Molecule PSR 1 Can Repair Damaged Nerve Cells

Today's post from sciencedaily.com (see link below) looks at the discovery of a unique 'wonder' molecule that can eliminate diseased cells but also apparently regenerate damaged nerve cells. The fact that it can re-join and fuse together broken axons in the central nervous system (frequent causes of neuropathic symptoms) is astonishing and has many implications for the future of neuropathy treatment. That said, as with so many of these findings, we're a long way from translating the theory into effective treatment models but take comfort from the fact that new discoveries are being made and will lead to improvements for future generations

Research findings have implications for regenerating damaged nerve cells 
Date:January 7, 2015 Source:University of Colorado at Boulder
 
Summary:

Two new studies have identified a unique molecule that not only gobbles up bad cells, but also has the ability to repair damaged nerve cells. Known as the phosphatidylserine receptor, or PSR-1, the molecule can locate and clear out apoptotic cells that are pre-programmed to die as well as necrotic cells that have been injured and are causing inflammation. Programmed cell death, or apoptosis, is a natural process that kills billions of cells in a typical human body each day.
 
Two new studies involving the University of Colorado Boulder and the University of Queensland (UQ) in Brisbane, Australia have identified a unique molecule that not only gobbles up bad cells, but also has the ability to repair damaged nerve cells.

Known as the phosphatidylserine receptor, or PSR-1, the molecule can locate and clear out apoptotic cells that are pre-programmed to die as well as necrotic cells that have been injured and are causing inflammation, said CU-Boulder Professor Ding Xue, who led one study and co-authored the other. Programmed cell death, or apoptosis, is a natural process that kills billions of cells in a typical human body each day.

But it is the finding that the PSR-1 molecule also can help reconnect and knit together broken nerve fibers, called axons, that has caught the attention of both science teams.

"I would call this an unexpected and somewhat stunning finding," said Xue of CU-Boulder's Department of Molecular, Cellular and Developmental Biology. "This is the first time a molecule involved in apoptosis has been found to have the ability to repair severed axons, and we believe it has great therapeutic potential."

Xue is the lead author on a paper being published Jan. 7 in Nature Communications that details how PSR-1 recognizes and removes cells that are pre-programmed to die or damaged. He also is co-author of the companion paper being published in Jan. 7 in Nature led by Associate Professor Massimo Hilliard of the UQ's Queensland Brain Institute that shows the major role played by PSR-1 in the regeneration of nerve axons, a holy grail of sorts for neurologists involved with patients who have suffered central nervous system damage from accidents or diseases.

Both studies relied on a popular lab organism known as C. elegans, a nearly microscopic nematode that is fast growing, translucent and has a sequenced genome showing that nearly half its genes are closely related to corresponding human genes.

"This will open new avenues to try and exploit this knowledge in other systems closer to human physiology and hopefully move toward solving injuries," said Hilliard. In the future, neurosurgery may be combined with molecular biology to deliver positive clinical outcomes and perhaps treat conditions like spinal cord or nerve injuries, he said.

During programmed cell death, apoptotic cells flag themselves for elimination by moving a specific cell membrane component known as phosphatidylserine (PS) from the inner membrane to the cell surface, setting them up to be engulfed. "These are what we call 'eat me' signals," said Xue.

In contrast, broken axons in nerve cells send PSR-1 molecules an SOS alert. "The moment there is a cut to the nerve cell we see a change in the cell membrane PS composition, which acts as a signal to PSR-1 molecules in the other part of the nerve that essentially says "I am in danger, come and save me," said Xue.

One of the most encouraging finding is that PSR-1 plays an early role in the axonal fusion process required for neuroregeneration, said Xue. "Whether human PSR has the capacity to repair injured axons is still unknown," he said. "But I think our new research findings will spur a number of research groups to chase this question."

While biomedical researchers have had some successes in repairing peripheral nerves and nerve clusters outside the brain and spinal cord in humans, there currently is no effective way to regenerate broken nerve cells in the central nervous system, said Xue. Such nerve damage can cause partial or total paralysis.

Xue, who first identified the PSR-1 receptor in 2003, said the collaboration between CU-Boulder and UQ has pushed scientific discovery forward. "We are trying to understand how PSR-1 removes cells through apoptosis and necrosis, and they are trying to understand if molecules involved in apoptosis also play a role in the neuroregeneration process," said Xue.

CU-Boulder postdoctoral researcher Yu-Zen Chen, a Nature Communications paper co-author, said the team currently is trying to find ways to raise the level of the PSR-1 in nematode cells, which likely would promote faster healing in nerve axons. "We think the higher the PSR-1 level, the higher the repair capacity of the molecule," said Chen.

Xue said C. elegans is an ideal organism to use in the hunt for new therapeutics to treat nerve damage because of its relatively small, well-known genome and short life span -- just a few days. "This makes drug screening much easier, faster and less expensive than using a mouse model, for instance," said Xue.

"The big finding is that we have a single receptor that does two different jobs," Xue said. "We don't have a solution yet for treating people with nerve damage, but we feel these findings offer promise in seeking new and effective therapeutics."

Story Source:

The above story is based on materials provided by University of Colorado at Boulder. Note: Materials may be edited for content and length.

Journal References:
Hengwen Yang, Yu-Zen Chen, Yi Zhang, Xiaohui Wang, Xiang Zhao, James I. Godfroy, Qian Liang, Man Zhang, Tianying Zhang, Quan Yuan, Mary Ann Royal, Monica Driscoll, Ning-Shao Xia, Hang Yin, Ding Xue. A lysine-rich motif in the phosphatidylserine receptor PSR-1 mediates recognition and removal of apoptotic cells. Nature Communications, 2015; 6: 5717 DOI: 10.1038/ncomms6717
Brent Neumann, Sean Coakley, Rosina Giordano-Santini, Casey Linton, Eui Seung Lee, Akihisa Nakagawa, Ding Xue, Massimo A. Hilliard. EFF-1-mediated regenerative axonal fusion requires components of the apoptotic pathway. Nature, 2015; 517 (7533): 219 DOI: 10.1038/nature14102

http://www.sciencedaily.com/releases/2015/01/150107122912.htm

Substance P Nerve Pain Killer Or Pain Promoter

Today's post from the ever-reliable sciencedaily.com (see link below) is an interesting one because it explains in terms we can all understand, a peculiar paradox that occurs in both the central and peripheral nervous systems concerning a mysterious substance called 'Substance P'. Now apparently, if substance P is found in the central nervous system (brain and spinal cord) it excites pain cells and causes more pain but if it is found in the peripheral nervous system (the rest of the body) it acts as a natural pain killer and prevents pain cells from becoming over-stimulated. So, what does all this mean? It means that drugs used to suppress substance P have actually caused more pain, when targeted at the peripheral nerve system and that has led to new drug 'failures' when in fact, they should have been used to suppress substance P in the central nervous system. Scientists are excited by this discovery because drugs that will promote substance P in the peripheral system will act as genuine pain killers. It's a question of targeting the right places. The article explains it much better but it's worth a read to see how research is progressing on our behalf.

'Pain paradox' discovery provides route to new pain control drugs
Date:July 28, 2016 Source:University of Leeds

A natural substance known to activate pain in the central nervous system has been found to have the opposite effect in other parts of the body, potentially paving the way to new methods of pain control.

The discovery could explain the repeated -- and costly -- failure over the last 20 years of clinical trials of potential pain-killing drugs that targeted the substance, known as 'Substance P'.

Substance P is produced in both the central nervous system (CNS) -- the brain and spinal cord -- and in our peripheral nervous system (PNS) -- all the other nerves and nerve cells that send signals to the brain.

The new research, by the Hebei Medical University in China and the University of Leeds in the UK, has found that, in the peripheral nervous system, Substance P makes nerve cells less responsive and excitable, thereby reducing sensations of pain. This is in direct contrast to its role in the central nervous system, where it triggers very different signals, exciting neurons and so promoting pain.

Lead researcher Professor Nikita Gamper, from the University of Leeds, explains: "We were really surprised by the results -- Substance P is described in the literature as a molecule that gets nerve cells excited and promotes pain. But we've discovered a paradox -- that in the peripheral nervous system it acts as one of the body's natural painkillers and actually suppresses pain.

"This means that when drugs were used in trials to suppress Substance P's action in the central nervous system, they may have also prevented it from acting as a painkiller in the peripheral system. So, although the drugs looked like they worked in the lab, when they moved to clinical trials, they failed."

Substance P works in the peripheral system by modulating the action of certain proteins that control the ability of pain-sensing neurons to respond to 'painful' stimuli. In particular, Substance P makes one type of these proteins extremely sensitive to zinc, so that natural trace levels of zinc in circulation are enough to dampen their activity and suppress the neuronal responses.

Professor Gamper -- who is also a visiting professor at Hebei Medical University -- believes this discovery could open the door to new drugs that don't have the negative side effects currently associated with stronger painkillers.

"Drugs like morphine hijack the body's natural painkilling mechanisms, such as those used by endorphins, but because they act within the central nervous system, they can affect other brain cells that use similar pathways, leading to side effects such as addiction or sleepiness," says Professor Gamper. "If we could develop a drug to mimic the mechanism that Substance P uses, and ensured it couldn't pass the blood brain barrier into the CNS, so was only active within the peripheral nervous system, it's likely it could suppress pain with limited side effects."

The study -- which looked at the action of Substance P within nerve cells in the lab and in animal models -- focused on acute pain, but Professor Gamper aims to look at its role within chronic pain as well.

Story Source:

The above post is reprinted from materials provided by University of Leeds. Note: Materials may be edited for content and length.

Journal Reference:
Dongyang Huang, Sha Huang, Haixia Gao, Yani Liu, Jinlong Qi, Pingping Chen, Caixue Wang, Jason L. Scragg, Alexander Vakurov, Chris Peers, Xiaona Du, Hailin Zhang, Nikita Gamper. Redox-Dependent Modulation of T-Type Ca2 Channels in Sensory Neurons Contributes to Acute Anti-Nociceptive Effect of Substance P. Antioxidants & Redox Signaling, 2016; 25 (5): 233 DOI: 10.1089/ars.2015.6560

https://www.sciencedaily.com/releases/2016/07/160728105608.htm

Why Nerve Cells Die Important To Neuropathy Patients

Today's post from neurosciencenews.com (see link below) provides further information on the subject of an earlier post here on the blog (Sat. 25th April - scroll down to find), concerning the death of nerve cells and how learning about this can lead to new neuropathy treatments in the future. Finding out why nerve cells and axons either die or degenerate is vital to finding out ways to stop that process from happening. This article both fills in the gaps of the earlier article and explains the science in a much easier understood way. It teaches neuropathy patients what goes on in our nervous system and why that can cause such extreme symptoms but more importantly, gives us hope that serious research is being done to improve the situation. Worth a read.

Major Pathway Identified in Nerve Cell Death Offers Hope for Therapies
Neuroscience News April 23, 2015

New research highlights how nerves – whether harmed by disease or traumatic injury – start to die, a discovery that unveils novel targets for developing drugs to slow or halt peripheral neuropathies and devastating neurodegenerative disorders such as Alzheimer’s disease, Parkinson’s disease and amyotrophic lateral sclerosis (ALS).

Peripheral neuropathy damages nerves in the body’s extremities and can cause unrelenting pain, stinging, burning, itching and sensitivity to touch. The condition is commonly associated with diabetes or develops as a side effect of chemotherapy.

The research, by scientists at Washington University School of Medicine in St. Louis, is reported online April 23 in the journal Science.

Nerve cells talk to each other by transmitting signals along communication cables called axons. Such signals underlie vital activities, such as thinking and memory, movement and language.

As part of the study, the researchers showed they could prevent axons from dying, a finding that suggests therapies could be developed to counteract the withering away of nerve axons.

“We have uncovered new details that let us piece together a major pathway involved in axon degeneration,” said senior author Jeffrey Milbrandt, MD, PhD, the James S. McDonnell Professor and head of the Department of Genetics. “This is an important step forward and helps to identify new therapeutic targets. That we were able to block axon degeneration in the lab also gives us hope that drugs could be developed to treat patients suffering from a variety of neurological conditions.”

A common thread among many neurological disorders and traumatic nerve injuries is the degeneration of axons, which interrupts nerve signaling and prevents nerves from communicating with one another. Axon degeneration is thought to be an initiating event in many of these disorders. In fact, an unhealthy axon is known to trigger its own death, and researchers are keenly interested in understanding how this happens.

Working in cell cultures, fruit flies and mice, Milbrandt and co-author Aaron DiAntonio, MD, PhD, the Alan A. and Edith L. Wolff Professor of Developmental Biology, and their colleagues showed that a protein already known to be involved in axon degeneration, acts like a switch to trigger axon degeneration after an injury.


Axon degeneration (top), caused by nerve injury or disease, depletes the energy supply within axons, shutting down communication between nerve cells. Washington University scientists blocked axon degeneration by supplementing neurons with a chemical called nicotinamide riboside, which kept the axons energized and healthy (bottom). The image is for illustrative purposes only. Image credit: Milbrandt lab.

Moreover, they found that this protein, once unleashed, causes a rapid decline in the energy supply within axons. Within minutes after the protein – called SARM1 – is activated in neurons, a massive loss of nicotinamide adenine dinucleotide (NAD), a chemical central to a cell’s energy production, occurs within the axon.

“When a nerve is diseased or injured, SARM1 becomes more active, initiating a series of events that quickly causes an energetic catastrophe within the axon, and the axon undergoes self-destruction,” said first author Josiah Gerdts, an MD/PhD student in Milbrandt’s laboratory.

Working in neurons in which SARM1 was activated, the researchers showed they could completely block axon degeneration and neuron cell death by supplementing the cells with a precursor to NAD, a chemical called nicotinamide riboside. The neurons were able to use nicotinamide riboside to keep the axons energized and healthy.

Nicotinamide riboside has been linked in animal studies to good health and longevity, but its benefits have not been shown in people. The researchers said much more research is needed to know whether the chemical could slow or halt axon degeneration in the body.

“We are encouraged by the findings and think that identifying a class of drugs that block SARM1 activity has therapeutic potential in neurological disorders,” Milbrandt said. “The molecular details this pathway provides give us a number of therapeutic avenues to attack.”
About this neurology research

Funding: The research is funded by the National Institutes of Health (NIH), grants RO1DA020812, RO1AG013730, RO1NS065053, RO1NS087632, RO1NS078007 and F31NS074517, and a grant from Vertex Pharmaceuticals.

Source: Diane Duke Williams – Washington University School of Medicine in St. Louis
Image Credit: The image is credited to Milbrandt lab
Original Research: Abstract for “SARM1 activation triggers axon degeneration locally via NAD+ destruction” by Josiah Gerdts, E.J. Brace, Yo Sasaki, Aaron DiAntonio, and Jeffrey Milbrandt in Science. Published online April 23 2015 doi:10.1126/science.1258366

Abstract

SARM1 activation triggers axon degeneration locally via NAD+ destruction

Axon degeneration is an intrinsic self-destruction program that underlies axon loss during injury and disease. Sterile alpha and TIR motif–containing 1 (SARM1) protein is an essential mediator of axon degeneration. We report that SARM1 initiates a local destruction program involving rapid breakdown of nicotinamide adenine dinucleotide (NAD+) after injury. We used an engineered protease-sensitized SARM1 to demonstrate that SARM1 activity is required after axon injury to induce axon degeneration. Dimerization of the Toll–interleukin receptor (TIR) domain of SARM1 alone was sufficient to induce locally mediated axon degeneration. Formation of the SARM1 TIR dimer triggered rapid breakdown of NAD+, whereas SARM1-induced axon destruction could be counteracted by increased NAD+ synthesis. SARM1-induced depletion of NAD+ may explain the potent axon protection in Wallerian degeneration slow (Wlds) mutant mice.

“SARM1 activation triggers axon degeneration locally via NAD+ destruction” by Josiah Gerdts, E.J. Brace, Yo Sasaki, Aaron DiAntonio, and Jeffrey Milbrandt in Science. Published online April 23 2015 doi:10.1126/science.1258366

http://neurosciencenews.com/peripheral-neuropathy-sarm1-1987/

Two Anti Depressants For Nerve Pain How Did They Do

Today's short post from alert.psychnews.org (see link below) reports that a new study has shown both Duloxetine (Cymbalta and others) and Venlafaxine ( ‎Effexor, Trevilor, Lanvexin, others) to be reasonably effective treatments for nerve pain. Well reasonable in the sense that they performed better than other pills...when compared to placebos. These two serotonin-norepinephrine reuptake inhibitors (anti-depressants) are already widely prescribed for neuropathic pain but as we know, what works for one patient, doesn't necessarily work for others, which leads to patient frustration and difficulties for researchers and studies to come to definitive conclusions. The article also states that pregabalin is FDA approved for neuropathic pain - it's not! The FDA goes as far as to demand that warnings about the side effects be placed on boxes. It's a minefield for patients wondering whether what their doctor has prescribed is a)going to work and b) going to be safe. It is safe to say that almost all drugs prescribed to limit neuropathic pain can have side effects and therefore it's vitally important that you have a serious discussion with your doctor before embarking on a course of drugs. Together you need to weigh up the benefits and risks and even then there's no guarantee that your symptoms will diminish. However, maybe that shouldn't stop you trying - anything is better than that relentless pain...right! But your doctor should monitor your progress on any given drug, with great care and if necessary change the treatment.
 

Duloxetine, Venlafaxine May Be Most Effective at Reducing Diabetic Nerve Pain
Posted by Psychiatric News Monday, March 27, 2017

The serotonin-norepinephrine reuptake inhibitors duloxetine and venlafaxine appear to have the best evidence for being effective at reducing nerve pain in people with diabetes, according to a meta-analysis published in Neurology. Duloxetine is FDA-approved for treating pain in diabetic neuropathy, though venlafaxine is not.

The researchers pooled together data from 106 clinical studies published between 2011 and 2015 examining the effectiveness of pharmacologic approaches to improving pain in patients with diabetic peripheral neuropathy. The analysis compared outcomes in patients taking 21 different medications, though the authors were unable to draw conclusions for any head-to-head drug comparisons due to insufficient evidence.

The researchers found moderate evidence to suggest that duloxetine and venlafaxine were more effective at reducing neuropathy-related pain than placebo. Tricyclic antidepressants, botulinum toxin, the opioids tramadol and tapentadol, and the anticonvulsants pregabalin and oxcarbazepine were also found to be more effective than placebo, but the evidence base for these medications was weak.

In contrast, the anticonvulsant gabapentin, mood stabilizer valproate, and capsaicin cream were all found to be no more effective than placebo; these findings run contrary to guidelines for treating diabetic peripheral neuropathy published by the American Academy of Neurology in 2011, which listed all three agents as probably effective.

“Our findings generally support the effectiveness of the three drugs approved by the Food and Drug Administration (FDA) for the treatment of pain in diabetic peripheral neuropathy: duloxetine, pregabalin, and tapentadol,” wrote Julie Waldfogel, Pharm.D., of the Johns Hopkins Hospital and her colleagues. “Additional studies evaluating longer term outcomes are needed to better inform clinical decision-making, patient choice, and clinical practice guidelines.”

http://alert.psychnews.org/2017/03/duloxetine-venlafaxine-may-be-most.html

Get Treatment for sciatic nerve pain questions

Treatment for sciatic nerve pain questions is normally one in every of this inside of the at present Small children with the track record bing To provide you with vital knowledge to the customers it was used to look for the actual closest importance pictures close to Treatment for sciatic nerve pain questions Together with at this point you might look at these days, these kind of photographs are actually consumed belonging to the top rated tool.

They will are around for down load, if you prefer not to mention aspire to carry it just click conserve logo about the web page, and even it’ll end up easily purchased inside your portable computers. Last of all if you'd like to increase different in addition to most current video relevant to Treatment for sciatic nerve pain questions , remember to comply with people in yahoo and google as well as as well as book mark this excellent website, most people look at all of our most effective to present you each day upgrade through impressive and even innovative subject matter. Hopefully you prefer the web site.

Treatment for sciatic nerve pain questions - this has really been shared with the expectation that you can certainly motivate good to a. This particular blog post will be able to fulfill to provide a blueprint while you are mixed up to choose the suitable guideline The Treatment for sciatic nerve pain questions discussions may perhaps be your foremost method to become put on the job strategy, simply because it has got some method could truly feel even more gratified Treatment for sciatic nerve pain questions - Valuable suitable for you subsequently we tend to making the effort see an honest supplier which often will let you uncover enthusiasm devoid of bafflement. take always into account that will lesemarke this page, due to the fact possibly 1 day you will require that again while your current inspirational concepts.

CBD Cannabidiol Oil A Major Breakthrough In The Struggle Against Nerve Pain

Today's post from peoplespharmacy.com (see link below) illustrates just how far we've come in finding solutions for neuropathic pain. Who would have thought ten years ago that marijuana and its derivatives would be able to play a major role in reducing severe pain (and...just as important, be sanctioned by the authorities because it helps in the current and over-hyped: 'war on opioids'). I can actually speak from personal experience regarding cannabis oil (CBD oil). I never expected it and was roundly skeptical but after a few days of 2 drops under the tongue, twice a day, my symptoms also reduced significantly. Now here I need to add a disclaimer:- my experience and the experience of those mentioned in the article, have absolutely no bearing on how you may react. As you probably know, neuropathy is a disease that is peculiar to each individual and each individual reacts differently to different treatments. Why do you think doctors are scratching their heads in frustration at not being able to provide a 'cure' or often, even help with the symptoms. There are over 100 sorts of nerve damage and over 100 causes - add that to over 100 potential treatments and you have one of the most frustrating and serious diseases on earth. This blog is aimed at providing information about as many options as possible but you still need to seek advice from your doctors and do your own research. An article such as this one below, needs to be looked at objectively and not jumped upon as being the 'elixir of life'. But you know all this don't you!

Cannabidiol Oil Solved Severe Seizure Problem and Painful Neuropathy Joe Graedon December 5, 2016 Diabetic Neuropathy (nerve pain)
 
Medical marijuana is now legal in many states but many people are unaware of the pros and cons. Does cannabidiol oil work for hard-to-treat pain and epilepsy?

Many doctors are skeptical about the benefits of medical marijuana. That’s because they did not learn about this “herb” in medical school. If it was discussed at all, the likelihood is that the lecture would have been part of a class on drugs of abuse rather than therapeutic benefits. Sadly, there has been relatively little research on medical marijuana. This reader shares a poignant story about cannabidiol oil.

Q. My 19-year-old son had intractable seizures starting at age 12. At age 17, he was up to 9 seizures a day despite taking three different meds (29 pills a day). The side effects were awful; he got so skinny that the doctors considered inserting a feeding tube.

Two years ago, I started him on cannabidiol oil (CBD). In California, you go to a special doctor who asks lots of questions to decide if you’d benefit from it. You get a special card for a dispensary.

We had to experiment to see how much he needed. We were able to gradually decrease his pills.

His neurologist was horrified at the idea two years ago, but he has watched in amazement as my son reduced his medication without a single seizure. CBD has made a world of difference in my son’s life!

A. Many states have approved the medical use of marijuana compounds. Cannabidiol oil does not cause the high associated with marijuana. Research is beginning to show benefit for some people with hard-to-treat epilepsy (Pharmacological Research, May, 2016).

A study in the journal Frontiers in Pharmacology (Sept. 30, 2016) also reported improvement:

“Novel antiepileptic compounds with new mechanisms of action, fewer side effects, and better safety and tolerability profiles have been approved over the last years. However, although more than 20 different drugs approved for the treatment of epilepsy exist today, around 30% of patients continue to have seizures…

“The medicinal effects of cannabis in epilepsy have been known for centuries and, nowadays, the anticonvulsant properties of its components have received increasing attention…

“The present report is in line with pre-clinical and preliminary clinical data suggesting that CBD may be effective for some patients with epilepsy.”

These researchers call for randomized controlled trials. We couldn’t agree more!

Stories from Readers About Cannabidiol Oil:
Ellie in Connecticut:

“Were it not for medical marijuana, I’d be taking opioids regularly to deal with my chronic pain. The world of med MJ is indeed a whole new world.

“Initially I stuck very closely to only oil based tincture strains that were very high CBD, with virtually no THC (the pyschoactive element in MJ that gets people high). Now I’m realizing that a small amount of THC along with high CBD produces the pain relief I’ve been looking for.

“Yes, I had to literally jump through hoops to become certified to purchase medical MJ in my state but it’s all been very worthwhile. Does the marijuana totally eliminate my pain? No, it doesn’t. But what it does is ease it back to a far more manageable level. I’m delighted to have this option to control my pain.”

David reports:

“My wife experiences relief from stroke related pain with oral CBD oil: an eye dropper full under the tongue when stomach is empty. She has experienced no adverse effects. It has a pleasant taste. CBD oil is derived from non-THC hemp and doesn’t get people high.”

Brian in California reports on cannabidiol for diabetic neuropathy:

“My diabetic neuropathy came on suddenly and without warning. The severity is such that I’ll literally scream out, even in a public place like a restaurant! The pain is very sharp but only lasts about a second. Sometimes it pulses. I’ve even been prescribed narcotics (opioids) but they don’t even touch it. Neurontin (gabapentin) doesn’t work, even after taking it for months.

“When I tried Marijuana it worked immediately and the relief lasted 3-4 days!

“Now, I make my own tincture and take about two dropperfuls every three days or so. If I forget, the pain will return to remind me, but if I have the tincture handy, it takes care of it immediately with NO side effects. I’m sure it is high in CBD but it also has some THC in it and I think a bit of THC is necessary for this purpose.

“I’m a retired Chiropractor with an additional degree in Natural Medicine. The synergy of the two substances working together is very important in natural products.”

A Doctor’s Perspective on Medical Marijuana:

If you would like to learn more about one physician’s experience with medical marijuana, we recommend our one-hour radio interview with David Casarett, MD, MA. In it you will learn about the use of cannabidiol oil and medical marijuana to treat neuropathic (nerve) pain. Dr. Casarett also explains how medical marijuana may be helpful in calming the agitation experienced by some patients with Alzheimer’s disease. Here is a link to the show.

https://www.peoplespharmacy.com/2016/12/05/cannabidiol-oil-solved-severe-seizure-problem-and-painful-neuropathy/

Seven Super Supplements For Nerve Health

Today's post from drperlmutter.com (see link below) is one for those of us with neuropathy and a fairly healthy wallet! I often think that supplement recommendations are a bit of a luxury for a select few because they're not cheap and many people's budgets just can't stretch to extras that may or may not work. That said, if it's possible financially, you may want to take a look at some of these seven recommendations here. They are all widely reported as having benefits for a health nervous system (apart from other beneficial health areas which you could see as a bonus) and the list and explanations could be very useful as a base from which to start, especially if your normal diet isn't the healthiest on the block. Unfortunately, supplement takers are often the people who are most conscious about their overall health and as such may not need them as much as others. If you do your research on the web, you'll see that each of these seven is claimed to be helpful for neuropathy patients but if you're at all concerned, talk to your doctor. Please watch out for supplements that claim to solve everything in one pill though - they are exorbitantly expensive and their claims are often wildly exaggerated - shopping for individual elements will work out cheaper in the end and then you know what you're putting in your mouth.

Grain Brain and the 7 Super Supplements 
Dr. Perlmutter

 
A brain-healthy, Alzheimer’s-fighting diet has properties that extend far beyond just decreasing your daily carb load. To truly provide your body with brain-boosting nutrients and vitamins that help stave off brain disease and other illnesses, you should consider a regular regimen of supplements. These seven supplements will go a long way towards helping you with prevention:

DHA: An omega-3 fatty acid that represents more than 50% of the omega-3 fatty acids in the brain. Numerous studies link high levels of DHA with a decreased risk for dementia, Alzheimer’s and other brain diseases (view some of these studies here on my site). Look to take in about 1,000mg/day. 

Resveratrol: If you like that red wine is permissible in the Grain Brain lifestyle, then you can thank this natural compound which slows down the aging process, boosts blood flow to the brain, and promotes heart health. In addition to the role it plays in stimulating brain function, resveratrol is also a key ally of our body’s immune system. Target 100mg twice daily.

Turmeric: If you follow me on social media (Facebook, Twitter), then you’ve heard me talk about turmeric before. Turmeric is well known for its anti-inflammatory and antioxidant properties. We can thank turmeric for protecting our mitochondria (thanks to its role in stimulating antioxidant properties), and it also improves glucose metabolism — both of which are essential for reducing one’s risk for brain disease. Try to get 350 mg twice daily.

Probiotics: Research conducted in just the last few years has started to conclude that eating food rich in probiotics can influence brain behavior, and may modulate the effects of stress, anxiety, and depression. In Grain Brain, I dive deeper into the relationship between probiotics and brain health, and today’s researchers are further exploring the role gut bacteria may play in maladies ranging from chronic pain to autism. Ideally, get your probiotics through a supplement that contains at least 10 billion active cultures from at least ten different strains, including lactobaccilus acidophilus and bifidobacterium.

Coconut Oil: If you follow this blog, you know I am a big fan of coconut oil and probably know why it’s an important part of our diet. It’s even a part of my anti-Alzheimer’s trio! Go for at least 1-2 tablespoons of an organic variety daily.

Alpha-lipoic Acid: Alpha-lipoic acid is a powerful antioxidant that works to protect brain and nerve tissue. Look to get 600 mg/day. 

Vitamin D: I can’t say enough about the importance of Vitamin D, and that’s why I devote five pages to it in Grain Brain. To learn more, watch my video on the subject. It’s ideal to start with 5,000 units of Vitamin D3 daily, get tested after three months, and adjust accordingly.

As with any dietary/health changes, these are suggested guidelines only, and you should consult with your physician before making any changes to, or beginning, a supplement plan.

For more information, order your copy of Grain Brain today and join Dr. Perlmutter’s email list.

http://www.drperlmutter.com/grain-brain-seven-super-supplements/?hvid=2vNL2

Knowing Sciatica nerve compression treatment

On this subject internet page us all could possibly enable go for a advantageous benchmark determined by investigation in up-to-date articles and reviews Sciatica nerve compression treatment probability topic for the reason that loads of buyers who seem to want them. during personal reference Getting people take advantage of a variety of serps here i list imagery who are associated Sciatica nerve compression treatment .

Pictured in this article it is easy to download and read and even keep it again towards the desktop computer computer with the intention that as soon as you demand it are usually direct entered conveniently. Sciatica nerve compression treatment will be vital suitable for you what person likes to corresponding ideas. Thus most of us had taken this project to accumulate the results pertaining to the advantages of each of our guests. Lesemarke some of our web-site the fact that will allow you to locate much more content articles linked to the particular keywords and phrases

Sciatica nerve compression treatment - to aid produce the interest individuals website visitors can also be pretty pleased for making this site. restoring the quality of the article will certainly many of us try on in the future so that you can really understand subsequently after reading this content. Eventually, it's not necessarily some text that must be manufactured to coerce you actually. yet as a result of limits regarding terminology, we can easily solely provide this Sciatica nerve compression treatment chat away at this point

Do You Need Extra Vitamins B12 And D3 For Your Nerve Problems

Today's post from nybc.wordpress.com (see link below) is a useful one for many neuropathy patients and not only those who have HIV as a co-morbidity. Vitamins B12 and D3 are often recommended for people suffering nerve damage but first, it's sensible to establish if you have a deficiency in these areas, leading to the symptoms that they may relieve. That's apparently not always as simple as a blood test because the vitamin blood tests are not always 100% reliable. However, many people living with HIV and other conditions, who also suffer from neuropathy, are vitamin deficient and will benefit from supplementation. This article very sensibly looks at the pros and cons of B12 and D3 supplementation and is well worth a read for those considering a visit to the vitamin counter. It's always wise to do your research regarding supplement absorption and buy the best you can afford.

Why Vitamins B12 and D3 Are Especially Important to People with HIV 
December 8, 2013 New York Buyers' Club 

Our friends at the Canadian AIDS Treatment Information Exchange (CATIE), a Canadian government-supported education and prevention organization, recently published an excellent guide to managing HIV medication side effects. This online guide covers the territory from body shape changes, to gastrointestinal disorders, to neurological effects, to emotional wellness, to fatigue, to sexual difficulties.

The Appendix to this guide focuses on two vitamins, both of which have been highlighted as especially important for people with HIV: B12 and D3. Deficiency of these two vitamins appears to be common among people with HIV, and supplementing to correct the deficiency can bring about major improvements in health. So it’s definitely worthwhile to check your B12 and D3 status, and, if you’re deficient, find a good supplementation strategy. Note that NYBC stocks both of these inexpensive vitamins: the methylcobalamin form of Vitamin B12 recommended below; and several strengths of Vitamin D3, including the commonly recommended D3 – 2500IU format.

Below are the CATIE recommendations:

Vitamin B12

A number of studies have shown that vitamin B12 is deficient in a large percentage of people with HIV, and the deficiency can begin early in the disease. Vitamin B12 deficiency can result in neurologic symptoms — for example, numbness, tingling and loss of dexterity — and the deterioration of mental function, which causes symptoms such as foggy thinking, memory loss, confusion, disorientation, depression, irrational anger and paranoia. Deficiency can also cause anemia. (See the section on Fatigue for more discussion of anemia.) It has also been linked to lower production of the hormone melatonin, which can affect the wake-sleep cycle.

If you have developed any of the emotional or mental symptoms mentioned above, especially combined with chronic fatigue, vitamin B12 deficiency could be contributing. This is especially true if you also have other symptoms that this deficiency can cause, including neuropathy, weakness and difficulty with balance or walking. On the other hand, these symptoms can also be associated with HIV itself, with hypothyroidism or advanced cases of syphilis called neurosyphilis. A thorough workup for all potential diagnoses is key to determining the cause.

Research at Yale University has shown that the standard blood test for vitamin B12 deficiency is not always reliable. Some people who appear to have “normal” blood levels are actually deficient, and could potentially benefit from supplementation.

The dose of vitamin B12 required varies from individual to individual and working with a doctor or naturopathic doctor to determine the correct dose is recommended. Vitamin B12 can be taken orally, by nasal gel or by injection. The best way to take it depends on the underlying cause of the deficiency, so it’s important to be properly assessed before starting supplements. For oral therapy, a typical recommendation is 1,000 to 2,000 mcg daily.

One way to know if supplementation can help you is to do a trial run of vitamin B12 supplementation for at least six to eight weeks. If you are using pills or sublingual lozenges, the most useful form of vitamin B12 is methylcobalamin. Talk to your doctor before starting any new supplement to make sure it is safe for you.

Some people will see improvements after a few days of taking vitamin B12 and may do well taking it in a tablet or lozenge that goes under the tongue. Others will need several months to see results and may need nasal gel or injections for the best improvements. For many people, supplementation has been a very important part of an approach to resolving mental and emotional problems.

Vitamin D

Some studies show that vitamin D deficiency, and often quite severe deficiency, is a common problem in people with HIV. Vitamin D is intimately linked with calcium levels, and deficiency has been linked to a number of health problems, including bone problems, depression, sleep problems, peripheral neuropathy, joint and muscle pain and muscle weakness. It is worth noting that in many of these cases there is a link between vitamin D and the health condition, but it is not certain that a lack of vitamin D causes the health problem.

A blood test can determine whether or not you are deficient in vitamin D. If you are taking vitamin D, the test will show whether you are taking a proper dose for health, while avoiding any risk of taking an amount that could be toxic (although research has shown that toxicity is highly unlikely, even in doses up to 10,000 IU daily when done under medical supervision). The cost of the test may not be covered by all provincial or territorial healthcare plans or may be covered only in certain situations. Check with your doctor for availability in your region.

The best test for vitamin D is the 25-hydroxyvitamin D blood test. There is some debate about the best levels of vitamin D, but most experts believe that the minimum value for health is between 50 and 75 nmol/l. Many people use supplements to boost their levels to more than 100 nmol/l.

While sunlight and fortified foods are two possible sources of vitamin D, the surest way to get adequate levels of this vitamin is by taking a supplement. The best dose to take depends on the person. A daily dose of 1,000 to 2,000 IU is common, but your doctor may recommend a lower or higher dose for you, depending on the level of vitamin D in your blood and any health conditions you might have. People should not take more than 4,000 IU per day without letting their doctor know. Look for the D3 form of the vitamin rather than the D2 form. Vitamin D3 is the active form of the vitamin and there is some evidence that people with HIV have difficulty converting vitamin D2 to vitamin D3. Historically, vitamin D3 supplements are less commonly associated with reports of toxicity than the D2 form.

It is best to do a baseline test so you know your initial level of vitamin D. Then, have regular follow-up tests to see if supplementation has gotten you to an optimal level and that you are not taking too much. Regular testing is the only way to be sure you attain — and then maintain — the optimal level for health.

With proper supplementation, problems caused by vitamin D deficiency can usually be efficiently reversed.

https://nybc.wordpress.com/category/neuropathy/

Treat a sciatic nerve after back surgery

Treat a sciatic nerve after back surgery could be the craze regarding present day well-known articles, we understand within the exploration within the se that will permits you to adorn enough suggestions all of us attempt to find pictures related to the Treat a sciatic nerve after back surgery . along with the effects you will observe underneath you should be aware many of the photographs is merely a great representation.

Foto Results Treat a sciatic nerve after back surgery

Treat a sciatic nerve after back surgery - it has recently been published with the expectation the truth that we can easily simply definitely really encourage currently employed to help persons. This may well perform in the form of benchmark while you're lost to choose the ideal instruction This Treat a sciatic nerve after back surgery content could be your better alternative that they are put on to the repair system, as it has its own plan will feel more satisfied Treat a sciatic nerve after back surgery - Beneficial for everyone for this reason people are attempting get a trusted supply that will help you discover motivation without having misunderstandings. never forget to help you store this site, due to the fact possibly 1 day you will require that again because your own inspirational suggestions.

Some Home Remedy Suggestions To Help Reduce Nerve Pain

Today's post from jbbardot.com (see link below) is a useful and informative article about what many call alternative treatments for neuropathic pain but are really more supplements, designed to help reduce the impact of the symptoms. It's important to realise that none of these treatments will work on their own. The key words are 'help to reduce'. Any successful treatment for nerve pain symptoms has to be based on a holistic view of your problems. The treatments mentioned here will probably help in combination with lifestyle changes, regular medication and mental adjustments but you need to explore the options to find what works best for you. Furthermore, they all need time to work (if they're going to work at all), so buying one pot and giving up after two weeks will not help you except by helping to empty your wallet. You need to do your research and find out what's best for your own situation and that, in combination with a good discussion with your doctor. Unfortunately, there are no miracle cures for nerve pain but there are hundreds of choices as to how you can best relieve your own pain. The suggestions mentioned below represent just some of the options you have.
 

Soothe Diabetic Foot Pain And Peripheral Neuropathy With Effective Home Remedies and Alternative Treatments 
Posted by JB Bardot 2017

Peripheral or diabetic neuropathy affects 60-70 percent of all diabetics with stabbing, burning pain in the hands, feet and especially the toes, according to DiabeticLiving.com. Additionally, many non-diabetics are affected with painful neuropathies of no known cause. Initially experienced as numbness, and tingling of the affected parts, neuropathies often develop into feelings of having hot or icy needles stabbing sensitive flesh. Pharmaceutical medicines may or may not help manage pain, and often produce unwanted side effects. Fortunately, there is a more natural, multi-disciplinary approach to pain management using a variety of home remedies, herbs, supplements, homeopathic remedies, and lifestyle adjustments.

Herbs, supplements and homeopathic remedies

• Topical applications of cayenne pepper mixed with olive or coconut oil relieves neuropathy pain for some people. Capsicum, the active ingredient in cayenne, may feel hot to the skin initially; however, it binds to the body’s pain receptors, fooling the neural pathways and lessening pain over a period of time.

• Omega 3 fatty acids in the form of fish oil supplements provide healthy fats that soothe nerves, helping to relieve pain and inflammation from peripheral neuropathy. Omega 3 fatty acids are also found in flax seeds and oil, borage oil and Evening primrose oil.

• Homeopathic remedies are effective at providing relief from peripheral neuropathies for many people. Remedies such as Plumbum Met, Phosphoric Acid, Phosphorous, Zincum Met, Pulsatilla, Graphites, Lachesis, Gelsemium, Baryta Carb, Causticum, Zincum Phos, Agaricus, Mercurius, Sulphur, Cuprum Met, and Rhus Tox. This list is not exhaustive. Consult a homeopath for the correct remedy based on your individual case.

• Acupuncture and Traditional Chinese Medicine (TCM) reduce stress hormones which can be the cause of some neuropathies. Treatment eventually leads to the reduction of inflammation and pain.

• Lecithin, a fat emulsifier, will reduce diabetic neuropathy pain by working to protect the liver and pancreas from the effects of eating oils high in trans fats and hydrogenated fats. Lecithin is found naturally in the body and is important in the production and transmission of energy. The myelin sheaths that cover nerves are made primarily from lecithin. Most lecithin is made from eggs or soy and it’s important to use a product that’s organic and labeled non-GMO.

• High doses of the B vitamin, Inositol added to one’s diet has been shown to reduce pain and the frequency of peripheral neuropathies. Additionally, increase doses of vitamin B-complex — especially B-6 and B-12 — to help calm and repair damaged nerves and provide pain relief.

• Alpha Lipoic Acid (ALA) works to regenerate nerves damaged by diabetes and other causes. ALA is a sulfur-containing compound found naturally in the body. Some studies suggest that this antioxidant may actually improve circulation, enhance the action of insulin and reduce oxidative stress, thus preventing neuropathies.

• Keep your body alkaline by drinking a pH drink from 1 to 3 times daily. Mix 2 Tbs. fresh lime or lemon juice with 1/2 tsp. baking soda. Allow all foaming and fizzing to go flat. Add 10 – 12 oz. water and drink all at once.

• Manage pain and frequency of attacks by keeping glucose levels stable, suggests pain specialist Dr. Robert Gerwin, of Johns Hopkins University. There are a number of ways to maintain blood sugar. Eat foods lower on the glycemic index scale and avoid those whose numbers are high. Take a daily supplement consisting of cinnamon and chromium to lower glucose levels and help prevent diabetic neuropathies.

Lifestyle adjustments

• Wear well-fitting shoes, with large toe boxes.

• Protect hands and feet in winter with warm socks, gloves and shoes that keep feet dry.

• Sit with legs uncrossed to encourage good circulation.

• Stop smoking cigarettes. Smoking causes the blood vessels to constrict, worsening circulation and aggravating neuropathy pain.

http://www.jbbardot.com/home-remedies-and-alternative-treatments-for-diabetic-foot-pain-and-peripheral-neuropathy-2/

Sciatic nerve treatment brisbane

Sciatic nerve treatment brisbane is one of a few possibilities inside at this time Could through the file yahoo and google In an effort to deliver worthwhile material to our followers we have now tried out to discover a best meaning illustrations or photos all over Sciatic nerve treatment brisbane And here you are going to see now, all of these visuals had been regarded on the foremost learning resource.

These people are for sale to obtain, if you need to and additionally plan to remove it click on help save marker around the site, and also it’ll become quickly saved into your notebook computer. In conclusion to earn unique in addition to most current video relevant to Sciatic nerve treatment brisbane , delight go along with u . s . relating to google and bing also or possibly lesezeichen neutral, everyone strive this top we are able to normal post to through impressive and even innovative subject matter. We hope appeals to you much of our websites.

Sciatic nerve treatment brisbane - it has long been circulated with the hope of which you’re able to easlily support employed to work in your direction should. This short article may function like a research if you end up unclear to find the best tutorial This Sciatic nerve treatment brisbane content articles may just be your own preference to become put on the job strategy, as it has its own plan will feel more satisfied Sciatic nerve treatment brisbane - Beneficial for everyone accordingly everyone are trying to look for a reliable source which can help you see drive free of indecision. never forget to help you store this site, because maybe one day you will need it back because your own inspirational suggestions.

Sciatic nerve treatment in dubai

Sciatic nerve treatment in dubai is actually among prefer to in the at this moment Could through the file yahoo and google In an effort to deliver worthwhile material to the visitors we certainly have sampled to search out that next importance shots available Sciatic nerve treatment in dubai And even these you may find out at present, all of these visuals had been regarded with the main aid.

These people are for sale to obtain, if you need along with would like to get it simply click protect badge at the website page, and additionally it’ll come to be automatically downloaded in your notebook computer. Finally if you wish to obtain brand new not to mention recent visual connected with Sciatic nerve treatment in dubai , i highly recommend you observe united states for bing and also and also take note of this web site, we tend to consider a lot of our preferred we could day to day renovate along with brand new as well as clean content material. Hopefully that appeals to you a lot of our blog.

Sciatic nerve treatment in dubai - this has been recently put up with the expectation which usually you might arouse beneficial to you'll. This informative article can easily assist being a guide when you're baffled to find the correct manual The Sciatic nerve treatment in dubai articles or blog posts may very well be hard possibility that should be ascribed to art arrange, precisely as it seems to have the liechtenstein package definitely will look further thrilled Sciatic nerve treatment in dubai - Very beneficial in your case therefore we are trying to find a trusted supply that will help you locate ideas with out distress. steer clear of reliability to make sure you lesezeichen this page, given that could be someday you may need it all to come back as your inspirational ideas.

Guide Treatment for pinched sciatic nerve in leg

In the following paragraphs most of us will probably allow you to get yourself a beneficial guide in accordance with exploring with present-day reports Treatment for pinched sciatic nerve in leg likelihood controversy as a good deal of the general public with who making the effort consider the theory. through useful resource Getting involved in collecting we tend to usage different yahoo here are a few illustrations or photos that can be related to Treatment for pinched sciatic nerve in leg .

Pictured preceding it is easy to download and read and even keep them on the laptop harddisk with the intention that as soon as you demand it will be straightaway connected readily. Treatment for pinched sciatic nerve in leg may be the crucial for you personally what person likes to corresponding ideas. So you went on that labor to get the details pertaining to the advantages of each of our guests. Search for your web page of which allows you to locate much more content articles relating to that search terms

Treatment for pinched sciatic nerve in leg - that can help build the interest your readers also are incredibly to help make this site. bettering the grade of this article definitely will we tend to test a later date so that you can really understand when encountering this blog post. At long last, not necessarily just a few ideas that need to be designed to persuade you will. yet as a result of limits regarding terminology, we are able to just existing the actual Treatment for pinched sciatic nerve in leg chat away at this point

Can Exercise Repair Nerve Damage

It's very difficult to know what to make of the information in today's post from sciencedaily.com (see link below). When you read about studies being carried out on mice leading to conclusions for neuropathy patients, you can sometimes feel that you're pretty far removed from the science. What's more, turning mice-studies into practical end-product help for a patient is often hugely time-consuming. However, this one does back up what neuropathy patients are frequently told...we need to exercise. However unpalatable and painful that advice sounds for many people with nerve damage, it does seem sensible and logical, if only to avoid muscular atrophy.
This study from two American universities however, suggests that exercise can help regenerate damaged nerves in certain situations; ie nerve damage caused by physical injury and not disease or drug side-effects. In the past this has been thought to be possible if done quickly enough after the injury. The question is, does exercise have any relevance for long-term neuropathy patients, in terms of nerve regeneration? The article doesn't give enough information regarding other forms of neuropathy but if we know we have to exercise anyway to maintain muscle tone and strength, we'll keep trying. If it helps in any other way with our nerve damage then that's a bonus. This study is interesting but we need more information to know whether it's relevant for a wider neuropathy population or not.

Study Sheds Light On Role of Exercise and Androgens Such as Testosterone On Nerve Damage Repair
ScienceDaily (Oct. 15, 2012)

A study by researchers from Emory University and Indiana University found that the beneficial effects daily exercise can have on the regeneration of nerves also require androgens such as testosterone in both males and females. It is the first report of both androgen-dependence of exercise on nerve regeneration and of an androgenic effect of exercise in females.

"The findings will provide a basis for the development of future treatment strategies for patients suffering peripheral nerve injuries," said Dale Sengelaub, professor in the Department of Psychological and Brain Sciences at IU. "And they underscore the need to tailor those treatments differently for men and women."

The researchers discussed the study on Monday at the Neuroscience 2012 scientific meeting in New Orleans.

Injuries to peripheral nerves are common. Hundreds of thousands of Americans are victims of traumatic injuries each year, and non-traumatic injuries, such as carpal tunnel syndrome, are found in even higher numbers. The researchers previously showed that two weeks of moderate daily exercise substantially improves regeneration of cut nerves and leads to functional recovery in mice, though different types of exercise are required to produce the effect in males and females. They now report that these beneficial effects of exercise require androgens such as testosterone in both males and females.

In the study they conducted, they exercised three groups of male and female mice. Nerves of the three groups were cut and surgically repaired. Once group received the drug flutamide, which blocks the androgen receptor. A second group received a placebo treatment. The third group was unexercised. Regenerating nerve fibers in the placebo group grew to more than twice the length of those in unexercised mice in both males and females. In flutamide-treated mice, the effects of exercise were blocked completely in both sexes.

The study, "Enhancement of peripheral axon regeneration by exercise requires androgen receptor signaling in both male and female mice," will be discussed from 11 a.m. to noon on Monday in Hall F-J. Co-authors are Arthur W. English and Nancy Thompson, both from Emory University.

http://www.sciencedaily.com/releases/2012/10/121015122205.htm

Sciatic Nerve Pain During Pregnancy

Sciatic Nerve Pain Relief

3 Sciatic Stretches for Pregnancy Prenatal Safe Stretch Routine Relief for insomnia, restless leg syndrome, sciatica more - Duration: 22:03..By Pregnancy.org Staff. Sciatic nerve pain often comes on suddenly, creating immediate distress. And while it usually resolves in a few weeks, the pain may linger for .How to treat sciatic nerve pain during pregnancy? Sciatica causes pain and weakness from the lower back down through the legs and to the feet..Pregnancy is a never ending group of changes. The sciatic nerve can be a great source of pain during pregnancy, but women can avoid and treat the condition with rest .What is sciatica? Sciatica is pain, tingling, or numbness produced by an irritation of the nerve roots that lead to the sciatic nerve. The sciatic nerve is formed by .Sciatic Nerve Pain During Pregnancy: Causes and Treatment. The sciatic nerve is the largest nerve in the body, providing sensory and motor function to the lower .The sciatic nerve goes across the buttock and runs down the leg clear to the toes. People complain of a pain that radiates from the hip down the thigh clear to the .I admit it. I am lousy at being pregnant. While other first trimester moms are being complimented on their healthy glow, I spend the first trimester of my pregnancy .Causes of Sciatic Nerve Pain. The biggest reasons for sciatic nerve pain development are herniated spinal discs and inflammation. For the majority of .Sciatic nerve paint is common during pregnancy, as the uterus can put pressure on the lower spine, but a few simple stretching exercises can help relieve .

Sciatic Nerve Pain Relief

Triple Threat Triathlon Ttt Mysteries Nervous Breakdown The Case Of

Sciatic Nerve Pain During Pregnancy: Causes and Treatment. The sciatic nerve is the largest nerve in the body, providing sensory and motor function to the lower .By Pregnancy.org Staff. Sciatic nerve pain often comes on suddenly, creating immediate distress. And while it usually resolves in a few weeks, the pain may linger .How to treat sciatic nerve pain during pregnancy? Sciatica causes pain and weakness from the lower back down through the legs and to the feet..Pregnancy is a never ending group of changes. The sciatic nerve can be a great source of pain during pregnancy, but women can avoid and treat the condition with rest .I admit it. I am lousy at being pregnant. While other first trimester moms are being complimented on their healthy glow, I spend the first trimester of my pregnancy . Sciatic nerve paint is common during pregnancy, as the uterus can put pressure on the lower spine, but a few simple stretching exercises can help relieve .What is sciatica? Sciatica is pain, tingling, or numbness produced by an irritation of the nerve roots that lead to the sciatic nerve. The sciatic nerve is formed by . Causes of Sciatic Nerve Pain. The biggest reasons for sciatic nerve pain development are herniated spinal discs and inflammation. For the majority of . 3 Sciatic Stretches for Pregnancy Prenatal Safe Stretch Routine Relief for insomnia, restless leg syndrome, sciatica more - Duration: 22:03..The sciatic nerve goes across the buttock and runs down the leg clear to the toes. People complain of a pain that radiates from the hip down the thigh clear to the .

How the nerve is damaged

This description is something I can understand:-

Myelin Layer

The myelin layer is a white fatty and protein covering that insulates and protects a nerve fiber. The concept of myelin can be thought of as similar to the insulating coatings that typically surround electrical wiring. Just like insulators are needed to protect electrical wires, myelin is needed to protect our nerve fibers which incidentally, conduct electrical current also.

Myelin is made up of roughly about 80% fat, and about 20% protein. In addition to protecting our nerves, having a myelin covering or sheath allows nerve signals to be transported much quicker and more effectively. When the myelin sheath is damaged, impulses do not get transmitted through the nerve as quickly as it should. In addition, much like a damaged insulator covering can result in frayed wiring, a compromised myelin sheath can result in the underlying nerves becoming damaged as well. Neuropathy symptoms are often the result of this damage.

Originally from www.LivingWithPeripheralNeuropathy.com

Are There Non Opioid Alternatives For Nerve Pain

Today's post from medscape.com (see link below) is an important one because it highlights the dilemmas facing doctors and patients alike when it comes to medicating severe neuropathic pain. The situation at the moment is clear: there is a global (but mainly North American) outcry at the use and abuse of opioid-strength medications and this has triggered a frantic search amongst the scientific community for non-opioid medications that are both strong and effective enough to combat nerve pain at its worst. This article is directed at trainee doctors and nurses and examines the problem in a sensible and well-balanced way and for that reason it's very interesting for neuropathic patients who have no option at the moment but to use the only means available for suppressing their pain and that is the opioid family of medications. It may seem a little technical but it will provide you with so much information about the thinking behind nerve pain drug prescription.

Non-Narcotic Options for Pain Relief with Chronic Neuropathic Conditions
Donna V. Wright, MS, RN, FNP
Journal for Nurse Practitioners. 2008;4(4):263-270.

Neuropathic pain is a misunderstood, usually inadequately treated condition. This article discusses the types of pain, mechanisms of pain, diagnosis, and rationale for treating neuropathic pain. The importance of working with patients to achieve their functioning goals is also addressed.

Tom Jacobson, a bail bondsman, is not getting adequate pain relief from hydrocodone/acetaminophen 10/500 (Lortab) four times a day. He is suffering from chronic low back pain with peripheral neuropathy secondary to a motor vehicle accident. He knows that his back pain is a long-term condition (with chronic pain, the recommended daily dose of acetaminophen is 2000 mg to minimize the risk of liver damage; therefore, increasing his daily doses is not an option). He has tried the generic equivalent with less acetaminophen and with less than satisfactory results. He does not want to take the next step up the pain ladder to oxycodone/acetaminophen (Percocet) at this time. He knows that in South Carolina, by changing his prescription to a schedule II medication, he will be required to obtain a new prescription monthly and that his nurse practitioner can no longer prescribe independently of her physician preceptor (in 29 states, prescription of scheduled drugs requires physician collaboration.)[1] This increase in required medical supervision and possible change of caregiver can be a deterrent for some patients. The most important consideration for Tom is the nature of his work. He does not believe that he can function effectively in his role unless he feels "totally in control." The nature of narcotic medications makes this a concern.

To better understand some of the mechanisms of neuropathic pain, a review of the types of pain, the mechanisms, the diagnosis, and the treatment of neuropathic pain is in order. Cadden describes three types of pain: acute, chronic, and acute on chronic.[2] Tom is experiencing chronic pain, which simplifies his care. When chronic pain sufferers have acute pain as well as chronic pain, they are at risk for undertreatment of pain. Table 1 reviews terms used to describe pain. There are basically three ways to treat pain: alter the central pain perception (inhibit mechanisms of pain perception in the dorsal horn of the spinal cord"'how most narcotics work), modify the pain source, and block transmission of pain impulses by modulating the transmission of the pain impulse.[2] The last mechanism is the area in which we will focus.

"Chronic neuropathic pain is the net result of sensory input greater than the central inhibitory response" the uniqueness of chronic neuropathic pain is that its multiple etiologies share a common pathway."[5] The pain signal is processed via the dorsal horn of the spinal cord and transmitted in the central nervous system (CNS). After an injury, the healing process may be altered and actually increase rather than decrease the pain response. The development of dendritic growth (neuroplasticity) can increase the number of alternate neural pathways, which may actually increase the sensitivity to pain. These alternate pathways may have an accumulation of Na+ channels that become "leaky" and fire spontaneously or with very little provocation. "Neurons fire, or spontaneously produce electrical impulses on a regular basis" they may fire more or less slowly depending on whether or not they are excited or inhibited from firing by various types of chemicals called neurotransmitters" naturally occurring chemicals i.e. substance P, glutamate and aspartate excite neurons responsible for pain transmission" drugs that block the action of these substances diminish our awareness of pain. Our body's narcotic chemicals in the brain and the spinal cord inhibit the transmission of pain impulses."[6] By decreasing the rate of impulse firing, these chemicals can help modulate the pain response. The chemicals or neurotransmitters involved are commonly affected by anticonvulsants, antidepressants, neuroleptics, and antiarrythmics (ie, betabockers, sodium channel blockers, acetycholinesterase inhibitors) ( Table 2 , Table 3 ). This very simplified explanation helps provide rationale for the diagnostic criteria and the management of neuropathic pain.

The initial goals for diagnosis according to Gilron[8] include: rule out treatable conditions (ie, a neoplasm), confirm the diagnosis of neuropathic pain, and identify the clinical features (ie, insomnia) that help individualize treatment. Neuropathic pain is most frequently diagnosed by history and examination. A common presentation would be a level of pain intensity that is disproportionate to the injury received. There may be a history of sensory disturbance (numbness, abnormal sensations, itching, burning, pricking) that worsens as the day progresses. This pain pattern may initially follow a dermatonal distribution but can begin to deviate as neuronal plastic changes advance. The development of new "leaky" neural pathways (neuroplasticity) after an injury can set the stage for development of chronic burning or electric (tingling, shocking, jolting) sensations. These overly sensitive pathways can become "exquisitely painful" or sensitive to sensations that are normally not considered painful (allodynia). Other manifestations of neuropathic pain are dysesthesia, altered or abnormal sensations, paresthesias, or hyperalgias. These pains can occur spontaneously due to regrowth connections to sympathetic nerve fibers or can be evoked. It may become difficult for the sufferer to perform his or her usual daily activities.

It is important to determine which medications or treatments have been attempted. Acetaminophen and nonsteroidal antiinflammatories (NSAIDs) are usually not effective. Concurrent alcohol or substance use and abuse issues can complicate treatment. This delayed symptomology combined with a tendency for the pain path to follow a dermatonal distribution meet the diagnositic criteria for neuropathic pain.[9]

On physical examination, disturbances in light touch, response to pin pricks, vibration, and proprioception may be noted. Sensory disturbances may be beyond the discrete nerve territory. There may be pain with a straight-leg raise exam, which suggests irritation of a lumbar root; Phalen's test or Tinell's sign may be positive (usually indicates carpal tunnel). Deep tendon reflexes may be abnormal. A skin examination may show temperature, color, and hair growth changes, along with abnormal sweating.[8] Stimulus-evoked hypersensitivities may be present and can occur in areas that have loss of sensation. "The symptoms most associated with neuropathic pain were dysesthesias, evoked pain, paroxysmal pain, thermal pain, autonomic complaints, and descriptions of the pain as being sharp, hot or cold, with high sensitivity."[10] It is common for there to be a relatively modest demonstration of clinical neurological deficits or an essentially normal examination.[10]

Confirmatory diagnostics include computed tomography (CT) scans and magnetic resonance images (MRIs) that may show compromised nerve root pathways and structural damage; electromyography and nerve conduction studies, which can show the extent of neuroplastic changes; quantitative sensory testing (QST "' measures sensory thresholds for pain, touch, vibration, and temperature); and three-phase nuclear medicine bone scans that may help diagnose complex regional pain syndrome (CRPS).[10] During the diagnostic phase, a physiatrist (a physician who specializes in physical and rehabilitation medicine) can be an invaluable ally who can perform and interpret many of these examinations as well as suggest other diagnostic tests that might be appropriate.

Once the diagnosis has been confirmed, the practitioner may want to consider using conservative nonpharmacologic treatment options. These options can be crucial if the patient has a history of alcohol and/or substance abuse. Consider the physical conditions and activities that may increase pain. Watch the patient walk, move, and transfer. Large wallets, improper shoes (especially heels and boots), inappropriate canes and walkers, and gaits that favor one leg or another can increase neuropathic pain. Also, evaluate physical activities that may be exacerbating pain. Riding lawnmowers, all-terrain vehicles, and post-hole diggers are among the common culprits.

Physical therapy may be an appropriate referral for gait training; to determine the need for assistive devices; to determine whether use of a TENS (transcutaneous electrical nerve stimulation) unit would be appropriate; to initiate the use of massage, therapeutic exercises, cold, heat, hydrotherapy, electrical stimulation, or light therapy; to improve the general physical condition and reduce stress levels;[9] or to assist with the development of a set of guidelines for patient activity. A physiatrist may not only be able to assist in confirming the diagnosis but also in performing nerve blocks (injection of an anesthetic to "deaden" a specific nerve pathway), facet injections (use of a corticosteroid to decrease inflammation around a nerve root), and in recommending appropriate physiologic therapies.

The other specialists that you may wish to consult include a pain clinic referral[9] (a facility supervised by a physician, usually an anesthesiologist, who specializes in pain management) for nerve blocks and other injections; a chiropractor[9] (a practitioner who uses spinal manipulation to treat disorders of the nervous system); or a homeopath[9] (a practitioner who uses a system of therapeutics based on the theory that "like cures like"). Due to the emotional impact of chronic pain, a referral to a behavioral therapist may be appropriate. This therapist may suggest various therapies to improve the patient's coping level, reduce stress, and raise the pain threshold, which include relaxation, biofeedback, distraction, or attendance at a support group.[9] "Early referrals for nerve blocks and injections can promote the effectiveness of physiotherapy and pain rehabilitation."[8] While you hate to discourage activity with chronic pain, management of pain requires that the patient achieve a balance between activity and rest.

What pharmacologic options are available for the nurse practitioner who wants to help his or her patients maintain their functional levels? "Pharmacologic interventions follow the guidelines of the three-step analgesic ladder for pain control as developed by the World Health Organization (WHO). Step 1: Mild pain is usually treated with aspirin, acetaminophen, or nonsteroidal antiinflammatories (NSAIDs).[11] This is usually not an appropriate treatment level for neuropathic pain. Step 2: "Step 2 of the WHO three-step ladder includes mild opiates" along with the adjuvant medications."[9] In this instance, the nurse practitioner may be delaying or minimizing the use of stronger opiods (i.e. morphine) which are reserved for moderate-to-severe pain (Step 3 of the WHO ladder). This combination can decrease the incidence of side effects and increase the functional level of patients. Which medication is best? Table 4 suggests options. However, the bottom line is "how functional is your patient with this medication?" Current guidance is that for neuropathic pain, "tricyclic antidepressants are the initial drugs of choice" .amitryptyline, nortriptyline, imipramine, or desipramine." "Second line medications are anticonvulsants that include phenytoin, carbamazepine, and valproic acid" . (they) are especially helpful in cases of neuralgia and paresthesia."[15] Atypical anticonvulsants have had a role in neuropathic pain treatment, ie, gabapentin (Neurontin). The Food and Drug Administration (FDA) also has recommendations based on research.

Antidepressants should be used with caution in patients whose psychiatric history is unknown. A patient with an undiagnosed bipolar disorder can be placed in a hypomanic state or in a state of rapid cycling subsequent to initiation of an antidepressant.[15] Tricyclic antidepressants, ie, amitriptyline (Elavil) have been used as an adjunctive in treatment of neurogenic pain. They are believed to inhibit reuptake of serotonin and norepinephrine. Amitriptyline has multiple drug effects and antiarrythmic effects. Dosing this medication at bedtime can help reduce the impact of sedation. It is a pregnancy category D.[15] It is investigational for adjunctive analgesia with phantom limb pain, migraine, diabetic peripheral neuropathy, peripheral neuropathy pain, and post herpetic neuralgia.[14] Doxepin (Sinequan) works similarly to amitriptyline but with more sedation. Its pregnancy category is NR.[15] Nortriptyline can be used for chronic severe neurogenic pain.[14] Desipramine is investigational for severe neuropathic pain.[14] Imipramine has been used for severe neuropathic pain but has a seizure risk with high therapeutic dosages.[14]

Other antidepressants used for pain control include venlafaxine (Effexor), which potentiates neurotransmitter activity in the CNS, especially serotonin and norepinephrine with weak potentiation of dopamine. This medication should not be discontinued abruptly. It is a pregnancy category C.[15] Duloxetine (Cymbalta) works similarly to venlafaxine. It was the first medication to have FDA approval for diabetic peripheral neuropathy. With duloxetine, you must use caution with severe renal and hepatic disease. It is a pregnancy category C (Lilly insert). With any medication that increases serotonin levels, be aware of the risk of serotonin syndrome. This is especially true when "triptans" (medications used to prevent migraines) and SSRIs (selective serotonin reuptake inhibitors) are used together.[13]

Anticonvulsants have been considered second line for neuropathic pain. One of the most commonly used drugs is gabapentin (Neurontin). It is believed to be a competitive and reversible inhibitor of acetycholinesterase, which decreases the available acetycholine for nerve impulse transmission. The dosage needs to be reduced if the patient has altered renal function. It is a pregnancy category C.[15] It is considered an investigation drug for neuropathic pain and prevention of migraines. It has been approved for treatment of post herpetic neuralgia (PHN). It can be dosed up to 1800 mg/day in three divided doses.[14] Pregabalin (Lyrica) has obtained FDA indications for post herpetic neuralgia, diabetic peripheral neuropathy, and primary fibromyalgia syndrome. It is believed to be a GABA analog that reduces calcium dependent release of several neurotransmitters. The dosing for pregabalin is more linear than that of gabapentin (Pfizer insert).[13]

Another anticonvulsant, carbamazepine (Tegretol) is commonly used for trigeminal neuralgia and restless leg syndrome. It reduces the post tetanic potentiation of synaptic transmissions (it possibly depresses activity in the nucleus ventralis anterior of thalamus, thus decreasing polysynaptic responses).[14] This medication is well known for its multiple drug interactions, especially with warfarin, tricyclic antidepressants, and monamine oxidase inhibitors. It is a pregnancy category D.[15] Valproic acid (Depakene) acts by increasing levels of GABA, an inhibitory transmitter. It may also improve membrane stability by affecting the potassium channel. It has been used for prophylaxis of migraine headache.[14] Concerns include decreased hepatic function, multiple drug interactions, and that it is pregnancy category D.[15] Phenytoin (Dilantin) has also been indicated for neuretic pain"'migraine, trigeminial neuralgia, Bell's palsy. This medication acts by stabilizing neuronal membranes by decreasing the influx of sodium ions across the cell membranes in the motor cortex during generation of nerve impulses. Concerns include hydantoin hypersensitivity, slowed cardiac conduction, and hepatic dysfunction. This medication is also a pregnancy category D.[15] It is considered investigational for trigeminal neuralgia.[14] In theory, any anticonvulsant could be used as an adjuvant. However, be wary of medications not commonly used for pain control. In my practice, the drug Gabitril (tiagabine) has precipitated seizures in nonepileptic patients and should not be used "off label." In fact, an FDA alert was issued February 28, 2005 discouraging off-label use of this medication due to seizure risk in nonepileptics.[13]

Other medications that can be used include skeletal muscle relaxants, ie, lioresal (Baclofen), which has a twofold effect. It inhibits transmission of monosynaptic and polysynaptic reflexes and it causes muscle relaxation. It has indications for analgesia and trigeminal neuralgia. This medication should not be withdrawn abruptly.[15] Its function is related to GABA with CNS depressant effects. It is investigational for trigeminal neuralgia, prevention of migraines, and neuropathic pain.[14] Chloroxazone (Parafon forte) modifies the central perception of pain through its sedative effects. Possible side effects can include angioedema and anaphylaxis.[15]

Do not overlook topical analgesics. In fact, some authors suggest that topical lidocaine should be the first pharmacologic intervention.[8] The three classes most commonly used include[5]:

Local anesthetics "' lidocaine and mexiletine (Mexitil) interfere with the exchange of sodium in the sodium channel. (Some patients find Biofreeze effective at decreasing pain.)

Formulations containing antiinflammatories

Topical capsaicin "' depletes substance p and decreasing transmission of pain impulses.

Consider having a compounding pharmacist tailor topical medications. Consult with the pharmacist regarding the specific compounds and their concentration. Table 5 provides a reference for discussion. Topicals are ideal when patients desire decreased side effects and decreased liver involvement.

Another consideration when choosing an adjuvant is the associated conditions that interfere with pain management. Has the patient recently started on a "statin" for lowering cholesterol levels? Does the patient also suffer from arthritis, muscle spasms, restless leg syndrome, insomnia, diabetes mellitus, or depression? Sometimes treating other conditions allows medications for chronic pain syndromes to work more effectively. Comorbidities may point to appropriate adjuvants. Tricyclic antidepressants are helpful if insomnia is a concern. Baclofen has been known to help with neuropathic pain due to its neurotransmitter and CNS effects. "Steroids have been and continue to be administered by multiple routes for complex regional pain syndrome therapy."[12] Methylprednisolone (Medrol dose pak) is an antiinflammatory and immunosuppressant that can provide significant relief when inflammation is present. It is not for long-term use.[15] "Nonsteroidal anti-inflammatory drugs, physical therapy, accupuncture, antidepressants, and antiepileptics have been used as adjunctive treatment for chronic low back pain."[12] Clonidine (Catapress) stimulates the alpha andrenergic receptors in the CNS, which inhibits the sympathetic vasomotor center and decreases nerve impulse transmission, thus decreasing pain. Side effects include bradycardia and hypotension. This medication has been used for post herpetic neuralgia and restless leg syndrome.

"Pain management requires ongoing evaluation, patient education and reassurance. Diagnostic evaluation of treatable underlying conditions (eg, spinal cord compression, herniated disc, neoplasm) should occur concurrently with pain management."[8] For many patients with neuropathic pain, the nurse practitioner who has developed a comprehensive plan of care and has a strong network for referrals can be the most appropriate primary care provider. However, severe intractable pain may require referral to a pain clinic or neurosurgeon (if significant damage is identified during diagnostic studies). In most cases, "treatments with the lowest risk of adverse effects should be tried first."[8]

There is both an art and a science to pain management. Rowbotham states that the "Treatment of complex regional pain syndrome is largely empirical."[12] Sometimes trial and error is the best guide with any neuropathic pain. Both the practitioner and the patient need a willingness to try various options. If "pain is whatever the person experiencing the pain says it is, existing whenever the patient says it does,"[17] perhaps optimal functioning can be defined similarly. Can optimal functioning be defined as being achieved when the patient can satisfactorily perform at their chosen activity level? My bail bondsman, Tom, is a case in point. After multiple trials, he started using pregabalin as an adjuvant. His pain was more controlled, he felt as if he was "in control," and he became better able to function without excessive sedation. An unqualified success. 

There is both an art and a science to pain management. Rowbotham states that the "Treatment of complex regional pain syndrome is largely empirical."[12] Sometimes trial and error is the best guide with any neuropathic pain. Both the practitioner and the patient need a willingness to try various options. If "pain is whatever the person experiencing the pain says it is, existing whenever the patient says it does,"[17] perhaps optimal functioning can be defined similarly. Can optimal functioning be defined as being achieved when the patient can satisfactorily perform at their chosen activity level? My bail bondsman, Tom, is a case in point. After multiple trials, he started using pregabalin as an adjuvant. His pain was more controlled, he felt as if he was "in control," and he became better able to function without excessive sedation. An unqualified success. 

References (click to open)
Journal for Nurse Practitioners. 2008;4(4):263-270. © 2008 Elsevier Science, Inc.

http://webcache.googleusercontent.com/search?q=cache:DtqGKvHZDuoJ:www.medscape.com/viewarticle/576064+&cd=1&hl=en&ct=clnk&gl=nl&client=firefox-b-ab