Wednesday, August 10, 2016

Wisdom Wednesday: Neuropathy

Neuropathy or nerve pathology is a term used to describe damage to a nerve as opposed to pain and inflammation. The signs of neuropathy are numbness, tingling and/or loss of strength but often these symptoms are overshadowed by pain.

Think of neuropathy as a loss of nerve function. If the damage is to the afferent nerve (signals going to the brain) supply, then the loss is sensory. If the efferent nerves (signals coming from the brain) are damaged, then a loss of motor control ensues.

Let’s look at sciatica, where the pain runs from the spine down the back of the leg. True sciatica effects approximately 5% of the population but many physicians continue to call all leg pain “sciatica”. When the nerve is just inflamed, treatment is fairly straight forward – correction of all injury reflexes, reduction of inflammation with supplementation and spinal/pelvic manipulation will resolve most cases is a couple of weeks.

However, if the sciatic neuralgia (nerve pain) is complicated by neuropathy, the prognosis is less favorable. In addition to the treatment described above, the nerve must also heal. Unfortunately, peripheral nerves are the slowest healing tissue in the human body.

The most common cause of neuropathy is diabetes. Over 50% of all Americans are either diabetic or pre-diabetic. About half of that number are developing neuropathy but currently are asymptomatic. The other half are well aware of their neuropathy symptoms.

It is said that all diabetics develop sciatica and are never cured. While that statement is certainly not true there is some truth in that statement.

I rely on two herbs and a former B vitamin to support healing from neuropathy. If a sciatic patient has no objective findings of neuropathy, I prefer to concentrate on reducing inflammation. However, once the inflammation is under control, if the patient is not responding well, it’s time to consider treating for neuropathy even if all the findings are symptomatic.

St. John’s Wort is my herb of choice. In addition to promoting healing of the nervous system, it has strong antiviral activity. Both Bell’s Palsy and shingles (forms of neuropathy) response extremely well to St. John’s Wort.

My second choice is inositol, the former B vitamin. I’ve posted a previous blog on this supplement that you can review by searching for the word “inositol”. If a patient is taking Coumadin or an antidepressant then St. John’s Wort is contraindicated but inositol is still quite safe. As our population ages more and more patients are on one or more of these drugs.

More recently, I’ve begun using Velvet Bean, another herb, in the treatment of neuropathy with some success. I originally used it to treat Parkinson’s disease and restless leg syndrome but my patients frequently noted reduction in neuropathic symptoms while taking Velvet Bean.

The Bottom Line:
Neuropathy is treatable and often curable with the correct nutritional support. However, it is important to determine and eliminate the causes of neuropathy if possible. Most importantly practitioners must be constantly on guard for the signs and symptoms of neuropathy as it complicates the simplest of conditions.

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