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/

Neuropathic Symptoms And The Cold Vid

Today's short video from beatingneuropathy.tv (see link below) is the latest from Dr. Hayes giving advice on how best to deal with extreme cold weather when you have nerve damage and chronic pain. Always worth a few minutes of your time.

Episode 41: Cold and Neuropathy Pain? YES! Here is What to Do! 
Posted by John Hayes Jr Thursday, January 9th, 2014

If you suffer from neuropathy, fibromyalgia, or really any form of chronic pain you already understand how the cold-weather can aggravate. In this brief video Dr. Hayes discusses practical steps you can take today to help you feel better almost immediately!



http://beatingneuropathy.tv/2014/01/episode-41-cold-and-neuropathy-pain-yes-here-is-what-to-do/

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Intra Muscular Vitamin D Injections Reduce Neuropathy Symptoms

Today's post from vitamindcouncil.org (see link below) makes some remarkable claims about the benefits of a single, high-dosage injection of vitamin D for neuropathy patients. The results were seen after some weeks and had no effect on the disability of a patient but definitely on the severity of their symptoms. Personally, I find it an encouraging research but it definitely needs some significant follow-up to confirm its conclusions. The injections were intra-muscular and therefore administered by a doctor or medical professional, which may be a good thing, to dissuade people from rushing to the supplement store to swallow 600,000 IU of vitamin D in pill form in one go! Vitamin D supplementation has been a buzz therapy among the neuropathy communities for some time now but most doctors will agree that vitamin D supplementation is only really necessary if there is proven vitamin D deficiency. The word has it that it is certainly beneficial for nerve health but you need to do more of your own research and consult with a trusted medical professional before embarking on a self-help course of vitamin D. Most articles place an emphasis on diabetes-related neuropathy patients but as we all know by now, that's only because the vast majority of neuropathy sufferers come from the diabetic community. Most information regarding neuropathy applies to the condition irrespective of its cause. More articles can be found by using the search button to the right of this blog.

Research finds vitamin D to be a safe and effective treatment for painful diabetic neuropathy
Posted on April 11, 2016 by Amber Tovey

A new study published in the journal BMJ Open Diabetes Research and Care discovered that treatment with a single intramuscular dose of 600,000 IU of vitamin D in patients with painful diabetic neuropathy caused significant reductions in symptoms.

Diabetic neuropathy is a type of nerve disorder that can occur if a person has diabetes. High blood sugar can injure nerves throughout the body, but diabetic neuropathy most commonly affects nerves in the legs and feet. It often causes pain and numbness in the extremities, but may also cause problems in the gastrointestinal tract, urinary tract, blood vessels and heart.

Approximately 21% of the population is affected by painful diabetic neuropathy. Treatments for diabetic neuropathy are limited. The therapeutic effectiveness for all medications is at best near 50% pain relief. In addition, most of the medications are accompanied by unwanted side effects. This has left the medical community searching for new treatments.

A previous study suggested vitamin D supplementation may help treat diabetic neuropathy. The researchers found that weekly vitamin D supplementation of 50,000 IU for 8 weeks reduced symptoms but not disability. In an effort to confirm the treatment effect of vitamin D on diabetic neuropathy, researchers recently conducted a prospective open-labeled trial in Pakistan.

A total of 143 patients with type 1 or type 2 diabetes were included in the study. All patients received a single intramuscular dose of 600,000 IU of vitamin D3.

Pain was assessed using three different questionnaires: The Douleur Neuropathique 4 (DN4), total McGill pain and Short Form McGill Pain Questionnaire (SFMPQ). The researchers wanted to compare pain severity before and after the administration of the vitamin D injection. Here is what they found:
Average vitamin D levels increased from 31.7 ng/ml at baseline to 46.2 ng/ml at week 20.
Total McGill pain score, DN4 and SFMPQ significantly decreased after vitamin D administration (p is less than 0.001).

The researchers concluded,

“The administration of 600 000 IU of vitamin D results in a modest but significant increase in 25(OH)D levels measured at 20 weeks. This improvement in 25(OH)D levels was associated with an improvement in several independent measures of PDN, which became significant approximately 10 weeks after administration of vitamin D.”

The researchers noted that the average vitamin D levels of the patients at baseline was much higher than previous studies, indicating that a proportion had likely received vitamin D supplementation from their primary physician previously. This shows vitamin D supplementation has become a more widely accepted practice for diabetic patients.

Future studies should follow a randomized controlled trial design and use a daily dosage regimen.

Citation

Tovey, A.; Cannell, JJ. Research finds vitamin D to be a safe and effective treatment for painful diabetic neuropathy. The Vitamin D Council Blog ; Newsletter, 2016.

https://www.vitamindcouncil.org/blog/research-finds-vitamin-d-to-be-a-safe-and-effective-treatment-for-painful-diabetic-neuropathy/

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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/

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Symptoms And Causes Of Neuropathy

Today's post from mayoclinic.org (see link below) is a no frills, simple neuropathy 123 description of the disease, its symptoms and its causes. You can use it to educate yourself, or friends, family and co-workers and to build up enough basic knowledge to at least have a sensible discussion with your doctor or neurologist. It's amazing how much more respect you get from doctors if you've done a little homework and it enables them to get down to the nitty gritty of treatment without spending too much time on explanation.

Peripheral neuropathy Symptoms and causes
By Mayo Clinic Staff 2016

Symptoms

Every nerve in your peripheral system has a specific function, so symptoms depend on the type of nerves affected. Nerves are classified into:
 
Sensory nerves that receive sensation, such as temperature, pain, vibration or touch, from the skin
Motor nerves that control muscle movement
Autonomic nerves that control functions such as blood pressure, heart rate, digestion and bladder

Signs and symptoms of peripheral neuropathy might include:
 
Gradual onset of numbness, prickling or tingling in your feet or hands, which can spread upward into your legs and arms
Sharp, jabbing, throbbing, freezing or burning pain
Extreme sensitivity to touch
Lack of coordination and falling
Muscle weakness or paralysis if motor nerves are affected

If autonomic nerves are affected, signs and symptoms might include: 
 
Heat intolerance and altered sweating
Bowel, bladder or digestive problems
Changes in blood pressure, causing dizziness or lightheadedness

Peripheral neuropathy can affect one nerve (mononeuropathy), two or more nerves in different areas (multiple mononeuropathy) or many nerves (polyneuropathy). Carpal tunnel syndrome is an example of mononeuropathy. Most people with peripheral neuropathy have polyneuropathy.
When to see a doctor

Seek medical care right away if you notice unusual tingling, weakness or pain in your hands or feet. Early diagnosis and treatment offer the best chance for controlling your symptoms and preventing further damage to your peripheral nerves.

Causes

Not a single disease, peripheral neuropathy is nerve damage caused by a number of conditions. Causes of neuropathies include: 

Alcoholism. Poor dietary choices made by people with alcoholism can lead to vitamin deficiencies. 

Autoimmune diseases. These include Sjogren's syndrome, lupus, rheumatoid arthritis, Guillain-Barre syndrome, chronic inflammatory demyelinating polyneuropathy and necrotizing vasculitis. 

Diabetes. More than half the people with diabetes develop some type of neuropathy.

Exposure to poisons. Toxic substances include heavy metals or chemicals.
Medications. Certain medications, especially those used to treat cancer (chemotherapy), can cause peripheral neuropathy.

Infections. These include certain viral or bacterial infections, including Lyme disease, shingles, Epstein-Barr virus, hepatitis C, leprosy, diphtheria and HIV.
Inherited disorders. Disorders such as Charcot-Marie-Tooth disease are hereditary types of neuropathy.

Trauma or pressure on the nerve. Traumas, such as from motor vehicle accidents, falls or sports injuries, can sever or damage peripheral nerves. Nerve pressure can result from having a cast or using crutches or repeating a motion such as typing many times.

Tumors. Growths, cancerous (malignant) and noncancerous (benign), can develop on the nerves or press nerves. Also, polyneuropathy can arise as a result of some cancers related to the body's immune response. These are a form of paraneoplastic syndrome.

Vitamin deficiencies. B vitamins — including B-1, B-6 and B-12 — vitamin E and niacin are crucial to nerve health.

Bone marrow disorders. These include abnormal protein in the blood (monoclonal gammopathies), a form of bone cancer (osteosclerotic myeloma), lymphoma and amyloidosis.

Other diseases. These include kidney disease, liver disease, connective tissue disorders and an underactive thyroid (hypothyroidism).

In a number of cases, no cause can be identified (idiopathic).

Risk factors
Peripheral neuropathy risk factors include:
Diabetes mellitus, especially if your sugar levels are poorly controlled
Alcohol abuse
Vitamin deficiencies, particularly B vitamins
Infections, such as Lyme disease, shingles, Epstein-Barr virus, hepatitis C and HIV
Autoimmune diseases, such as rheumatoid arthritis and lupus, in which your immune system attacks your own tissues
Kidney, liver or thyroid disorders
Exposure to toxins
Repetitive motion, such as those performed for certain jobs
Family history of neuropathy
Complications

Complications of peripheral neuropathy can include: 
 
Burns and skin trauma. You might not feel temperature changes or pain on parts of your body that are numb.
Infection. Your feet and other areas lacking sensation can become injured without your knowing. Check these areas regularly and treat minor injuries before they become infected, especially if you have diabetes mellitus.
Falls. Weakness and loss of sensation may be associated with lack of balance and falling.

http://www.mayoclinic.org/diseases-conditions/peripheral-neuropathy/symptoms-causes/dxc-20204947

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Sildenafil Improves Neuropathy Symptoms

Today's post from nutritionreview.org (see link below) is the latest in a range of posts on the Net expounding the virtues of sildenafil (viagra amongst others) not for erection difficulties but for neuropathic symptoms and problems. The research has been confined to mice at this point but is gradually being expanded and you have to wonder what people's real-life experiences are. Because neuropathy can seriously affect your sex life (either through pain or through malfunction of the necessary nerves) it's entirely likely that many neuropathy patients have been taking sildenafil regularly to improve sexual performance but have they also noticed any side effects which back up the theory that it will improve nerve function? And what about women? Can they take sildenafil too? Over to you!

ED Drug Relieves Diabetic Peripheral Neuropathy in Animal Study
by NutritonReview.org on August 3, 2015 ·

New animal studies at Henry Ford Hospital reveal that sildenafil, a drug commonly used to treat erectile dysfunction, may be effective in relieving painful and potentially life-threatening nerve damage in humans with long-term diabetes. The research targeted diabetic peripheral neuropathy, the most common complication of diabetes, affecting as many as 70 percent of patients. Lei Wang, M.D., the Henry Ford neuroscientist who led the research, said that although numerous drugs have been shown to be effective in earlier animal experiments, most have not provided benefits in clinical trials.

“Generally, young diabetic animals with an early stage of peripheral neuropathy are used to investigate various drug treatments,” Dr. Wang explains. “But patients with diabetes who are enrolled in clinical trials often are older and have advanced peripheral neuropathy.

“Failure to develop and properly evaluate treatments in the laboratory that properly reflect the target clinical population with diabetic peripheral neuropathy may contribute to the failure of clinical trials.”

To mimic clinical trials in which diabetes patients have advanced peripheral neuropathy, the Henry Ford researchers chose male mice with type II diabetes that were 36 weeks old, roughly equivalent to middle age in humans.

Earlier animal experiments showed that sildenafil, commonly known by the brand name Viagra, improved blood supply to the sciatic nerve. In addition, it was noted that diabetes patients who took Viagra for erectile dysfunction had fewer symptoms of peripheral neuropathy. However, it was not known if this therapeutic effect held true for long-term peripheral neuropathy because the diabetic mice used in the previous experiments were relatively young – 16 weeks old.

So the researchers chose diabetic mice that were more than twice as old. In one group, 15 such mice were treated with an oral dose of sildenafil/Viagra every day for eight weeks. A control group of 15 age-matched diabetic mice were treated daily with the same amount of saline.

After a battery of nerve and function tests were performed on both the drug-treated and control groups, results “revealed that sildenafil markedly improved sensory function starting at six weeks after treatment compared with saline-treated diabetic mice,” Dr. Wang says.

“These data indicate that sildenafil improves neurological function even in middle-aged mice with long-term diabetic peripheral neuropathy.”

While stressing that the findings remain experimental, Dr. Wang says they provide new insights into the underlying mechanisms of long-term diabetic nerve damage and may lead to the development of a sildenafil treatment for long-term diabetic peripheral neuropathy.

Diabetic peripheral neuropathy is particularly insidious because, as it progresses and damages nerves in extremities and other parts of the body, many patients are unaware of it because pain sensors are numbed.

As a result, a cut or sore on the bottom of a foot, for instance, may not be noticed until an infection sets in and spreads, possibly leading to amputation or even death.

Because diabetic neuropathy results from chronically high blood sugar levels, diabetes patients are strongly encouraged to closely monitor those levels and control them through diet.

Over-the-counter and prescription drugs – including antidepressants and opiates – are available to treat neuropathy pain, but often have undesirable side effects.

Source: Lei Wang, Michael Chopp, Alexandra Szalad, LongFei Jia, XueRong Lu, Mei Lu, Li Zhang, Yi Zhang, RuiLan Zhang, Zheng Gang Zhang. Sildenafil Ameliorates Long Term Peripheral Neuropathy in Type II Diabetic Mice. PLOS ONE, 2015; 10 (2): e0118134 DOI: 10.1371/journal.pone.0118134

Journal Link: http://journals.plos.org/plosone/article?id=10.1371%2Fjournal.pone.0118134

http://nutritionreview.org/2015/08/ed-drug-relieves-diabetic-peripheral-neuropathy-in-animal-study/

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