TENS units, vitamins and peripheral neuropathy

Most clinicians who work with peripheral neuropathy begin to adopt the mindset that if anything (legal!) helps a patient feel better they should do it. If it can provide some peripheral neuropathy relief and still be safe it may be worth a try.
In our practice working with hundreds (maybe thousands by now?) we have had reports of many things that patients have felt helped at least a little.
You will see that most options are for patients that have pain with their neuropathy. More evidence points to there being a large population of patients that have non-painful neuropathy. These patients unfortunately have even fewer options as the medications have no way to “numb” their numbness. And you can’t medicate to better balance. Here I write about the numbness and mobility side of neuropathy if you care to take a look.

As always, before messing around with some of these, especially with the supplements, ask your doctor for the ok to try these.

In no particular order and my comments are in quotations and bold:
• Amino acids
• Alpha Lipoid Acid
• Acetyl L Carnitine
“Amino acids are the building blocks of protein and these two in particular have a decent amount of research on them with regards to nerve function. Worth a try IMO.”
• EPA/DHA or Fish Oils
“I tend to like these. Like the amino acids above, anything (anti-oxidant) that tends to lower the oxidative stress on the body could be helpful in reducing the pain side of the neuropathy.”

• Acupuncture
“Some patients have said it provided some relief and more that said they did not notice any difference. There is not much downside. I am certified in acupuncture but due to my own experience with it I do not perform it on our neuropathy patients.”

• Biofeedback
“No real experience with this. Other than time I can’t see how it would hurt anyone.”

• Tighter fitting shoes
“Some patients like having something in contact with the skin. They say it decreases some of the discomfort.”

• Loose fitting shoes
“Most patients like to have more room in the shoes especially in the toebox.”

• Wearing no shoes
“Some patients would rather wear no shoes when they are not standing but even they tend to feel more comfortable with some support.”

• Grains of rice in the shoe
“This is interesting as I could see it providing more stimuli to functioning proprioceptive fibers to perhaps help with balance? We have one patient who swears by this but I do worry about the dry rice abrading the skin of the foot and causing a sore. I wouldn’t recommend this at this time.”

• Massage
“I think this can be helpful in the short term as there is commonly a sensation of tightness that comes with peripheral neuropathy.”

• Miscellaneous anecdotes
Walking on the beach barefoot.
“Some have said it felt great, others that the sand felt like broken glass”

• Laser treatment for neuropathy
“There is no “neuropathy laser”. There is evidence that controlling parameters such as dosage can provide significant relief from neuropathy. This is one thing we do in our neuropathy centers. We see significant reduction in all symptoms of neuropathy – not just pain. You can see a link to live (i.e. real patient) data here or you can look at a randomized clinical trial we just completed here but they will charge for the copy. If you would like a free copy mailed to you just click here and let us know where to send it.”
Unfortunately there are companies that sell marketing packages to clinics who might not have a clue what they are doing. Maybe they have “a laser” or some electric pads or vitamins or any combination thereof. Ask to see their data. Unfortunately most will only have unsupported claims and a handful of testimonials.”

• TENS (Basically anything with sticky pads that sends an electrical current through the body)
“Some patients report that they have some temporary relief of a portion of their pain. Many say they feel something happening when they are using them but as soon as they take the pads off their pain returns. TENS units are VERY AFFORDABLE nowadays. In my opinion don’t pay hundreds or thousands of dollars when quality units can be ordered from Amazon.com for $20-40.”

Anything that helps this frustrating disease is worth investigating! I’ve become very interested lately in oxidative stress and general inflammatory state as it pertains to the treatment of peripheral neuropathy. Stay tuned!
Timothy Kelm DC is one of the clinicians at Realief Medical PA. Since 2007 ( or as he would put it, before you ever saw an advertisement for neuropathy therapy) he has worked with many patients with peripheral neuropathy. He also trains new clinicians for Biolyst LLC, a medical company working for solutions to peripheral nerve damage. He has presented at the University of Minnesota Gynecological

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