has any advice on tibial nerve entrapment or Peripheral neuropathy I would sure love to hear it. Thanks for reading!
Sincerely,
Radical Rose
http://radicalrose.wordpress.com

Resources:

http://www.mayoclinic.org/diseases-conditions/peripheral-neuropathy/basics/definition/con-20019948

http://institutefornaturalhealing.com/2013/10/this-amino-acid-reverses-nerve-damage/

http://www.diabeteslibrary.org/View.aspx?url=Gymnema_sylvestre

 http://beforeitsnews.com/health/2014/07/peripheral-neuropathy-massage-strecthing-and-hebal-remedies-can-help-video-2541126.html

Block Pain Channels And You Can Block Neuropathic Pain

Today's post from diabetes.co.uk (see link below) reveals new research which looks promising for future treatments of neuropathy. There seem to be quite a few close investigations of pain processes within the brain recently and like most others, this one has discovered that blocking a particular channel (which pain signals use), neuropathic pain can be also blocked and therefore not felt by the patient. It centres on the anterior cingulate cortex (ACC), which is the region of the brain most commonly and consistently involved in the pain processing and looks at so-called, HCN channels which carry pain signals. By blocking these in rats, pain can be 'blocked out' so to speak. Interesting development and hope for therapeutic treatments for humans in the future.

Researchers target molecular mechanisms that could relieve pain from peripheral neuropathy
Kurt Wood September 2015

A group of researchers have found molecular mechanisms that could be responsible for the pain caused by peripheral neuropathy.

The study, conducted by researchers at McGill University in Montreal, Canada, sheds new light on what was a poorly understood condition.

Peripheral neuropathy is the scientific term for nerve damage. Neuropathy can have a number of causes, including diabetes. In fact, diabetic neuropathy is one of the most common complications of diabetes. Diabetic neuropathy is caused by prolonged exposure to high blood glucose levels over a number of years.
Neuropathy, pain and the anterior cingulate cortex

This study focused on the anterior cingulate cortex (ACC), the region of the brain most commonly and consistently involved in the pain processing. The researchers made new discoveries about one type of channel (hyperpolarisation-activated cyclic nucleotide-gated channels, or HCN) that influences pain signals to the ACC.

They then tested their findings on a group of rats. By blocking HCN channels, the researchers lessened the stimulation of the ACC, which significantly reduced the pain transmitted to the rats.

The researchers hope that targeting the HCN channels will reduce the pain of neuropathy in humans, but further studies are needed to confirm that this is viable and safe.

"Our study has revealed one important mechanism linking chronic pain to abnormal activity of the ACC and it provides a cellular and molecular explanation for the overstimulation of neurons in the prefrontal cortex," said senior author Philippe Séguéla.

"This gives us new perspectives on therapeutic strategies that could target the HCN channels to help relieve chronic pain.

"Our findings open new doors to research possible treatment of these debilitating symptoms that are linked to chronic pain."

The findings were published in the Journal of Neuroscience.

http://www.diabetes.co.uk/News/2015/Oct/researchers-target-molecular-mechanisms-that-could-relieve-pain-from-peripheral-neuropathy-90193351.html

Can Neuropathic Pain Prematurely Age the Brain

Another interesting article from conquerchiari.org (see link below) talks about the long term effect of chronic pain on the brain. Logical really but not something which we normally think of first when considering neuropathy side effects. The fact that long-term HIV-patients are often confronted with brain-aging, related diseases, is a little disconcerting when you realise that consistent neuropathic pain may just be enabling that process a little more. Yet another thing to discuss with your HIV-specialist, especially if you are beginning to notice changes in your own brain behaviour.

Chronic Pain Is Hard On The Brain...
--Rick Labuda

Chronic pain prematurely ages the brain. That was the most significant - and disturbing - finding of a group of researchers from Northwestern University. Scientists have known for some time that chronic pain alters neurons in the spine, but Dr. Apkarian, a neuroscience researcher, and his colleagues wanted to know if and how chronic pain effected the structure of the brain.

In order to study this, Dr. Apkarian and his team used MRI's to measure the volume and density of the brains of 26 people with chronic back pain (CBP) and compared them to the brains of 26 healthy volunteers. They published their results in the November 17, 2004 issue of the Journal of Neuroscience.

Each of the 26 members of the pain group had experienced unrelenting pain for more than a year in their lower back. In some, the pain radiated down into the legs, in others it didn't. In addition to the brain MRI's the CBP subjects reported their pain intensity and how long they had been in pain. To aid in the analysis, members of the pain group were also classified as having neuropathic pain - due to nerve damage - or non-neuropathic pain. The 26 volunteers that composed the control group were recruited to match the age and gender makeup of the CBP group as closely as possible.

The researchers used two different techniques to measure the volume of the neocortical gray matter (the part of the brain responsible for most higher order functions) from the MRI's. They found that overall, the subjects in the pain group had 5%-11% less gray matter volume than the control subjects, a statistically significant finding. People normally lose about 0.5% of their gray matter each year as they age, so this result translates to the pain patients experiencing 10-20 years of aging compared to the control group.

In looking at neuropathic versus non-neuropathic pain, the team found that in the neuropathic pain group, the volume loss was related to pain duration. In fact, in the neuropathic group, each year of pain equated to a 0.2% loss in gray matter (1.3cm3). In the non-neuropathic group, pain duration was not related to volume loss.

The neuropathic pain group also fared worse when the team measured the density of the gray matter in specific regions of the brain. In the prefrontal cortex - responsible for high level functions - they found that people in neuropathic pain had gray matter that was 27% less dense than the control group, and people with non-neuropathic pain had gray matter that was 14% less dense. They also found that the thalamus - a region of the brain which relays pain and other sensations - was significantly less dense in the pain group as compared to the control group.

Although this study can not prove it conclusively, the authors believe the results mean that the chronic back pain is causing brain tissue to atrophy in certain areas. If proven to be true, this would mean that chronic pain not only alters the neurons of the spine, but has a structural effect all the way to the brain as well. While it is a significant finding, it is also important to keep in mind that this study looked at chronic back pain specifically and the results may be different for other types of chronic pain.

Still, with millions of people in the US alone suffering from chronic pain, and with neuropathic pain an all too common problem for CM/SM patients, this area of research is definitely worth paying attention to..

--Rick Labuda

http://www.conquerchiari.org/subs%20only/Volume%203/Issue%203(1)/Chronic%20Pain%20Brain%203(1).asp

How The Cone Snail Can Reduce Nerve Pain

Today's post from spacecoastdaily.com (see link below) revisits an older animal poison and its potential for alleviating nerve pain. We're still on the tip of the iceberg regarding the use of venoms from the natural world to help with chronic pain but as more money is ploughed into research, it's becoming clear that there is an enormous potential in the poisons of spiders, fish, snakes, scorpions and the rest, to significantly aid us in controlling pain in humans. In this article, the venom-based, pump-action fluid Prialt is used (Prialt (or Zoconitide) is a non-narcotic synthetic form of a naturally occurring venom (neurotoxin) found in the Conus Magus snail) as an effective alternative to standard pain medications. This also means a lessened future reliance on chemical pills. Yet again another by-product of the current hysteria about opioids and overdosing - pharmaceutical companies are beginning to see the financial benefit in investing in alternative sources of analgesics. It's like they say: every disadvantage has its advantage😌 By using the search button to the right of this blog, you will come across more articles about this subject.

Cone Snail Venom Effective Remedy For Pain
By Dr. Richard Gayles // June 21, 2013 

ARTICLE COURTESY OF SPACE COAST MEDICINE & ACTIVE LIVING MAGAZINE

Broadly speaking, there are two types of pain. There is nociceptive pain, which is caused by tissue injury or inflammation. This pain tends to be temporary, lessening as the tissues heal. 



THE INTRATHECAL PUMP delivers Prialt directly into the spinal space. The entire pump system is placed under the skin, and the pump is refilled every 60- 90 days by placing a needle through the skin into the pump. (Shutterstock image)

The second type of pain is far more difficult to manage and is called neuropathic pain. This pain is caused by trauma to the nervous system that directly injures nerves or interferes with the ability of nerves to process pain signals.

The intrathecal pump delivers Prialt directly into the spinal space. The entire pump system is placed under the skin, and the pump is refilled every 60- 90 days by placing a needle through the skin into the pump.

Neuropathic Pain

For patients with neuropathic pain, oral medications are often unsatisfactory. The typical patient with severe neuropathic pain has failed trials of physical therapy, TENS units, anti seizure medications (neurotin, lyrica, topamax, lamictal), anti depressant medications (Elavil, pamelor, cymbalta, effexor), and eventually may be placed on narcotics.

Prialt (or Zoconitide) is a non-narcotic synthetic form of a naturally occurring venom (neurotoxin) found in the Conus Magus snail. The snail’s venom was known since antiquity as a topical remedy for burns, abscesses and other wounds.

Neuropathic pain often does not respond well to oral narcotics, resulting in some patients being placed on escalating doses.

The most concerning aspects of high dose narcotics are side effects (which increase with the dose), tolerance (loss of effect with time requiring increasing doses), hyperalgesia (escalating doses paradoxically increasing pain), physical dependence (withdrawal if narcotics are suddenly stopped) and, rarely, addiction (uncontrolled use and craving).

Naturally Occuring Venom

Prialt (or Zoconitide) is a non-narcotic synthetic form of a naturally occurring venom (neurotoxin) found in the Conus Magus snail. The snail’s venom was known since antiquity as a topical remedy for burns, abscesses and other wounds.

Cone snails are hunting animals, which use neurotoxins to paralyze their prey. The snails use their harpoon like limb to grab, inject, and then consume the fish after it is paralyzed. Prialt is now FDA approved specifically for neuropathic pain.

In fish, prialt is a paralyzing agent, but in humans it reduces or stops pain transmission.

 

If taken by mouth prialt would be rapidly and completely destroyed by our digestive enzymes. Therefore, Prialt is only delivered by the Medtronic pain pump directly into the spinal canal fluid.

In the spinal fluid the Prialt molecules block pores on pain sensing nerve cells, which stops the flow of calcium into the cells. This reduction of calcium flow prevents the nerve cells from sending signals to the brain, reducing the perception of pain.

When used in the pain pump, Prialt can often reduce neuropathic pain allowing the patient to significantly reduce or wean off narcotics.

The pain management physician determines that a patient is a good candidate for Prialt by administering a test dose in which a small amount of Prialt is injected into the spine under x-ray guidance.

The patient is then observed closely and pain levels are recorded for the next several hours. Then the patient is asked to perform specific exercises to determine the drug’s effect on the pain. If greater than 70-80 percent of the pain is reduced, the trial of Prialt is considered successful.

After the successful test dose with Prialt, the patient may be scheduled for implantation of a Medtronic intrathecal pump.

Pump Implantation

The pump implantation is a minor outpatient surgical procedure, which provides the patient with a constant infusion of the pain relieving Prialt. After implantation, the pump is programmed to deliver slowly increasing amounts of Prialt to minimize drug side effects.



THIS SEQUENCE of events shows a cone snail catching, injecting, paralyzing, and swallowing a helpless fish.

As the Prialt dose increases and pain is reduced, narcotics are simultaneously weaned.

If you have a severe pain condition that has failed all other standard conservative therapies, consider undergoing evaluation by a pain management specialist to determine if this mode of direct intrathecal medication therapy is appropriate for you.

Facts About Cone Snail

Less than one percent of the more than 500 species of cone snails have been studied. Each snail produces multiple neurotoxins in its venom. Some scientists feel the cone snails hold more promise for new medicines than any other species in nature.

Different snail toxins in preclinical trials already hold promise for new treatments for pain, Parkinson’s Disease, and depression. The snails are found in the warm tropical coral reefs.

Unfortunately the coral reefs are being destroyed; over 26 percent of the reefs are damaged beyond repair and between 30 to 50 percent are severely degraded. If the reefs are lost, we also lose the potential cure for many diseases.

http://spacecoastdaily.com/2013/06/cone-snail-venom-effective-remedy-for-pain/

How Nerve Cell Stiffness Can Make You Cry From Pain

Today's post from .sciencedaily.com (see link below) may not be the easiest read but is nevertheless a fascinating one which once more looks into research progress in neuropathy treatment at a cellular and molecular level. Put in its simplest terms, it talks about the discovery that hypersensitive nerve pain may have a lot to do with nerve cell stiffness. If they can find a way to 'relax' this stiffness, they will be able to reduce pain to a manageable level. You will need to read the article to understand it better but it's worth the effort, if only to see where scientists are going in the search for ways of controlling nerve pain.

Study offers approach to treating pain 
Date: December 13, 2016 Source: European Molecular Biology Laboratory (EMBL)

For many patients with chronic pain, any light touch -- even just their clothes touching their skin -- can be agony. Scientists at EMBL and the Werner Reichardt Centre for Integrative Neuroscience (CIN) of the University of Tübingen have found a possible new avenue for producing painkillers that specifically treat this kind of pain. In a study published online today in eLife, they discovered how the stiffness of our nerve cells influences sensitivity to touch and pain.

"Being able to stop this mechanical pain could be very powerful, and it's something that current drugs are not very good at doing," says Paul Heppenstall, who led the work at EMBL.

Whether it's a light brush or a painful poke, when something touches you, receptors on the nerves under your skin sense it and carry that information to the brain. To be more precise, those receptors detect -- and respond to -- the bending of the nerve cell's membrane. The EMBL scientists have now discovered a molecule which, by influencing how stiff or bendy a nerve cell is, affects how sensitive a mouse is to touch and pain.

Heppenstall and colleagues genetically engineered mice so that they could not produce a molecule called Atat1. Working with Jing Hu's lab at CIN and Laura Andolfi at Istituto Officina dei Materiali-CNR, in Trieste, they found that the nerve cells in the affected mice became more stiff, and they became insensitive to light touch and to mechanical pain. This happened both when they prevented all of a mouse's cells from producing the molecule and when they did so just in the mouse's sensory neurons.

The Atat1 molecule is present in all cells. Scientists know that it modifies microtubules -- tiny tubes that act as transport network and scaffolding inside cells -- and that this happens in all cells, especially in nerve cells. So Heppenstall, Hu and colleagues were surprised to find that the other senses seem not to be affected in the mice.

"It could be that the molecule also affects the stiffness of nerves involved in other senses, but because stiffness is not important for detecting smells or tastes, for example, changes in cell stiffness might not have a detectable effect on those senses," says Shane Morley, who carried out the work at EMBL.

One difference that the scientists found between nerve cells that detect touch and other cells is in how their microtubules are arranged. In sensory cells, they form a ring just below the cell membrane. In other cells, they don't. The scientists think that this ring probably fine-tunes how stiff or bendy a nerve cell's membrane is, influencing how sensitive that cell -- and the animal in general -- is to touch.

The nervous system and sense of touch are similar in mice and humans, so the results likely hold true for people, too. And although problems in cell stiffness are unlikely to be at the root of most patients' hypersensitivity to touch, controlling how stiff nerve cells are could nevertheless be an effective way of treating that sensitivity.

"We're now looking for small molecules that interfere with this fine-tuning of cell stiffness, and which might one day be used to make painkillers specifically to treat this mechanical pain," says Heppenstall. "This is the first step in our sense of touch, so if we can stop the signal there, then we have a good chance of stopping everything which is downstream. And because only these touch-sensing nerve cells would be affected, there's hope that such a drug might not have many unwanted side-effects."

Story Source:

Materials provided by European Molecular Biology Laboratory (EMBL). Original written by Sonia Furtado Neves. Note: Content may be edited for style and length.


Journal Reference:
Shane J Morley, Yanmei Qi, Loredana Iovino, Laura Andolfi, Da Guo, Nereo Kalebic, Laura Castaldi, Christian Tischer, Carla Portulano, Giulia Bolasco, Kalyanee Shirlekar, Claudia M Fusco, Antonino Asaro, Federica Fermani, Mayya Sundukova, Ulf Matti, Luc Reymond, Adele De Ninno, Luca Businaro, Kai Johnsson, Marco Lazzarino, Jonas Ries, Yannick Schwab, Jing Hu, Paul A Heppenstall. Acetylated tubulin is essential for touch sensation in mice. eLife, 2016; 5 DOI: 10.7554/eLife.20813


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European Molecular Biology Laboratory (EMBL). "Study offers approach to treating pain." ScienceDaily. ScienceDaily, 13 December 2016. .


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https://www.sciencedaily.com/releases/2016/12/161213074114.htm

Non smokers Can Benefit From Cannabis based Neuropathy Relief Too

Non-smokers and ex-smokers have often been put off trying cannabis for the relief of neuropathic pain (the laws of the land are often a discouraging factor too!) because of the potential damage to their lungs. However, using a vaporizer may well be the answer as it apparently delivers the same amount of THC, with the same biological effects, without the inhaling of tobacco, or other toxins normally associated with smoking. As always, assuming that you are able to access regular marijuana, the decision has to be made as to whether the benefits outweigh the risks. This article comes from imarijuana.com (see link below).

Same Level Of THC and Fewer Toxins with Marijuana Vaporizer
Posted on 22 November, 2011 by admin

According to researchers from the University of California San Francisco, a smokeless cannabis-vaporizing device delivers the same level of active therapeutic chemical and produces the same biological effect as smoking cannabis.

Results of a UCSF study that focuses on delivery of the active ingredient delta-9-tertrahydrocannibinol, or THC, are reported in the online issue of the journal “Clinical Pharmacology and Therapeutics.”

“We showed in a recent paper in the journal ‘Neurology’ that smoked cannabis can alleviate the chronic pain caused by HIV-related neuropathy, but a concern was expressed that smoking cannabis was not safe. This study demonstrates an alternative method that gives patients the same effects and allows controlled dosing but without inhalation of the toxic products in smoke,” said study lead author Donald I. Abrams, MD, UCSF professor of clinical medicine.

The team of researchers looked at the effectiveness of a device that heats cannabis to a temperature between 180 and 200 degrees C, just short of combustion, which occurs at 230 degrees C. Eighteen individuals were enrolled as inpatients for six days under supervision in the General Clinical Research Center at San Francisco General Hospital Medical Center. The participants received three different strengths of cannabis on different days by two delivery methods–smoking or vaporization–three times a day, under the study protocol.

THC plasma concentrations were measured along with the exhaled levels of carbon monoxide, or CO, which served as a marker for the many other combustion-generated toxins inhaled when smoking.

“Using CO as an indicator, there was virtually no exposure to harmful combustion products using the vaporizing device. Since it replicates smoking’s efficiency at producing the desired THC effect using smaller amounts of the active ingredient as opposed to pill forms, this device has great potential for improving the therapeutic utility of THC,” said study co-author Neal L. Benowitz, MD, UCSF professor of medicine, psychiatry and biopharmaceutical sciences.

Benowitz added that pills tend to provide patients with more THC than they need for optimal therapeutic effect and increase side effects.

“By a significant majority, patients preferred vaporization to smoking, choosing the route of delivery with the fewest side effects and greatest efficiency,” said Benowitz.

Co-authors include Cheryl A. Jay, MD, UCSF neurology; and Starley B. Shade, MPH; Hector Vizoso, RN; and Mary Ellen Kelly, MPH, UCSF Positive Health Program at San Francisco General Hospital Medical Center.

The study was funded by the University of California’s Center for Medicinal Cannabis Research.
Reference:University of California – San Francisco

http://www.imarijuana.com/tag/smoked-cannabis

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How Pain Can Affect Your Relationship

Today's post from paincommunity.org (see link below) is another 'self-help' article for people suffering from chronic pain and in our case, neuropathic pain. This time it talks about the strains put upon relationships when one partner is living with chronic pain. Again, you may feel there are cliches written here but there is also some good advice too. Worth a read over your coffee.

Is Pain Hurting Your Love? 
Posted by Teresa Shaffer | January 21, 2014

It is hard enough living a life with pain. Add in trying to keep a healthy, happy relationship going and you could find yourself drifting in unknown waters without a paddle. I know that is how I feel sometimes.

It doesn’t matter how long you have been in the relationship nor does it matter how much each person loves the other. Pain can get in the way. It can make things difficult–uncomfortable at best.

So how do we keep our relationships healthy with our partners (much less our family and friends) as we keep up with our pain?

Do we hide the pain from those we love and hold on tight to what we hope is a healthy relationship?

Do we talk to our partner and try to explain how our hurt interferes with how and when we express our love?

How often does pain affect your intimate relationship with your partner?
Not at all Some of the time More often than not All of the time
VoteView Results Polldaddy.com

There is no right way or wrong way that I can tell. What is important is that we are willing to talk and we walk that talk. Both people in the relationship needs to be able to openly express what they are feeling and how the pain affects the relationship, even if the words may sting and hurt a little to say or hear.

If the lines of communication are open then the topic doesn’t fester into something that drives a huge wedge between the two of you. Avoid this by finding the time to talk. Make sure it is a time where you can sit with each other and not be interrupted. Find a place where you both feel comfortable, a quiet place where the two of you can open up and share your feelings gently but honestly.

Talk with each other and find ways to stop holding back thinking you are just “keeping the peace”. It may not happen the first time you talk and it may take several different conversations to allow both of you to express everything that each of you are feeling.

Be open, keep talking with each other and remember that your loved one is more than likely doing the very best that they can to understand how the pain affects you in every aspect of your life. After all, it affects them too.

Don’t forget that your pain is also affecting their life in ways that they may have never shared openly with you. They just may need you to ask them how they are dealing with the life changes that pain can causing for both of you.

Don’t give up; this is just another stepping stone in the journey of living with pain.

http://paincommunity.org/is-pain-hurting-your-love/