Diabetic and Neuropathy Treatment Centers is a paid sponsor of Sonoran Living Live
Robb Leigh, MD
Medical Director, Diabetic & Neuropathy Treatment Centers, Phoenix, AZ
Peripheral Neuropathy is a condition where nerves outside the central nervous system are affected and don't work properly. It is a huge health concern as it affects approximately 25 million people in the United States.
The nervous system is divided into Central Nervous System consisting of the brain, the brainstem and the spinal cord, and Peripheral Nervous System which is composed of the nerve roots that exit the spinal cord and reach all organs in our system. The nervous system is like a tree upside-down. The brain and the brainstem are the tree root and the spinal cord, the tree trunk. Think about a pine tree. Just like it gives out branches as it goes straight up, the spinal cord gives out branches as it goes straight down.
In peripheral neuropathy the nerve endings become diseased and they start to atrophy (or shrink) progressively through the years. The distancing of the nerve endings from the skin causes numbness. Numbness on the soles of our feet causes unsteadiness and falls as the feedback from the soles of our feet called proprioception is necessary for maintaining proper balance. In addition, the nerve endings are inflamed (or irritated) and keep firing impulses when there isn't much happening. These signals are interpreted by our brain as aching, burning, tingling, pins & needles, or stabbing pain. Therefore, people with peripheral neuropathy experience numbness, unsteadiness and discomfort that can range from aches to burning, to pins & needles, and to sharp shooting pains. Their quality of life is significantly affected as trivial activities of daily living become major hurdles. They can no longer enjoy recreational and sporting activities such as walking, hiking, running, playing tennis or golf, because their balance is affected and the discomfort is such that it takes the enjoyment away and they cannot continue on.
The commonest cause of peripheral neuropathy is diabetes, which is responsible for about a third of cases of peripheral neuropathy. Other common causes are chemotherapy and radiation therapy for cancers, conditions affecting the low back area such as bulging discs, injuries or surgeries, and toxic exposures. Autoimmune disorders such as lupus or rheumatoid arthritis are also fairly common and alcoholism and vitamin deficiencies can also cause neuropathy. Kidney disease, liver disease and hypothyroidism can also cause neuropathy and the list is quite extensive.
Fortunately, peripheral neuropathy can now be treated with a new treatment modality called Electrochemical Analgesia. The treatment consists of electricity applied through electrode pads in combination with nerve blocks. Although some resemblance exists between TENS units and electronic devices specifically built for the treatment of neuropathy, the devices made for the treatment of neuropathy are calibrated in a very specific way to target the pain signal carrying nerve fibers. Therefore, these devices and TENS units are markedly different in their utility and one cannot replace the other.
You are likely to receive a nerve block when you go to your dentist for a dental work. We perform a similar procedure on the peripheral nerves that carry pain signals from the feet. Dentists use Novocaine and we use Marcaine, a very similar local anesthetic but it lasts longer. Researchers found out that when both electricity and nerve block treatments are given together twice a week for a period of 8 to 16 weeks it produces the best results that are long-lasting. The observed results were synergistic with the result of combined therapy being greater than the sum of individual results. This combined electroanalgesia treatment allows the tissues to open up the blood vessels carrying more oxygen and nutrients to the extremities, optimizes the tissue environment by clearing toxic metabolites, and allows the nerves to relax, heal the inflammation and start to regenerate their diseased endings that have shrunk. The nerve blocks stop the conduction of painful impulses alleviating the discomfort and also giving the nerve endings a chance to relax and regrow. Biopsy results in patients before and after treatment show that the nerve endings actually grow back and nerve conduction studies also support the same results with improved nerve conduction after treatment, all consistent with clinical improvement experienced by patients. The electrochemical analgesia has revolutionized the treatment of neuropathy, has been cleared by the FDA and it is covered by Medicare and major health insurances.
Conventional treatment for peripheral neuropathy consists of administering medications such as Neurontin, Lyrica or Cymbalta. Some patients even require narcotic medications because their pain is so severe. These drugs act on the brain easing the perception