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Kestner

If you have ever experienced nerve pain or know someone that has, this column is for you. Nerve pain, often called neuropathy or sometimes neuralgia or neuritis, can be a particularly aggravating condition.

Although many people with neuropathy experience pain, and often a burning, stabbing, tingling or electrical type pain, other symptoms are possible. In fact, since the actual nerves are the damaged structures the symptoms can be widely varied. It is possible to feel any sensation the nerve is capable of transmitting

Neuropathy is very common for people with diabetes. Approximately 60 percent to 70 percent of people that have diabetes will have neuropathy.

There are many other conditions that can cause neuropathy, however. Many drugs have been identified as possible causes of neuropathy. People that have had chemotherapy are vulnerable to nerve pain as are people that consume excessive alcohol. Vitamin deficiency can cause neuropathy. Certain infections or other illnesses can be the underlying problem.

Many patients with nerve pain have been told that the only treatment is drugs such as Cymbalta, Lyrica or Neurontin (gabapentin).  While these drugs are useful in helping reducing the symptoms, many patients find that the drugs aren’t effective enough. Or they may find the side effects intolerable. 

Conditions that cause neuropathy are generally progressive so the condition gets worse over time. Since the drugs are prescribed solely for the hope that they will reduce symptoms the underlying cause continues to worsen. After the drugs have reached the maximum dose there is little more to be done using medications.

This creates a very frustrating situation for clinicians and patients alike. Providers like to be able to help patients solve their pain, so when options are limited it is frustrating.

Patients become desperate for help and it is disappointing to be told there are no answers.

Recently new therapies have been used to help control the symptoms of neuropathy.  I have been researching the effectiveness of several of these therapies for the past year. I’m encouraged by what I have found.

One therapy that has been used by podiatrists (foot doctors), physicians, therapists and chiropractors is application of therapeutic diffuse infrared light waves. This therapy has been shown to reduce the painful symptoms after only a few weeks of treatment.

Results have been mixed, with some studies showing more success than others. It appears that the discrepancy in results may be related to variables in the duration, frequency and persistence of application. In other words, dosage matters.

Low level laser therapy (LLLT) has also been used in much the same way. Like the infrared light waves, some studies have been more effective than others. Some frequencies (wavelengths) are more helpful than others. Factors such as dosage, duration, frequency of application and persistence make a difference in success of treatment.

Interestingly many research studies are so narrow that the therapy may be judged to be effective or ineffective after evaluating the therapy in a very limited setting. When used in a real world clinical setting the therapy is often successful. That is the result of a clinician using his or her training and clinical judgement to vary the application as appropriate.

Another high-tech therapeutic approach uses electroanalgesia. Similar to low frequency and low power TENS (transcutaneous electrical nerve stimulation) in some ways, electroanalgesia uses very high frequencies to create a nerve block to erase the pain of neuropathy. By providing successive continuing treatments the provider can bring about long-term symptom control.

I first worked with electroanalgesia 35 years ago using a device made be a German company called a Nemectron. The technology has advanced considerably in recent years. We recently added the newest form of electroanalgesia to our office. We have been very pleased with the results.

Patients have reported complete relief after reporting pain as high as 8 on a 1-10 scale prior to being treated.

In our experience the key to effective treatment of neuropathy is dependent upon selecting and applying the right combination of therapies. By combining multiple therapies, we are able to multiply the effectiveness.

It is also important to work with patients to try to address the underlying condition to slow the progression.

These new therapeutic options are bringing renewed hope for people across the country who must deal with nerve pain.

Dr. Mark Kestner is a chiropractor in Murfreesboro. His office is at 1435 NW Broad St. Contact him at mkestner@DrKestner.com

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