The Role of Complementary Medicine in Peripheral Neuropathy

Everywhere you look for information about neuropathy, whether it be on information sites, advertisements for private clinics and practices or the many forums where people exchange experiences, you will come across some strange names for complementary treatments. TENs, FREMs, MFT, ATS,acupuncture, biofeedback and massage treatment, are all widely mentioned on the Internet. There are a lot of people, especially in North America, who undergo these treatments with apparent success, although I wonder once more; if they're so effective, why aren't they standard practise for neurologists? Anyway, today's post from Medifocus health (see link below) examines some of the most commonly seen complementary treatments and describes in simple terms what they are.

Treatment Options for Peripheral Neuropathy

There are no studies to prove the efficacy or safety of most complementary and alternative therapies in the treatment of peripheral neuropathy. It is important that individuals notify their health care provider if they are using any alternative therapies no matter how insignificant or benign they may seem. Various complementary therapies have been used to help manage discomfort and anxiety of peripheral neuropathy, although not all of these therapies are approved by the U.S. Food and Drug Administration (FDA). Treatments include:

•Transcutaneous electrical nerve stimulation (TENS) - Also known as electrotherapy, TENS has been shown to be effective in reducing localized pain and discomfort for the duration of treatment in diabetic peripheral neuropathy. Electrodes connected to the portable TENS unit are placed on the skin. Electric signals are then sent to the painful area, blocking or "interrupting" pain signals before they reach the brain. Pain reduction is experienced in up to 80% of patients and some data indicates that when amitriptyline is administered in conjunction with TENS therapy, pain reduction is noted in up to 85% of patients with diabetic peripheral neuropathy. Treatment is reported to be effective even when used over a prolonged period. Various TENS stimulators have been approved by the U.S. Food and Drug Administration (FDA).

•Frequency-modulated electromagnetic neural stimulation (FREMS) - In a study involving 31 patients with diabetic peripheral neuropathy, FREMS was applied to the lower extremities of each patient using four electrodes that were stimulated for 30 minute sessions, with ten treatments over a six week period. Results indicated a significant reduction in pain, a significant increase in sensory tactile perception, an increase in motor nerve conduction velocity, and an increased sensation of foot vibration for at least four months. For more information about FREMS, please view the following link: http://www.ncbi.nlm.nih.gov/pubmed/15834546

•Magnetic field therapy (MFT) - MFT involves the use of magnets which may be taped or placed over the over the area of pain in patients with peripheral neuropathy. The mechanism of action of MFT is not understood. One possible explanation of its beneficial effect on the body is its ability to change the alignment of the body's electromagnetic fields. In a study investigating the use of special magnetized insoles for patients with diabetic peripheral neuropathy, encouraging results were noted. To read more about this therapy, please click on the following link: http://www.ncbi.nlm.nih.gov/pubmed/12736891

•Acupuncture - Acupuncture has provided relief for some patients, although the benefits tend to be short term and frequent treatments may be required.

•Biofeedback - Biofeedback is a technique that teaches individuals how to deal with pain by learning to divert their attention or to perceive the pain differently. It is also useful in increasing the temperature of hands and feet. This is a safe treatment method that can be very effective for some patients.

•Relaxation/Massage therapy - Apprehension or anxiety about neuropathic pain may be alleviated by massage therapy for some patients.

•Anodyne Therapy System (ATS) - ATS is a near-infrared medical device that may bring relief to patients with diabetic and non-diabetic peripheral neuropathy through improving circulation. Pads containing infra-red photo energy heat are placed on the skin over the affected area. The energy penetrates into the skin and the patient feels relief. Patients with painful neuropathy report an improvement in balance, sensation in their feet, and reduction of pain. Anodyne therapy has been approved by the FDA since 1994 and is used also in the physical therapy setting. While an article appearing in 2004 in Diabetes Care (vol.27(1):168-72) indicated that there was benefit to anodyne therapy, another article published in 2008 in Diabetes Care (vol.31(2):316-21) indicated that there was no difference between anodyne therapy and a sham procedure.

•Rebuilder device - This is an FDA-approved device that sends nerve stimulation signals through the limbs via a pad placed over the affected area resulting in increased circulation, rebuilding of nerves, and strengthening of muscles. The device can be used with a wet (limb immersed in water) or dry option.

For a review of electrotherapy treatment for the management of painful diabetic neuropathy, please view the following link: http://www.ncbi.nlm.nih.gov/pubmed/20461329

http://www.medifocushealth.com/NR021/Treatment-Options-for-Peripheral-Neuropathy_The-Role-of-Complementary-Medicine-in-Peripheral-Neuropathy.php