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Posts for tag: foot numbness and tingling

  Peripheral neuropathy, as we have spoken about before, is a gradual degenertaion or deterioration of the nerves, especially the small nerves of the feet.  It is most commonly seen in people with diabetes, but there are many other causes as well.  This can include idiopathic (where there is an unknown underlying cause, but many things have been ruled out), as a result of chemotherapy for cancer, vitamin deficiency (especially B12, although Thiamine and other vitamin deficiencies can also be to blame), heavy metal toxicity (mercury, lead, and even arsenic), and several others.  No matter what the cause of the neuropathy, the result is often the same.  There is usually numbness, tingling, pins and needles sensations, paresthesias (crawling sensations or other feelings of things that are not there), burning pain, sharp shooting electrical shocks, muscle abnormalities (causing hammertoes, change in muscle tone, muscle wasting, etc.), and autonomic changes (decrease in sweating, dry skin, discoloration, cold or hot feeling, etc.).  A person may have NONE or ALL of these findings.  Much of this will depend on how long the problem has been present (Diabetics, for example, may show no changes or have no symptoms at first, but the longer they are diabetic, the more of these problems may present themselves).  

   Once the diagnosis of peripheral neuropathy is confirmed, there are a number of treatment options.  Many drugs can be used to treat the symptoms of peripheral neuropathy.  The problem with drugs is that they just treat SYMPTOMS.  For the most part, these reduce the pain and burning, but really do little or nothing for the numbness or lask of sensation, which can be worse for the patient in the long run.  Narcotic medication is often the worst, because in addition to just masking the pain, the patient can suffer from sedation and constipation, and can, and often does, become addicted to the narcotic.  

     There are a number of vitamins that can help, and often help quite a bit, not only with the pain and burning of neuropathy, but also with the numbness and tingling that occurs.  These vitamins, in some cases, can actually result in the growth of new small nerve fibers within the skin.  One of these that has shown great promise is alpha lipoic acid.  Taking up to 600mg of this vitamin, up to three times per day, has often been shown to be beneficial in treating neuropathy in the diabetic patient, and the non-diabetic as well.  A lower dose is often advised to start with, and many pharmacies sell the vitamin in as low as 100mg.  B vitamins, such as B6, B9, and B12 have also shown beneficial effects in treating neuropathy.  A prescription medical food, known as Metanx, can also be prescribed if the over the counter vitamin therapies are not working.  One must understand, that none of these vitamin therapies will show results quickly.  A month is often the minimum amount of time needed to see any change at all, and in many cases it may take 2-3 months to see a significant improvement.  The advantage to using these vitamin therapies is that there are typically NO side effects, little or no drug interactions, and often the cost is significantly less.  In many cases, the beneficial effects of these can be measured OBJECTIVELY using an ENFD - or epidermal nerve fiber density test.  This is a skin biopsy, usually done just above the ankle, to measure how many nerve fibers are present within the epidermis (the outer layer of the skin) BEFORE the vitamins are prescribed, and can be repeated  AFTER (usually six months) treatment has been started.  This can often show a significant increase in the number or density of nerve fibers.

     In an upcoming blog, we will be talking about the use of LASER for peripheral neuropathy, another NON-INVASIVE treatment that is showing great results for a number of people with peripheral neuropathy.


Richard S. Eby, DPM

7348 East Brainerd Road

Chattanooga, TN.  37421

(423) 760-3115