Thursday, 23 November 2017

Is Classifying Pregabalin And Gabapentin As Class-C Drugs, The Tip Of The Iceberg?

Today's short post from (see link below) is slightly worrying in several ways. While this blog is pretty much against using pregabalin (Lyrica) for neuropathic pain and has its doubts about gabapentin too - because of the potential for severe side effects - this move by the Advisory Council on the Misuse of Drugs (ACMD) to categorise them as class C drugs in the UK, may have disturbing ramifications for patients who find they they are the only things that control their nerve pain. Now while the current hysteria about opioids as prescription pain killers has led to lawmakers issuing bans left, right and centre, you can see how easily the trend can spread. Pregabalin (Lyrica) and Gabapentin both have well-documented side effect issues that are sometimes worse than the original pain itself but that applies to many drugs currently issued for neuropathy symptoms. There is also suspicion that they're just not that effective in dealing with nerve pain but does this mean that they should be banned. or listed as a 'dangerous drug'? The answer is; yes, probably but not before alternatives have been found that do the job better. Neuropathy patients are sick to death of being treated with drugs essentially meant for other illnesses, just because the theory says that pain receptors should react positively to them. This has been the case for decades but in all that time neuropathy patients have learned to make do with what's available and take whatever relief these drugs may provide...because frankly, the alternative is unthinkable (this applies to opioid treatment too). Reading this article may lull you into a false sense of security that health authorities are trying to protect us from harmful drugs but actually, they're implementing using the sledgehammer to crack a nut theory, without any thought as to what the patient is supposed to do when all the options run out, or are banned. We're not guinea pigs and we already have to put up with second-hand, ineffective treatments but these are better than having absolutely nothing to control our nerve pain...and that is the logical outcome of such moves as outlined in this article. Well worth a read.

Pregabalin and Gabapentin set to become controlled drugs: uncertainty for CRPS and other Chronic Pain sufferers  
BLB Chronic Pain News Richard Lowes
Oct 2nd, 2017

Following our recent article regarding Pregabalin and its suggested link to a rise in deaths, it has now been announced that both Pregabalin and Gabapentin are set to become controlled ‘Class-C’ drugs. This followed the Advisory Council on the Misuse of Drugs (ACMD) recommending to the Home Office in January 2016 that they should be controlled, warning that both drugs “present a risk of addiction and a potential for illegal diversion and medicinal misuse.”

The Home Office has now accepted this recommendation, subject to a consultation.

Not effective

Dr Steve Brinksman of Substance Misuse Management in Group Practice network, said “they have psychotropic effects, which means patients are likely to continue taking them even if they are not proving effective. They probably do have a withdrawal effect – though that has not been proven conclusively yet”.

Earlier this year, a Cochrane Review concluded that Gabapentin “can provide good levels of pain relief to some people with postherpetic neuralgia and peripheral diabetic neuropathy” but “evidence for other types of neuropathic pain is very limited.” Further, “over half of those treated with gabapentin will not have worthwhile pain relief but may experience adverse events.”

This followed a study published last year by researchers from the University of Kentucky that found that misuse of Gabapentin was “40-65% among individuals with prescriptions”. In this study, misuse was defined as using Gabapentin “primarily for recreational purposes, self-medication or intentional self-harm” where it is “misused alone or in combination with other substances, especially opioids, benzodiazepines and/or alcohol.”

Concern for chronic pain sufferers

Many thousands of people in the UK suffering CRPS and other forms of chronic pain take Pregabalin or Gabapentin as part of their daily medication regime. It is yet to be seen exactly how the re-classification of the drugs will affect not only those already taking them, but also those who develop chronic pain in the future. However, at the very least it is bound to result in a greater reluctance among doctors to prescribe them.

Whilst there are clearly a minority of people misusing these drugs for a variety of purposes, for the majority the thought of their possible withdrawal will undoubtedly cause concern. People suffering chronic pain often find themselves taking Pregabalin or Gabapentin following considerable trial and error in exploring what type and combination of medication best suits them and their condition, including the ‘pain versus side effects’ set off. For many there is unlikely to be a readily identifiable alternative.

I have spoken today to one client with CRPS who takes Pregabalin in conjunction with Amitriptyline and Celebrex. It is now 18 months since she was first prescribed Pregabalin and whilst her daily dosage required increasing initially, she reports that since adding Pregabalin to her medication, her level of pain has improved. Whilst she does experience some side effects including drowsiness and occasional slurred speech, she is able to function better and, with less pain, her sleep has improved. She says that “since I heard the news last week I am dreading what might happen. I just hope that as my doctor knows I’ve gotten myself into a good routine that works, they’ll leave me alone.”

Wednesday, 22 November 2017

Oxycontin: The Devil's Drug, Or Misused, Misunderstood And Abused?

Today's post from (see link below) is a pretty heavy-hitting condemnation of Oxycontin and the pharmaceutical family company that brought it onto the market. My first instinct is to agree - Oxycontin is a dangerous and addictive drug if used wrongly and not controlled by the issuing doctor. However, after reading it again, the article comes across as pretty biased and (if you like) band-wagon-jumping. Like many articles of its type in reputable publications and written by reputable authors, it's a little thin on the evidence and a little quick to judge. By using Mark Zuckerberg's name and by portraying the company as being money-grabbing opportunists, it sells the whole issue somewhat short. What it doesn't mention is that Oxycontin was fully FDA approved and hundreds of thousands of doctors across the world, saw little wrong with it, providing it was used properly and the patient was kept under close control. Now I'm no friend of Oxycontin. I too was on it for some time and only with great difficulty managed to wean myself off it as the side effects started to take hold and the nerve pain was hardly touched but to portray it as the root of all evil, pays lip service to the current hysteria about opioids rather than being based on solid evidence. The problem is the criminality with which it's associated. The fact that on the street, Oxycontin costs more than heroin and that that's the reason that people are returning to heroin as a cheaper alternative, is a criminality issue rather than a shortcoming of the drug itself. Yes communities across the world are suffering from opioid and Oxycontin addiction and are turning to the black market to feed their addiction but that's a social problem rather than a problem with Oxycontin. Tackle the junks and the dealers people because thereby hangs the problem not with innocent patients who have been prescribed these drugs and then been left to get on with it. Doctors need to take responsibility for their actions. If you're going to prescribe any opioid it is your duty to monitor your patient closely so that addiction issues don't arise. The criminals are a tiny minority that have fed the opioid hysteria to the point that anybody taking opioids is branded and stigmatised. The dealers are the criminals, not the patients!


What is OxyContin, the drug behind America’s opioid crisis?
 By Xan Rice  19 November 2017

Since 1999, 200,000 Americans have died from overdoses connected to OxyContin and similar prescription drugs.

Ten months into his “listening” tour of America, the Facebook CEO, Mark Zuckerberg, better understands the big issues that have divided the country. Some he anticipated, such as the lost jobs and economic uncertainty resulting from technological advances and free trade. But there was one that he did not.

Speaking in Kansas on 10 November, Zuckerberg said his “biggest surprise by far” was the extent of the opioid crisis – fuelled by the overprescription of pain management drugs – and its effect on the American psyche. Around 64,000 people died from drug overdoses in the US last year – more people than died from Aids at the height of that epidemic, Zuckerberg noted. “It’s more people than die of car accidents and gun violence, I think, combined, and it’s growing quickly.”

Opioids are drugs derived from the juice of the opium poppy, including heroin and prescription painkillers, or their synthetic equivalents, such as fentanyl. The best-known painkiller and the one attracting the most criticism for its part in America’s opioid crisis is OxyContin.

For many years, doctors were wary of prescribing strong opioids, except in cases of extreme pain or palliative care, because of their well-known addictive properties. But Purdue Pharma, which was acquired by the doctors Raymond and Mortimer Sackler in the mid-20th century, sought to change this.

Their breakthrough product was a slow-release morphine pill, MS Contin. The drug dissolved gradually over several hours in a patient’s bloodstream, allowing cancer patients to sleep through the night. When MS Contin’s patent was due to expire, Purdue decided to develop a new drug that could be used much more widely for chronic pain. Instead of morphine, which carried a stigma among patients who weren’t terminally ill, Purdue designed a new slow-release pill made of pure oxycodone, another, more powerful, chemical derived from opium.

Purdue launched OxyContin in 1996, making a bold claim: one dose relieved pain for 12 hours, twice as long as generic alternatives. The company paid doctors and funded research to support the case that the addiction risk was exaggerated and that the drug was effective for a wide range of ailments, including less severe, long-term complaints such as back pain. As the New Yorker reported in October, Purdue marketed OxyContin as a remedy to “start with and to stay with”.

The pill was effective in helping many people with chronic pain who until then had received inadequate treatment and, by 2001, annual sales exceeded $1bn. But controversy was mounting. For some people, the drug only lasted for six or eight hours, resulting in withdrawal symptoms. This created “a cycle of crash and euphoria that one academic called ‘a perfect recipe for addiction’”, Esquire noted in a investigative report last month. Sales reps told doctors, many of whom mistakenly believed that oxycodone was weaker than morphine, to prescribe stronger doses rather than more frequent ones, increasing the risk of overdose. And addicts had worked out that the pills could be crushed and snorted for a quick, intense high.

Purdue settled a number of class action suits before they came to trial. But in 2007 it was charged by the US federal government with “misbranding a drug with intent to defraud or mislead”. The company paid $635m in fines, one of the largest pharmaceutical settlements in US history, and three executives pleaded guilty to misdemeanour charges. But sales continued to soar. OxyContin sales now total $35bn, and have made the Sacklers one of the richest – and most controversial – families in the US.

Since 1999, 200,000 Americans have died from overdoses connected to OxyContin and similar prescription opioids. Addicts who can no longer source or afford prescription drugs often turn to heroin. The American Society of Addiction Medicine says four in five people who try heroin today started with prescription painkillers.

Though many of the opioid-related deaths are linked to drugs other than OxyContin, many experts blame Purdue’s marketing tactics for the significant rise in prescriptions of opioids. For every million Americans, nearly 50,000 doses of opioids are taken daily – four times the rate in the UK.

In Kansas, Zuckerberg said that the crisis has influenced people’s attitude to policy issues. Seeing family and friends succumb to addiction has made people more fearful of crime and eager for border controls that could stop the flow of drugs, he said.

White, working-class, middle-aged people have been especially affected. The Princeton economists Anne Case and Angus Deaton have noted the rise in the number of “deaths of despair” – from suicide, overdoses and drug- and alcohol-related diseases – among that demographic. Decades of wage stagnation and the decline of well-paying jobs were the main underlying causes, they wrote in the Washington Post. But: “Opioids are like guns handed out in a suicide ward; they have certainly made the total epidemic much worse.”

Xan Rice is Features Editor at the New Statesman.

Tuesday, 21 November 2017

Bacterial Halloween Horrors That Attack The Nervous System

Today's post from (see link below) may scare the living daylights out of you because it deals with bacteria that directly attack the nervous system. Fortunately, they're relatively rare but they can all lead to one form of neuropathy or another, along with other nasty conditions. We're not talking viruses here but bacteria, that we normally deal with by taking antibiotics. However, these ailments need pretty strong antibiotic treatments, plus various other radical therapies. The point is that we should be aware that they exist, especially if we're suffering from neuropathic symptoms. That said, they're not an invitation for hypochondriacs to rush to their doctor insisting that they have one or another of these bacterial infections. Knowing where they come from and how they work is half the battle towards ruling them out and putting our minds at rest. If after careful research, you believe you may have been prey to an attack, talk it over with your doctor. That all said, this post is more a late Halloween gift than a reason for panic😊

The 7 most ruthless bacterial infections of the nervous system
November 17th 2917 Ibrahim Imam 

This is a follow up to our previous post, the 7 most devastating viral neurological infections. The list of bacteria that invade the nervous system is endless, but some stand out because of the fear they evoke, and the peril they pose. Here then are the 7 most horrifying bacterial infections that threaten the nervous system. 

1. Bacterial meningitis Klebsiella pneumonia bacterium. NIAID on Flikr.

Many bacteria invade the covering of the brain, the meninges, without invading the brain substance. The commonest are Neisseria meningitidis, causing meningococcal meningitis, and Streptococcus pneumoniae, causing pneumococcal meningitis. Other relatively frequent meningeal intruders include Listeria monocytogenes and Haemophilus influenzae. Bacteria may get into the brain following infections elsewhere, such as sinusitis or otitis media (inner ear infection). There are many complications of bacterial meningitis such as cerebral venous thrombosis (CVT) and brain abscess.

2. Tuberculosis Mycobacterium tuberculosis bacteria, the cause of TB. NIAID on Flikr.

Tuberculosis (TB) is probably as old as history. It is caused by mycobacterium tuberculosis, a slow groing but pernicious organism. TB spares no part of the nervous system, and manifests often as tuberculous meningitis (TBM) or Pott’s disease of the spine. Nervous system TB may also present as an encephalopathy, tuberculoma, brain abscess, vasculopathy, arachnoiditis, radiculomyelitis, and calvarial TB. 

3. Neurosyphilis ff treponema pallidum. isis335 on Flikr.

Treponema pallidum, the bacterium behind the dreaded syphilis, is another ancient bug. It has a variety of ways it terrorises the nervous system, and the longer it inhabits the neurones, the worse the outcome. Typical manifestations of neurosyphilis are tabes dorsalis, general paresis of the insane (GPI), taboparesis, stroke, meningovascular syphilis, optic neuritis (ON), and several movement disorders. 

4. Lyme neuroborreliosis Lyme Disease Bacteria, Borrelia Burgdoferri. NIAID on Flikr.

Lyme disease has acquired an infamy which is probably beyond its real notoriety. It is best known for its tick-borne transmission, and for its classical dermatological feature, erythema chronicum migrans. It affects the nervous system in diverse ways such as encephalomyelitis, lymphocytic meningitis, cranial neuropathies, spinal radiculitis, stroke, diaphragmatic paralysis, and peripheral neuropathy. Post-Lyme syndrome is a very contentious topic; you may read more on this in a post from our sister blog, The Neurology Lounge, titled ‘Why is chronic Lyme disease so frustrating to neurology.

5. Neurobrucellosis By This media comes from the Centers for Disease Control and Prevention‘s Public Health Image Library (PHIL), with identification number #1902.Note: Not all PHIL images are public domain; be sure to check copyright status and credit authors and content providers.English | Slovenščina | +/−, Public Domain, Link

Neurobrucellosis is a rarely discussed bacterial infection but it is a significant contributor to neurological morbidity and mortality around the world. It is caused by various brucella species usually grouped under the name Brucella militensis. It has a long reach in the nervous system, causing a variety of insults such as encephalitis, meningoencephalitis, cranial neuropathies, intracerebral haemorrhage (ICH), subarachnoid haemorrhage (SAH), transverse myelitis, radiculitis, and peripheral neuropathy. 

6. Leprosy Public Domain, Link

This most distasteful of infectious diseases unfortunately has a strong affinity for the nervous system. Unlike its distant cousin, TB, leprosy favours the peripheral over the central nervous system. Its hallmark is thickening of the nerves or nerve hypertrophy. Caused by Mycobacterium leprae, leprosy has a legion of neurological manifestations such as mononeuritis, mononeuritis multiplex, cranial and peripheral neuropathy, myelitis, and leprous ganglionitis. 

7. Botulism Clostridium botulinum. Phil Moyer on Flikr.

Botulism is the end result of damage by the toxin of Clostridium botulinum. This toxin produces a deadly paralysis by blocking neural transmission across the neuromuscular junction (NMJ). Botulinum toxin respects no borders, able to gain access to the nervous system through the gut, the skin, or the lungs. It paralyses everything, causing acute limb, ocular, and bulbar weakness. Left unchecked, botulism results in autonomic dysfunction and respiratory failure.

PS: For Tetanus, check out The Neurology Lounge blog post on The 13 most dreadful neurological disorders


Explore more neurological infections in neurochecklists!

Bacteria. AJ Cann on Flikr.

Monday, 20 November 2017

How To Start Creating Your Own Holistic Nerve Pain Treatment (Vids)

Today's post with videos from (see link below) is an extremely well-thought out and constructed look at some alternatives for chemical pain relievers if you suffer from chronic pain (in our case - neuropathy). It fits in perfectly with the sort of modern thinking that asks for holistic approaches to pain control and without being patronising, offers some useful advice as to how you can take the first steps towards creating a personal, holistic plan for yourself. Nobody is saying that you should stop any medication that you may be taking but by gradually adding some of these ideas to your daily living, you may well find that your dependence on prescription drugs lessens and that you feel better too. Open-minded thinking is all that's required to start thinking differently about your pain control. The doctors are a long way off creating persona, multi-disciplinary plans for their patients - their time and budgets have a stranglehold on what they can do at the moment. In the meantime, you can start thinking creatively for yourself by building up therapies that suit you personally. Remember, the word holistic refers to an overall picture and is not narrowed down to one aspect. Following some of the many links will provide much more information. There are many other possibilities but this article may encourage you to make a start adding to your treatment options.

14 Natural Pain Relievers
By Stephanie Burke

Not all pain relief has to come from a medical treatment. There are some natural pain relief options that can go a long way in helping you cope with and manage chronic pain.

Watch Video: 4 Little-Known Natural Pain Relievers

While many of these treatments will not work for everyone, sometimes gaining even a little more pain relief makes it worth a try.

See Modern Theories of Chronic Pain

Not all pain relief has to come from a medical treatment. There are some natural pain relief options that can go a long way in helping you cope with and manage chronic pain.

Watch Video: 4 Little-Known Natural Pain Relievers

While many of these treatments will not work for everyone, sometimes gaining even a little more pain relief makes it worth a try.

See Modern Theories of Chronic Pain

It's possible to make a moist heat pack with common household items. 

Watch: Video: How to Make a Moist Heat Pack

Try heat therapy. Applying some form of heat can go a long way in easing your pain. Try a hot water bottle, gel-filled pad heated in the microwave, electric heating pad, or hot bath.

The benefits of heat therapy are twofold: it increases the flow of healing oxygen and nutrients to the damaged area, and it suppresses pain signals. Some find that wearing a heat wrap, such as those from ThermaCare, is best because it releases a low level heat for several hours and can be worn under clothes so you can remain mobile. You can also combine the benefits of aromatherapy and a heat by adding an essential oil to the hot pack; you can experiment by making your own microwaveable heating pad at home and adding different essential oils to see what works best for you.

See Heat Wrap Therapy Can Reduce Post-Exercise Low Back Pain

Try massage therapy. Studies have shown that massage therapy not only helps with relaxation, but can also help diminish the body's perception of pain. A high quality therapeutic massage spurs blood flow, which in turn helps nourish and heal the soft tissues in throughout your body. Massage also releases endorphins, which are your body's natural analgesics. Massage therapy is defined as soft tissue—muscles, tendons, and ligaments—manipulation through hands-on massage by a qualified massage therapist. Like many complementary therapies, there is no substantial agreement in terms of how much massage therapy can help reduce pain, or which type of massage is best for which type of pain, so you may need to try more than one approach to find what works best for you.

See Massage Therapy for Lower Back Pain In addition to traditional massage techniques, such as Swedish massage or deep tissue massage, there are some techniques that involve the use of instruments, such as the Graston Technique or other instrument-assisted methods.

See The Graston Technique: An Instrument Assisted Soft Tissue Manual Therapy for Back Pain

The chair hamstring stretch is a low-pressure way to stretch. 

Watch: Seated Chair Hamstring Stretch for Low Back Pain Relief Video

Loosen up. Almost everyone can benefit from stretching the soft tissues (the muscles, ligaments, and tendons) in and around the spine. Your back is designed for movement, and if your motion is limited because you are in pain, it can make your back pain worse.

See Spinal Anatomy and Back Pain

If you suffer from chronic back pain, you may find it takes weeks or months of stretching to loosen up your spine and soft tissues, but meaningful and sustained pain relief will follow the increase in motion. Warming up your muscles by applying a heating pad for 15 minutes before stretching can help make the stretching more tolerable.

Read more about Stretching to Relieve Back Pain

It is best to work with a physical therapist or other health professional before starting any type of stretching routine, as the type of stretching should be tailored to your specific condition; e.g. the form of stretch will be very different if you have lumbar spinal stenosis versus a herniated disc

Enjoy the outdoors. 10 to 15 minutes of sun exposure a day can help the body produce vitamin D. People who got the recommended daily 400 to 800 IU of vitamin D experienced less pain than those who didn't, according to a Boston University study of 221 men and women with knee osteoarthritis.

In one recent study, the 200 study participants with chronic lower back pain that had no identifiable cause were had significantly lower levels of vitamin D than the 200 people in the control groups without lower back pain, indicating that insufficient vitamin D levels may contribute to or worsen chronic pain.2

Other research shows increasing vitamin D may help soothe pain: out of 150 people with unexplained persistent musculoskeletal pain, 93% were recently found to be deficient in vitamin D levels, according to recent research at the University of Minnesota.3 


About 15 minutes of sun exposure on your face and hands a day produces your daily dose of vitamin D

Read more: Calcium and Vitamin D Requirements 

Imagine yourself in a better place. This option has to do with a form of meditation - called guided imagery - harnesses the power of your mind to devalue pain signals. Guided imagery allows you to hear and internalize therapeutic suggestions that help you feel better.

See How to Stop Your Pain with Your Mind 

In one study of 28 women with osteoarthritis pain, half of the women listened to a 10 to 15 minute recorded script twice daily that guided them through muscle relaxation techniques. Women in the guided imagery group showed statistically significant improvements in their pain levels and mobility within 12 weeks, versus women in the control group who did not see any improvements.4 Guided imagery can be learned with a practitioner or on your own using audiotapes or CDs.

Ease inflammation with ice packs made with household items.
Watch: Video: How to Make a Gel Ice Pack

Reduce the inflammation that's contributing to your pain. It may seem obvious but it bears repeating; inflammation is a contributor to most forms of chronic pain, and reducing the inflammation will help reduce your pain. A simple way to address inflammation is to regularly apply a cold pack or ice to the local area of pain. Ice also helps by acting as a local anesthetic and by slowing nerve impulses, which in turn can interrupts the pain signals generated in the affected area.

See How to Use Ice Massage Therapy for Back Pain

Meditate twice daily. Meditation comes in many varieties, some complex, others simple. One common approach is just to find a sound that is pleasing to you but has no particular meaning (like "som"), close your eyes, sit still and comfortably, and repeat the sound in your mind. When your thoughts wander, notice that they have wandered and return to your sound. If you feel your pain, notice the pain and return to your sound. You don't have to sit up straight with your legs crossed—any position that you find comfortable is fine. You can sit in your recliner with a heating pad on your back if that is best for you. You can sit back and soak in a warm bathtub.

Start with a few minutes, and gradually lengthen to thirty minutes. You will find yourself refreshed and reinvigorated, with less pain overall. 

Meditation can also help reduce the depression, anxiety, stress, and sleeping problems that often accompany chronic pain. 

Read more: Mindful Meditation vs. Chronic Pain
Laugh more often
. One study showed that social laughter actually increases pain tolerance.5 Laughing along with others was shown to have the highest positive impact. Laughter has many positive effects, including increasing circulation and oxygen, and raising your body's level of endorphins (the body's natural pain killers). There is a whole movement called "laughter yoga"—which helps people enjoy the many benefits of laughter without having to need a reason to laugh—it just focuses on laughing for its own sake.

See Acupuncture: An Ancient Treatment for a Current Problem
Getting to sleep faster and staying asleep longer can promote healing. 
Read more: 11 Unconventional Sleep Tips: How to Get to Sleep and Stay Asleep

Get enough restorative sleep. Getting enough sleep is critical to managing pain and promoting healing, so it's important to employ a variety of sleep aids to help you get a healthy amount of sleep. Regular exercise that physically exhausts the body helps promote deep sleep. Visualization, meditation, and other psychological techniques can also help you get to sleep and stay asleep.

See Sleep Aids for People with Chronic Pain

Stay well hydrated. It is common knowledge that drinking enough water throughout the day is good for you, but did you know it can also help reduce pain? For people with back conditions, staying well hydrated helps the intervertebral discs stay healthy. Drinking enough water also helps reduce stiffness, it helps your blood carry healing nutrients and oxygen throughout the structures of you body, and helps flush toxins out of your muscles and other soft tissues. It will help prevent constipation (a side affect of many pain medications).

All of the above are not prescriptive; rather, they are intended as ideas for you to consider on your personal journey with managing chronic pain.

Tsao JC. Effectiveness of massage therapy for chronic, non-malignant pain: a review. Evid Based Complement Alternat Med. 2007;4(2):165-79.
Lodh M, Goswami B, Mahajan RD, Sen D, Jajodia N, Roy A. Assessment of Vitamin D status In Patients of Chronic Low Back Pain of Unknown Etiology. Indian J Clin Biochem. 2015;30(2):174-9.
Plotnikoff GA, Quigley JM. Prevalence of severe hypovitaminosis D in patients with persistent, nonspecific musculoskeletal pain. Mayo Clin Proc. 2003;78(12):1463-70.
Baird CL, Sands L. A pilot study of the effectiveness of guided imagery with progressive muscle relaxation to reduce chronic pain and mobility difficulties of osteoarthritis. Pain Manag Nurs. 2004;5(3):97-104.
Dunbar RI, Baron R, Frangou A, et al. Social laughter is correlated with an elevated pain threshold. Proc Biol Sci. 2012;279(1731):1161-7.

Sunday, 19 November 2017

Letter Calling For Common Sense In The Opioid Debate

Today's plea for common sense from (see link below) is addressed at all those currently involved in the opioid prescription debate. It's a plea from someone suffering from chronic pain, who takes low-dose opioids because it's the only thing that works. Now, as you will already know, neuropathy can lead to chronic pain. There's no cure and the treatments are at best, patchy in their success rate. Apart from that, they bring side effects that can add to your daily misery. For many people with nerve pain, opioids are the only treatment that will relieve the pain and yet their prescriptions are severely under threat from politicians and media who only see one side of the story. We all know how the media can whip up hysterical reactions, especially in the current climate but all we're interested in is balanced thinking that allows for genuine chronic pain patients to receive the drugs they need. of course the criminality and addiction problems need to be addressed but not by blanket bans and the sort of stigma that is leading patients into despair. This article calls for common sense - nothing more - and for the legislators to listen to the medical profession. An excellent article...well worth a read.

Dear Prescription Opioid Debaters:
October 22, 2017 BeingCharis 

Dear debaters,

I am a 30 year old who inherited a lifelong inflammatory disease called ankylosing spondylitis (AS). AS can cause the spine to fuse together from bone spurs and can affect organs and other joints. AS causes significant pain, to put it lightly.

I am also a former college athlete and marathoner. I know what it means to push through pain as an athlete. But I cannot push through the pain caused by my disease. Pushing through it causes the disease to progress and the pain to increase.

My main treatment is a drug made from living cells (the same class of drugs that treats many cancers); it helps slow the progression of my disease. Because this treatment is [finally!] working, it also reduces some of the worst symptoms. But AS is a severe disease with no cure, so even with this specialty drug I still have plenty of pain.

And, like millions of chronic pain patients who fight simply to survive daily, I’ve tried everything to control the pain.

I’ve tried massage and acupuncture. They help, but I cannot afford a massage or acupuncture every day, which is how often I would personally need them in order to function. Even if I could, massage and acupuncture are not available in my bedroom in the middle of the night, when I often have the most pain.

I’ve tried the strongest anti-inflammatories there are. I’ve tried muscle relaxants. I’ve tried steroids. I’ve tried topical pain-relief patches.

I’ve tried over the counter remedies and I’ve tried homeopathic remedies.

I’ve tried mindfulness. I’ve tried yoga. I’ve tried diet. I’ve tried a different bed.

I’ve even tried CBD (marijuana) oil.

None of these treatments have been effective in treating my pain, but the low-dose opioid pain pill I tried as a last resort has made a big difference in my life. I take hydrocodone/acetaminophen (Norco) when my pain is the worst it can be and I take it to prevent the pain from reaching that “worst it can be” level, which is almost daily. I began taking Norco several years ago and my dose has remained the same since then, except during particularly severe flares when I increase the dose for a short time.

My doctor agrees that Norco is the most effective sustainable method of immediate pain relief for me:

When I can’t fall asleep because it feels like shards of glass are being rubbed inside my joints, Norco is my only option. Just so I can sleep.

When I somehow bend in the wrong direction and an explosion of pain shoots through my spine so intense that it takes a half hour to inch my way to my bed, actually screaming in pain the whole way, Norco is the only thing that will reduce my pain enough to be able to even talk again.

When I need groceries but I can barely turn my neck without grimacing, I take a Norco so I can do my shopping, then come back home.

I just took a Norco to finish writing this because of the increasing joint pain in my wrists and fingers from using the keyboard.

I do not take an opiate to feel high or drugged. I actually do not like having to take it; but I do because it is the only effective option to manage my pain just so I can function. The pain never goes away completely, but I cannot imagine having a sustained high level of pain without immediate access to an effective treatment that reduces that pain. I can imagine that I might not want to live with that pain.

It is difficult for many to imagine that trauma-level pain could possibly be a permanent part of someone’s life, so sometimes I refer to chronic pain as a series of lifelong short-term pain events. Sometimes that helps people understand.

Legislation proposals across the country would (some already are) forcibly reduce and in some cases completely remove access to prescription opiates in the name of reducing deaths by addiction, but without putting in place equally effective pain treatment options for chronic pain patients.

Some legislation mandates additional funding for recovery treatment for people for whom addiction is a problem. I agree – there will always be people who are addicted to something, so this funding is needed.

I also agree that prevention is important, and that programs should also be in place to keep addiction from happening in the first place.

I also realize some people become addicted to opioid drugs after using prescription opiates for pain after injury or surgery, and I agree that finding ways to manage temporary pain with a well-monitored tapering dose of medication is important. I also agree there should be consequences for doctors who prescribe recklessly. It is a no-brainer to look at ways to address such abuse of medications by both doctors and patients whose pain is truly short-term.

But Chronic Pain patients who rely on a well-managed, consistent treatment plan that includes opiates are not addicts. Many of us need long-term pain medications to function, to keep us out of the emergency room, to reduce our need for additional medical care, and, often, to keep us from becoming more disabled.

By restricting access to pain medications across the board, many chronic pain patients and our doctors – who agree we need these medications to function long term – are being targeted unnecessarily.

Much of the legislation that I have read proposes cutting access to prescribed opiates without including a provision for how to adequately address lifelong pain management needs for people whose pain will never improve without adequate pharmaceutical intervention.

Is it ethical for chronic pain patients to be effectively punished, and possibly die medically or by suicide as a result of loss in treatment? If the goal is to save lives by cutting access to opiate medications, a strong message is sent to the chronic disease community that our pain and our lives do not matter.

What would help?

Here are some ideas: 

Legislate funding for the expedited creation and approval by the FDA of pain medications that treat pain in the same way as opiates, but without the same addictive properties.
Mandate insurance companies as well as Medicaid and Medicare to cover complementary treatment options like massage, acupuncture, medical devices, physical therapy and water therapy at an equal level that it covers pharmaceutical treatments. Often doctors and pain management specialists prescribe these treatments, but many patients who live with chronic pain cannot afford them. If patients who rely on pain medications are expected (and physically able) to take them less, the alternatives must be just as affordable and accessible. 

Create provisions for certain types of doctors to be permitted, perhaps through a series of mandated Continuing Medical Education (CME) courses, to bypass opiate restriction clauses through a formal process with the intention of expediting the delivery of opiate medications for chronic pain patients and others who need them long term. 

Create the infrastructure and mandate universal digital medical records nationally. 

Fund research at a much higher level to create better treatments and future cures for people living with severe, incurable diseases. 

Create a healthcare system that provides more incentive and an intentional framework that allows doctors to spend more time with their patients, thus safeguarding mistakes that are made when 5, 10, or 15 minutes is not enough to gauge a patient’s actual pain needs (whether that is remaining on opiates or not).

These approaches will not halt the need for pain medications to exist, but they will reduce the need while providing access for the millions who legitimately need them. Restricting access across the board will only encourage those who are addicted to seek different substances – often more dangerous, while creating an environment where chronic pain patients who need opiates will either find unsafe alternatives or a way out of the pain by attempting or completing suicide.

Targeting people who struggle with addiction is one thing. Helping those who are addicted without also having a plan in place to continue to adequately treat people who live with incurable, severe chronic pain is inhumane and frankly dangerous. We cannot trade one life struggle for another.

If the country moves forward with legislation that restricts access to pain medication with the intention of saving lives, it will be a mistake. Because it will also be restricting access to the same medications that keep millions of chronic pain patients alive and functioning. I agree that we need to address addiction – it is indeed a problem. But we need to find a way to prevent and treat addiction that that does not also restrict chronic pain patients’ access to the most effective treatments for our pain.

Saturday, 18 November 2017

Optimism: The Most Difficult Emotion When It Comes To Neuropathy

Today's post from (see link below) is a strong piece of advice to those living with neuropathy, who have reached the end of their tether and are on the point of giving up. Not going to preach here - the message is in the article! Well worth a read.

The Importance of Optimism When Trying New Chronic Pain Treatments
Jessica Schultz November 2017 Contributor • defines “chronic” as “persisting for a long time; constantly recurring.” This definition of chronic applies to our chronic pain, it lasts for a long time, meaning: months, years, decades and can be constantly recurring from remission to disease, and the cycle repeats. Despite this disheartening diagnosis that many of us have received, it hasn’t stopped many of us from constantly trying new treatments or therapies.

I, like many of you, have tried almost everything imaginable to get some relief from this chronic, unrelenting pain, from medications to acupuncture, essential oils to homeopathic remedies. There have been a few things that make my day go a bit better, make my headaches a bit less intense or things that I just really like the idea of, but of course I have found nothing to “cure” or at least give me a bit of relief from my chronic pain. So, why do we keep trying new regimens?

Our implacable desire for some sort of relief from this terrible curse we’ve been given is evidence of the power of optimism and hope. Hope is a strong force that has helped many people perform the impossible, it is the ceaseless praying of family members, the support of friends, and the friendships formed internationally from one tragic thing that unites us all, pain. We have a blessing in this day-in-age of the internet that allows us to find refuge and resources for when our hope has worn thin, and we need encouragement from other people who are fighting the insurmountable fight alongside us of finding some reprieve from pain.

Optimism isn’t smiling through the pain in order to fake feeling “normal” so we don’t have to explain our problems to other people. It isn’t saying, “Oh well, I’ll just live with it,” with a smile on our faces so that our family members don’t feel worse than they already do. It is maintaining the hope that the next treatment, the next therapy or this new supplement will give us the outcome we have desired for so long. Optimism is going into that infusion therapy session with our minds set that this treatment will work, not doubting the efficacy of the treatment, but believing that it will produce desirable results. The placebo effect is something that can happen, but the reverse is also true – if you believe that something isn’t going to work, it may not.

This type of optimism, of entering a new treatment despite having been disappointed numerous times in the past, isn’t silly or naïve. It is courageous and brave. I can’t count the number of times that I have gone into a new therapy preparing myself for the therapy not to work because I couldn’t bear to think about get my hopes up just to have them crushed again and again. That vulnerability is what makes us susceptible to changes from therapies or treatments, it is that vulnerability that opens us up to the possibility of a new and pain-free future. As Helen Keller once said, “Optimism is the faith that leads to achievement. Nothing can be done without hope and confidence.”

Friday, 17 November 2017

Alcohol And Nerve Damage - The Links Are Strong

Today's post from (see link below) looks at yet another specific cause of neuropathy and that is alcoholism. Now there are other articles on this subject here on the blog and it is very easy to come over as 'preachy' but excessive alcohol use really can cause severe nerve damage. The question is: what is excessive? Moderate alcohol intake  should not lead to nerve damage symptoms but often does, especially if used in combination with other medications and lack of exercise. So telling yourself that you don't drink that much may be a little self-deceptive. At the first signs of neuropathy symptoms (burning feet, tingling, pain, numbness etc) you should really talk to your doctor and not use yet more alcohol to mask the symptoms. Neuropathy is currently for life I'm afraid, so you need to ask yourselves if it's worth taking the risk by drinking too much! More information elsewhere on the blog (see search button).

Alcohol: Pain Killer or Pain Causer?
Written by Susan McQuillan, MS, RDN, CDN

Some people find that having a few drinks helps ease chronic pain. Others have good reason to abstain.

If you have a glass of wine or a cocktail or two most nights to cope with chronic pain (eg, back pain), you may be on to something. Research studies have found that moderate use of alcohol does, in fact, relieve pain for many people, and those who routinely drink reasonable amounts of alcohol reportedly cope better with pain and disability than those who don’t drink at all. That makes sense, because alcohol is an analgesic and anesthetic and as such, can reduce the sensation of both physical and emotional pain.


Alcohol is an analgesic and anesthetic and as such, can reduce the sensation of both physical and emotional pain.Although research has not yet shown that alcohol reduces inflammation specifically associated with chronic pain, studies have shown that moderate drinking reduces inflammation in the body that leads to cardiovascular disease. Other studies have shown that, compared to nondrinkers and heavy drinkers, those who consume light to moderate amounts of alcoholic beverages, including beer and wine, have reduced markers of inflammation throughout the body, and that this reduction may be due directly to the ethanol content of the alcoholic beverages consumed.

According to the Centers for Disease Control and the U.S. Dietary Guidelines, moderate drinking is defined as up to one drink a day for women and up to 2 drinks a day for men. Unfortunately, not everyone who drinks alcohol does so in moderation, and for some people, alcohol, even in small doses, carries big risks to health and well-being.

Some people who drink alcohol to cope with pain were heavy drinkers before they had a chronic condition. Others became more dependent on alcohol after developing a painful disease or disability, suggesting that chronic pain can put some people at risk of alcohol abuse and addiction. Studies have found that when people who are in recovery from alcohol addiction suffer from chronic pain, they have a significantly higher rate of relapse than those who don’t have chronic medical conditions.

For many people, excessive drinking can lead to even more pain and other health complications. For instance, chronic alcoholism is linked to peripheral neuropathy, or damage to peripheral nerves that causes stabbing pain and numbness in your hands and feet, and interferes with your central nervous system’s ability to send signals from your brain and spinal cord to the rest of your body.

Pain can lead people to drink more alcohol than they might otherwise consume, and researchers have found the most pain relief comes from drinking amounts that are well above general guidelines for moderate use. But even if you stick to the guidelines for drinking in moderation, routine use of alcohol could still be harmful to your health, especially if you are also taking pain medication. This is as true for aspirin and other over-the-counter drugs used to treat inflammatory pain as it is for stronger prescription medications. Over time, combining alcohol with aspirin can cause bleeding in the stomach and combining alcohol with acetaminophen can cause acute liver failure.

The bottom line? Speak with your doctor if you regularly drink alcoholic beverages to relieve or cope with pain. That way you’ll be sure the amount you drink can safely be combined with any medications you take and that, overall, the benefits of drinking outweigh any risk of side effects that could cause more damage and pain in your body.

Thursday, 16 November 2017

Entrapment Neuropathies: What's Involved There?

Today's post from (see link below) talks about entrapment neuropathy, (or nerve compression) another form of neuropathy that may have confused you when you first started experiencing nerve damage symptoms. It's pretty specific, so it's a little easier to rule out or identify, when it comes to diagnosing your problem. Basically, we're talking about trapped nerves here, that will bring about many of the symptoms we normally associate with nerve damage. The difference is that entrapment neuropathies may be able to be helped, generally by means of surgery, or stopping the activity that causes the entrapment in the first place, leading to a release of the trapped nerve. However, surgery doesn't help in all cases and if you have had entrapment neuropathy for some time, the nerve damage may have been so severe that releasing the entrapment doesn't solve the long term symptoms. If you're not sure where your symptoms are coming from, discussing it with your doctor, with reference to your daily activities, may provide the answer.

Entrapment Neuropathy or Nerve Compression Syndrome: Types, Causes, Symptoms, Treatment
Written, Edited or Reviewed By: Pramod Kerkar, MD, FFARCSI Last Modified On: March 6, 2017 Pain Assist Inc.

Entrapment neuropathy as the name suggests is a medical condition in which the affected nerve gets trapped by direct pressure. This may also refer to nerve root compression such as by a herniated disc in the spine. Typical symptoms include muscle weakness, pain, numbness and tingling. The symptoms affect just one particular part of the body depending upon the nerve that is affected.

Common location for entrapment neuropathy to occur is the joints. The pressure on the nerve can be very painful and can result in damage to the nerve and eventually muscle weakness and wasting if left untreated. Other conditions such as bone spurs, joint swelling, cysts and trauma also can result in nerve entrapment.

Entrapment Neuropathy is also known as Nerve Compression Syndrome or Compression Neuropathy.

Classification and Types of Entrapment Neuropathy or Nerve Compression Syndrome

There are different forms of compression neuropathies depending on the nerve that is affected, but the most common forms are carpal tunnel syndrome and cubital tunnel syndrome, which affect the nerves in the wrist and elbow. When a nerve is compressed, symptoms are often felt away from the actual site of the entrapment. For instance, entrapment neuropathy in the hip or thigh area can result in pain in the legs and feet as the nerves in these areas carry signals to the rest of the leg.

A few of the common forms of Entrapment Neuropathies are mentioned below.

Carpal Tunnel Syndrome: An individual is said to have carpal tunnel syndrome if that individual's median nerve, a major nerve in the upper extremity that travels down the arm and enters the hand through carpal tunnel located in central part of wrist, gets compressed in carpal tunnel causing irritation of the nerve. Typically, this disease affects thumb, index, and middle finger.

Cubital Tunnel Syndrome: An individual is said to have cubital tunnel syndrome if that individual's ulnar nerve, a major nerve in upper extremity gets compressed. Ulnar nerve supplies movement directions to the forearm muscles and sensory information from the hand. In case of cubital nerve syndrome, ulnar nerve gets compressed near the elbow causing wrist and hand weakness, numbness as well as pain. The main fingers involved are little and ring fingers.

Peroneal Neuropathy: Peroneal neuropathy relates to entrapment of the peroneal nerve, most commonly at the knee, however the entrapment can occur at the hip and ankle as well. This commonly leads to weakness of the ankle dorsiflexors and evertors.

Tarsal Tunnel Syndrome: Tarsal tunnel syndrome relates to tibial nerve dysfunction where the tibial nerve gets trapped when it passes through a narrow structure called the tarsal tunnel. This leads to altered sensation in the foot and toes such as numbness, tingling and burning sensation and weakness of the foot muscles.

Handlebar Palsy: This disease is generally experienced by long-distance cyclists. In handlebar palsy, the ulnar nerve in the wrist gets compressed due to long periods of direct pressure on the nerve when the weight of the upper body is resting on the handlebars, thus the term handlebar palsy.

Epidemiology of Entrapment Neuropathy or Nerve Compression Syndrome

Carpal tunnel syndrome
is the most common form of entrapment neuropathy. Lifetime risk is approximately 10% and annual risk is 0.1%. Overall prevalence in women is about 3% and in men about 2%. Commonly occurs in females over 55 years.

Cubital tunnel syndrome
is the second most common entrapment neuropathy more common in men than in women. Men have less fat content when compared to women in the medial elbow overlying the ulnar coronoid tubercle. The tubercle itself is larger in men. These anatomical factors can be taken as an explanation for higher frequency of ulnar neuropathy or cubital tunnel syndrome in men.

Peroneal neuropathy
is the third most common entrapment neuropathy most common type of mononeuropathy in the lower extremities. Next comes the tarsal tunnel syndrome, which again involves the lower extremities.

Pathophysiology of Entrapment Neuropathy or Nerve Compression Syndrome

Repetitive trauma and injury to a nerve may result in microvascular changes, leading to edema and injury to the myelin sheath or the outside layers of the nerve that aid in the transmission of the nerve's messages, and structural alterations in membranes at the organelle levels in both the nerve axon and the myelin sheath. The common feature of compression syndromes is the focal segmental demyelination in the area of compression. Complete recovery of function in less chronic cases after surgical decompression relates to remyelination of the injured nerve. In more chronic cases, entrapment is due to Wallerian degeneration of the axons and permanent fibrotic changes in the neuromuscular junction. This may prevent complete reinnervation and restoration of function.

Causes and Risk Factors of Entrapment Neuropathy or Nerve Compression Syndrome

Compression neuropathies are considered to be the most common forms of nerve injuries. Compression neuropathy can be caused due to various reasons. Compression of the nerve in a small space such as carpal or cubital tunnel is the most common cause. Median nerve getting compressed in the carpal tunnel, posterior tibial nerve compression in the tarsal tunnel, spinal nerve root compression in the intervertebral foramen are few of the examples. Oftentimes the tunnel or space through which the nerve travels is narrowed down by inflammation of the local surrounding tissues or structures, which in turn results in reduced space within the tunnel leading to compression of the nerve.

Other times an injury is caused by an outside mechanical force like for instance radial nerve getting injured in the axillary region due to misfit of crutches. Prolonged pressure from the crutches underneath the axilla results in compression of the radial nerve.

Tension neuropathies are increasingly emerging as important clinical problems though they are not as common as compression neuropathies. It is a known fact that the nervous system must have significant mobility for the body to move properly, especially in the extremities in which the nerves must bend around joints to allow for increase in length as the joints bend at sharp angles. If the mobility is reduced at these joints, it leads to increased tension on nervous tissues which in turn lead to pathological changes.

Signs and Symptoms of Entrapment Neuropathy or Nerve Compression Syndrome

The common signs and symptoms experienced in various types of entrapment neuropathies can be broadly listed as follows: 

Tingling sensation
Burning sensation
Muscle weakness
Muscle wasting
Impaired movement of affected joints or body part

Chronic Cases Of Entrapment Neuropathy or Nerve Compression Syndrome Can Cause The Following Additional Symptoms: 

Dry skin
Thinning of the skin
Thick ridged nails
Recurrent skin ulcers.

Treatment for Entrapment Neuropathy or Nerve Compression Syndrome

As a rule the underlying medical condition that is the cause of entrapment neuropathy needs to be treated first. There may be instances where the patient may have gained weight. The first treatment for such patients will be to lose the excess weight. If there is no underlying medical condition, then in most of the cases surgery is the next option though there are rare chances that surgery may not relieve all the symptoms in chronic cases.

Nonsurgical Treatments For Entrapment Neuropathy Include The Following:

Non-steroidal anti-inflammatory drugs or NSAIDs. Anti-inflammatory medicines such as ibuprofen are recommended at the initial onset of symptoms to help reduce the swelling around the nerve.
Steroid injections like cortisone are very effective anti-inflammatory medicines though steroid injections around the ulnar nerve are generally avoided because of risk of damage to the nerve.
In case of carpal or cubital tunnel syndrome, bracing or splinting is recommended to wear especially at night to keep the elbow in a straight position.
Nerve gliding exercises.
Putting an ice pack on the spine at the site of the pain.
Physical therapy to reduce tissue swelling and muscle spasms.
Chiropractic treatment, which falls under alternative medicine.
Electrotherapy treatments such as transcutaneous electrical nerve stimulators (TENS).

If nonsurgical treatment fails, surgical treatment may be necessary to relieve the pressure off the compressed nerve. Few of the common surgical procedures performed to treat Entrapment Neuropathy are:

Carpal tunnel release
Cubital tunnel release
Ulnar nerve anterior transposition
Medial epicondylectomy
Tarsal tunnel release

Diagnosis of Entrapment Neuropathy or Nerve Compression Syndrome

Entrapment neuropathy may be easily diagnosed in cases of external injuries, but diagnosing entrapment neuropathy may be tough at times in case of lack of external injury and the patient may have no clue as to the reason behind the pain. A good physical exam with tests such are Tinel's and Phalen's for hand or other similar tests depending on the part of the body involved help in the diagnosis of entrapment neuropathy.

Following Are The Commonly Used Imaging Tests For Diagnosing Entrapment Neuropathy:
Magnetic Resonance Imaging (MRI)
Nerve Conduction Velocity Studies (NCV)

Wednesday, 15 November 2017

Inherited Neuropathy: What's That All About?

Today's post from (see link below) looks at a form of neuropathy you've probably come across in your research so far and that is hereditary neuropathy. You may have wondered what that entails, unless you know the history of your family in some detail and it applies to you. As the name suggests, it's a form of nerve damage that you've inherited through your family and if you've already been diagnosed, your neuropathy has probably been assigned a name (see below) but in essence, the symptoms of hereditary neuropathy are much the same as any other form of neuropathy and will be treated in much the same way. That said, because it may strike at an earlier age, there can be more specific symptoms, which may be stronger than with normal neuropathies. The only sure way of testing is by doing a genetic test but in the end, like all forms of nerve damage, discovering why you have it is of secondary importance as to where you go from there regarding treatment. Doctors take great pride in identifying causes but most people with nerve damage end up on the same courses of treatment with the same varying degrees of success.

Did You Inherit Your Neuropathy?
by John Hayes Jr| May 29, 2011

Chances are, if you’re reading this and you’re already in your late 20’s or early 30’s (or older) and you have [1]

• Charcot-Marie-Tooth disease

• Hereditary Neuropathy with Liability to Pressure Palsies (HNPP)

• Dejerine-Sottas Disease (DSD)

• Hereditary Motor Neuropathy (HMN)

You were probably diagnosed in your teens or possibly earlier. But if you or someone you know is in their teens (or younger) and they have a combination of the following symptoms:

• Numbness

• Tingling

• Pain in their feet and hands

• Weakness and loss of muscle mass (especially in their calves or lower legs and feet)

• Impaired sweating

• Insensitivity to pain

• Foot deformities such as hammer toes or high arches

• Scoliosis (curvature of the spine)

It might be time to do some genetic testing to determine if they have a form of hereditary neuropathy.

What is Hereditary Neuropathy?

Hereditary neuropathies are inherited disorders that affect the peripheral nervous system, often resulting in peripheral neuropathy. Hereditary neuropathies can affect you in many different ways but they are usually grouped into four different categories[2]:

• Motor and sensory neuropathy – affecting movement and the ability to feel sensations

• Sensory neuropathy – affecting the senses

• Motor neuropathy – affecting the ability to move

• Sensory and autonomic neuropathy – affecting the ability to feel sensation and the autonomic nervous system (the system that controls your ability to sweat, your heart rate, your body’s ability to regulate your blood pressure, your digestion, etc.)

As the names imply, they are classified based on exactly which nerves are affected and which functions are impaired.

The most common form of hereditary neuropathy is Charcot-Marie-Tooth disease (a motor and sensory neuropathy) affecting 1 out of every 2500 people. Most people with CMT are diagnosed before they reach their 20’s but their symptoms can begin years earlier. CMT may take a while to diagnose because the symptoms can wax and wane over a period of years.

How Can I Find Out if I Have Hereditary Neuropathy?

The only way to diagnose hereditary neuropathy is through blood tests for genetic testing, nerve conduction studies and nerve biopsies. If you’ve been diagnosed without going through any of these tests, you probably don’t have a good diagnosis.

Your doctor should take a very thorough history and physical. In order to really determine if you are at risk for hereditary neuropathy, you need to look as far back as three generations. However, a word to the wise, even if you hereditary neuropathy has not shown up in your family previously, all inherited diseases have to start somewhere. You could just be the person starting it in your family. That makes genetic testing even more important.

Are Hereditary Neuropathies Curable?

There are no cures for the various types of hereditary neuropathies. Treatment is usually to treat the symptoms and give your body the support it needs to function as normally as possible. That usually means physical and occupational therapy, as well as

• Care and correction for your muscular and skeletal systems

• Treatment for any other underlying medical problems

• Nutrition education and diet planning

• A step by step exercise regimen

• Medication as needed or necessary

A highly skilled medical professional well versed in diagnosing and treating nerve damage is your best place to start for treatment of your Hereditary Neuropathy. An excellent place to start is with a NeuropathyDr® clinician. They have had great success in treating patients with hereditary neuropathy in all its various forms.

If you have a confirmed diagnosis of Hereditary Neuropathy or think you may have it, seek treatment now. While you can’t be cured, you can take steps to treat and lessen your symptoms and greatly improve your quality of life. Contact us today for information on how your Hereditary Neuropathy can be treated, your suffering lessened and exactly how to find a NeuropathyDr® in your area.



Tuesday, 14 November 2017

Can Essential Oils Really Improve Nerve Damage Symptoms?

Today's post from (see link below) looks at the potential benefits of essential oils for neuropathy symptoms. Now like most neuropathy patients, I will try most things to try to alleviate the symptoms of nerve damage but have never really warmed to the theory of essential oil therapy. However, that's a personal opinion and I know that many people swear by them and hey, if it works, don't knock it. I'm certainly open to the possibilities but people should be aware that essential oils are not cheap (if they are...they're probably not 'essential oils') and that they should do their research before trying them out. Furthermore, results should not be expected overnight; like anything of this nature, it takes time and regular use to achieve benefits. That said, there's no doubting the popularity of essential oils and aromatherapy. Whether they can do anything to improve the symptoms of neuropathy is for each individual to decide. Referring to the original site (see link below) will provide much more information.

18 Essential Oils For Nerve Pain and Neuropathy [Infographic]

What is Nerve Pain or Neuropathy?

Essential oils come from natural plants, and can help you alleviate the pain associated with the nerves. Nerve pain or neuropathy is an excruciating condition that occurs when there is damage to the peripheral nervous system. It feels like sudden shocks of electricity, pinpricks or a burning sensation. It can be debilitating and stop you from functioning in your daily life. Neuralgia is a recurrent pain along a nerve pathway, but does not involve any nerve damage or inflammation.

The peripheral nervous system consists of nerves that connect the central nervous system to the rest of your body. These nerves include your muscles, skin, hands, feet, face and internal organs. They are responsible for transmitting messages about your physical sensations, back to the brain.

When nerves become damaged, they can misfire, sending pain signals to your brain.

Symptoms of Nerve Pain

There are many symptoms of nerve pain, which might limit your ability to continue with normal daily activities. They include:
Extreme sensitivity to touch.
A sharp, burning sensation or stabbing pain.
Muscle weakness.
Numbness in the hands and legs.
Lack of coordination and falling down.

Causes of Nerve Pain

There are many causes of nerve pain; it might be from a physical injury or a disease.
Physical Injuries – Nerve pain can occur after physical injuries from car accidents, sports 

injuries, fractures, falls, etc. The pain occurs when nerves are severed, compressed or crushed.
Diabetes – Diabetes is one of the most common causes of nerve damage. The high levels of unregulated blood sugar, high blood pressure and obesity in diabetes patients can lead to injured nerves.
Vitamin Deficiencies – If you lack vitamin B1, B6, B12 and E, it may lead to nerve pain, because those vitamins are essential to nerve health and activity.
Toxins – Exposure to toxic chemicals like insecticides and solvents can lead to nerve damage. In addition, Mercury and some heavy metals exposure can contribute to the disorder.
Cancer – Tumors from cancer can also cause nerve pain. As they grow, they can press on the nerves surrounding them, with some cancers growing out of the nerves themselves.
HIV – Nerve pain occurs in one-third of people infected with HIV. Treatment of HIV using antiretroviral drugs can also lead to nerve damage pain.
Alcoholism – Too much alcohol has a toxic effect on the nerve tissue. People with severe alcoholism have a higher risk of nerve pain.
Hereditary – Nerve pain can also be hereditary.

Natural Remedies for Nerve Pain

Some natural remedies can address the causes of nerve pain, but many remedies treat the nerve pain by providing pain relief.

For example, if your legs are affected, wearing more comfortable shoes can reduce the pain.

Nerve pain caused by diabetes can be improved by making some changes to your lifestyle, such as:
Quitting smoking.
Reducing alcohol consumption.
Getting more exercise.
Changing your diet.

Essential oils for nerve pain is one treatment that can help reduce the effects.

18 Best Essential Oils For Nerve Pain

Scientific studies have shown that essential oils can not only help with sleep disorders, stress, anxiety, depression, and circulation, but can also provide relief from nerve pain (or neuropathy). Using essential oils for nerve pain is also a natural alternative treatment to control the symptoms associated with many illnesses.

There are a number of essential oils that have been studied that can be used to treat nerve pain:

1. Balsam Fir Abies balsamea

Balsam Fir is often part of the quintessential Christmas tree. The Fir Needle is a natural analgesic and antispasmodic for relaxing muscle aches and pains. It is often used in the treatment of muscle recovery following exercise or a work out. It works by promoting more blood flow to the skin, which increases recovery.

How to Use: Balsam fir needle essential oil can be applied topically in a 1:1 ratio with a carrier agent.

Learn More

2. Bergamot Citrus bergamia, Risso

Research studies conducted by the University of Calabria have reported that Bergamot essential oil modifies and inhibits the nociceptive behavioral effect. Another study showed that data gathered so far indicates that bergamot is endowed with anti-nociceptive effects.

How to Use: To reduce muscle and nerve pain, massage 5 drops of bergamot oil on the area or where you feel tension.

Learn More

3. Black Pepper Piper nigrum

This essential oil is a known pain reliever by toning the muscles and use in sciatica. It acts as a tonic and analgesic for the nervous system and increases circulation. One study showed that black pepper essential oil possesses antioxidant, anti-inflammatory and anti-nociceptive properties.

How to Use: Make sure it is diluted in a 50:50 ratio, before applying to any affected area (one part essential oil: one part carrier oil).

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4. Roman Chamomile Chammaemelum nobile or Anthemis nobilis

This is an essential oil with anti-neuralgic properties. It helps to relieve the pain associated with nerve damage by constricting the blood vessels surrounding that particular nerve. In doing so, it reduces the built-up pressure and relieves the pain.

How to Use: There are several ways to apply Roman Chamomile:
You can apply the oil to reflex points of the body.
You can dilute chamomile oil with olive oil and apply to the aching muscles by massaging.
Add a few drops to a bath.

Learn More

5. Peppermint Mentha piperita

Peppermint is one of the most widely researched oils by the scientific community. It is known for its analgesic and anti-inflammatory properties. As a pain reliever it provides nervous system support, improves respiration, controls muscle spasms and relieves gas and bloating.

How to Use: Diluting peppermint oil with a carrier oil is recommended before applying.

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6. Rosemary Rosmarinus officinalis CT 1,8 Cineol

This essential oil is a mild pain reliever that increases circulation, helps with sciatica and neuralgia. It helps to relax the muscle fibers and remove lactic acid. Being anti-rheumatic it can suppress muscle spasms and improve respiration.

How to Use: Apply 2 drops each of helichrysum oil, cypress oil, and rosemary oil. Blend with 1/2 tsp of a carrier oil. Massage into the affected area.

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7. Marjoram Origanum majorana

This essential oil is another natural pain reliever that is effective in helping to manage nerve pain. It works as a tonic on the entire nervous system by strengthening the area where the nerve damage has occurred.

How to Use: Add 10 drops of marjoram, 10 drops sage oil, and 10 drops of rosemary essential oil. Combine with 2 tablespoons of carrier oil. Apply with massage to the affected area.

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8. Black Spruce Picea mariana

This essential oil is a natural antiseptic, antiparasitic and anti-inflammatory pain reliever. It helps to relieve muscle spasms, promote muscle repair, improve circulation, help to stimulate the immune system and help to clear cell receptor sites. It is especially used for back pain, arthritis, and sciatica.

How to Use: Combine 5 drops of Black Spruce with 1 tablespoon of carrier oil. Massage to the affected area a couple of times a day.

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9. Lavender Lavandula angustifolia

Lavender essential oil has calming and stress relieving properties. It helps to relieve nervous tension and nerve pain. It has also been used and shown in some surgical procedures to reduce pain.

How to Use: 2 drops of Lavender and Rosemary + 20ml cocoa butter. Mix all ingredients and pour in a vial to store. Use it as a massage oil.

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10. Helichrysum Helichrysum italicum

Helichrysum essential oil is an anti-inflammatory antispasmodic naturally occurring nervine that strengthens and regenerates the nervous system. It helps to relieve nerve pain by reducing stress levels associated with it. It can also reduce inflammation for joint pain, acne and burns.

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11. Eucalytpus Eucalyptus radiata

Eucalyptus oil is extracted from the bark and leaves of the Australian Eucalyptus tree. Eucalyptus is a must have oil for any household. Because it has antispasmodic, ant-inflammatory and analgesic properties, it has been recommended for relieving nerve pain, aches and muscle pain. One of the best ways to apply is by massaging eucalyptus oil on the skin so it can help to relieve stress and pain.

How to Use: Use Eucalyptus Oil in a cream or warming balm to apply topically.

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12. Frankincense Boswellia frereana, Boswellia carterii

The oil is known to transmit messages to the brain’s limbic system, which influences the nervous system. It stimulates the immune system, relaxes the muscles and works as an antiseptic.

How to Use: Combine 1 drop of frankincense with 2 drops of a carrier oil, and apply over the affected area.

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13. Geranium Pelargonium graveolens

Geranium oil acts to reduce neuropathic pain, especially when applied to the skin. Studies have shown that it is effective in reducing pain after shingles.

How to Use: Mix 5 drops of geranium essential oil with 1 tablespoon of jojoba oil and massage into the pain affected area.

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14. Ylang Ylang Cananga odorata

Among its many uses Ylang Ylang acts as a nervine and sedative. It repairs and reduces the stress of nerve damage.

How to Use: Ylang-Ylang blends very well with bergamot, grapefruits, lavender and sandalwood. You can also combine it with a carrier oil (such as jojoba, sweet almond, or avocado), and applied directly to the skin, or included in your bath.

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15. Wintergreen Gaultheria procumbens

One of its main compounds is methyl salicylate, an organic ester which metabolizes in the body to salicylic acid, which has similar properties to cortisone, an NSAID. The oil therefore, has excellent properties for relieving nerve pain as a natural analgesic, anti-arthritic numbing agent.

How to Use: Use 1–2 drops of wintergreen essential oil, and mix it together with jojoba or coconut oil before rubbing into the skin and massaging into muscles.

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16. Ginger Zingiber officinale

Ginger consists of sesquiterpenes, which are responsible for its anti-inflammatory, antibacterial, and other analgesic properties. One study identified Ginger essential oil as possessing antioxidant activity as well as significant anti-nociceptive properties.

How to Use: Ginger essential oil works well when blended.

Combine 5 drops ginger, 5 drops rosemary, 5 drops lavender, 3 drops marjoram, and 5 teaspoons of a carrier oil (coconut, jojoba, or grapeseed).

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17. Clary Sage Salvia sclarea

One of its best uses is for soothing nervous tension. It can also be helpful for stomach pains, kidney problems, and tumors when applied to the skin.

How to Use: Dilute 5 drops of clary sage oil with 5 drops of a carrier oil (coconut oil or jojoba) and apply to affected areas.

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18. Clove Eugenia caryophyllata

Clove oil is high in anti-oxidants, and was used in the Four Thieves Vinegar which was believed to protect people from the Plague:

Take three pints of strong white wine vinegar, add a handful of each of wormwood, meadowsweet, wild marjoram and sage, fifty cloves, two ounces of campanula roots, two ounces of angelic, rosemary and horehound and three large measures of camphor. Place the mixture in a container for fifteen days, strain and express then bottle. Use by rubbing it on the hands, ears and temples from time to time when approaching a plague victim.

One of its current applications is in toothpaste as it has the same analgesic effect as benzocaine, a topical agent also used for ingrown toenails, hemorrhoids, tooth pain and sunburn. It works by blocking the nerve signals.

How to Use: Mix 1 drop Clove oil with 5ml Grapeseed oil. Massage around the affected area with the blend.

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How to use Essential Oils for Nerve Pain

There are many other ways that you can administer essential oils to your body. Some of them are listed below:

Creams and Lotions
– There are creams and lotions available that contain the essential oils you need. You can also make your own cream and lotions by buying a blank lotion or cream and adding the essential oils to it.

Aromatherapy Bath
– You can use essential oils in aromatherapy baths. Add a few drops of the essential oil directly to the bath water and then add some Epsom salt to allow the oil to blend with the water and enhance the effect. This will prevent it from floating on top of the water.

Essential Oil Massage
– You can massage essential oils into the areas affected by pain. If you are making your own massaging oil, apply by blending with carrier oils.

Diffusing – One of the most common ways to apply essential oils is aromatically by using an essential oil diffuser. There are several types ranging in the way the oils are dispersed. Please check out our infographic.

Reflex Points
– Applying essential oils to known reflex points can have many benefits, especially if you know what each point is used for.

Pre-Made Synergy Blends
– Many of the major essential oil companies now sell synergic blends of different essential oils for a particular ailment or purpose e.g. “Anxiety Ease”, so it is useful to look out for them if you didn’t want the hassle of creating your own recipe or blend.

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I often stress that you should not use essential oils undiluted, and never apply a neat oil directly to the skin. Most essential oils that are from reputable companies come with safety instructions and these should always be read prior to use.

Always check before administering to pregnant women, babies and small children as there are a number of essential oils that should not be used.

And you should always consult with your doctor as some oils can interact with other medication.

Safety with essential oils.


I hope you have found this list helpful when using essential oils for nerve pain and neuropathy. I love essential oils and know how much they can help with so many illnesses and conditions. If you are sick of taking medication and not getting anywhere then please try essential oils as a natural treatment.

How to use essential oils.

Thanks for reading! ..Susan 😉