Cancer is one of the most persistent scourges of modern medicine. Not only are the various types of cancer extremely dangerous, but the methods to combat them, including chemotherapy, can be aggressive to the point of heavily impacting a person’s health and quality of life. Hundreds of thousands of cancer patients in North America alone receive chemotherapy every year, and many of them experience damage to the peripheral nervous system—chemotherapy-induced peripheral neuropathy, or CIPN.
Like most neuropathy, chemotherapy-caused neuropathy shows up in the form of pain, numbness, tingling, and loss of temperature sensation, most commonly in the extremities. Other symptoms, while less ubiquitous, are still common: loss of bladder control, constipation, loss of body awareness, and difficulty walking or standing. Sometimes the condition is chronic, and will be a factor in the rest of a sufferer’s life. In many cases, however, the pain and discomfort from chemotherapy-caused neuropathy can be effectively managed, allowing a cancer survivor to lead a normal, active life.
So what can you do to help protect yourself from chemotherapy-caused neuropathy? First, report any unusual sensations, pain, or numbness to your doctor or a qualified NeuropathyDR® clinician. Like any neuropathy, the sooner we identify a problem, the better we will be able to control your symptoms. Let your chemotherapy provider know you might be experiencing a complication; in some cases, they may decide to postpone treatments to help your nerves recover.
Second, take steps to protect your peripheral nervous system, which is already under strain from the chemotherapy. Wear gloves when performing manual labor. Make sure your clothing and shoes do not rub against your skin and cause abrasions (loose clothing can aggravate neuropathy symptoms). Work with a NeuropathyDR® clinician to develop a diet and exercise regimen that will contribute to overall nerve stimulation and health. Perhaps most importantly, make sure to abide by your cancer doctor’s orders—managing the underlying condition is the most important factor in treating any kind of neuropathy.
Our patient, Joanne, knows firsthand how hard chemotherapy can be on the nervous system. Joanne is a cancer survivor who, when she came to us, had been recovering from the effects of her chemotherapy for five years. Along with most of the common symptoms of peripheral neuropathy, Joanne complained of severe pain in her lumbar back, extreme stiffness in her neck and shoulders, and weakness in her legs. Joanne’s pain, especially in her feet, was intense to the point of affecting her daily lifestyle. She was taking medication for pain, but the medicine was marginally effective at best.
Our treatment plan for Joanne involved a combination of manual therapies to her spine, as well as 2 forms of electro-stimulation to her feet and hands. We treated Joanne three times a week for five weeks; in only four weeks, Joanne was commenting that her symptoms had subsided dramatically. Immediately following each treatment, Joanne noticed a reduction in her pain level. The pain and numbness in her feet subsided a whopping 65-70%!
In a thank-you note Joanne wrote us a long time after the completion of the clinic portion of her NeuropathyDR® treatment plan, Joanne told us she had been able to stop taking her pain medications and was feeling fine, almost entirely pain-free. Her strength had begun to return, and her mobility improved as well.
Cold, burning and tingling, scaling skin and loss of sensation are unfortunate but treatable!
Joanne is a success story we are proud to have to our credit. To be entirely honest, not many patients show the level of improvement we saw in Joanne in such a short time. Even so, it goes to show that not only is there hope for cancer survivors who live with neuropathy pain, but in some cases the recovery can be swift and dramatic. Everyone who experiences neuropathy can learn to manage their symptoms, and our treatment methods are highly effective. If you suffer from CIPN or any other kind of neuropathy, contact us! NeuropathyDR® can answer your questions and put you in touch with a specially-trained clinician who can help you get back to living at your best!
If you are a regular NeuropathyDR® blog reader, you know that we tend to focus on the latest developments and research in treating neuropathy pain. With peripheral neuropathy, though, pain is only one component. This week, we’re going to talk about how neuropathy can affect your muscles, also called motor neuropathy.
There are essentially three kinds of motor neuropathy. The first is the overall weakening effect of the muscles, especially in the extremities, which often accompanies peripheral neuropathy. This can occur because the nerves which control motor function in the muscles have become damaged, or—in the case of a compression neuropathy—constricted. The second kind is called multifocal motor neuropathy, and takes place when the immune system itself begins to attack the nerves, as can happen after a series of infections or after an illness. The third kind is Hereditary Motor Sensory Neuropathy, which, as the name suggests, is genetic in nature. Hereditary Motor Sensory Neuropathy, or HMSN, occurs when there is a naturally-occurring deterioration in the nerves that control the muscles, causing the muscles to not be used, become weak, or even atrophy.
Motor neuropathy usually starts in the hands and feet, and can affect the full extension of fingers and toes. In addition to the dexterity problems this obviously causes, it often also has a visual appearance of “clawlike” fingers. The condition is degenerative, getting worse over a period of months and years. Twitching and spasms can also happen in affected limbs. While motor issues associated with peripheral neuropathy usually accompany pain, tingling, and numbness, multifocal motor neuropathy involves no pain (only the motor nerves are affected). Generally, none of the varieties of motor neuropathy are life-threatening, although they can absolutely impact your comfort and quality of life if you suffer from them.
When we met our patient Robert, he complained of a steady and declining loss of strength in his feet, which he had experienced over the past 4 years. Robert had had cancer during that time, culminating in having his prostate removed. His motor neuropathy caused Robert to have trouble walking or standing for long periods, and he even had trouble feeling his feet on some occasions. He also complained of shooting pain, tingling, and soreness in his feet, all typical calling cards of peripheral neuropathy. Since in cases of multifocal motor neuropathy, the sensory nerves are usually unaffected, Robert’s pain and numbness ruled that out. Sure enough, when we performed a battery of tests, we found that Robert’s sensation to vibration was all but gone in several places on his feet.
Motor Neuropathy is Characterized by Weakness of The Muscles
Robert did not respond with the typical level of relief we usually see after treating a patient with electro-stimulation. Over the course of three treatment sessions, Robert’s level of strength and comfort in his feet did not change in any meaningful way. While this is unusual, it highlights an important theme: neuropathy is a complex problem with many symptoms and manifestations, and NO single therapy technique or tool—even those with a very high rate of success—can stand on their own as a complete treatment.
We designed a treatment for Robert intended to produce more long-term benefit, as his short-term progress was not substantial. Motor neuropathies require an extensive MULTI-MODAL level of treatment, sometimes pharmaceutical and sometimes homeopathic, and usually involving some level of regular exercise and controlled diet. Robert is currently improving steadily, and is seeing his NeuropathyDR® clinician as prescribed to monitor his condition and progress.
If you suffer from weakness or pain in your limbs, you may have peripheral neuropathy. If so, we are here to help! Contact NeuropathyDR® right away and we will help you find the best course of treatment for your specific symptoms. We can even put you in touch with a specially-trained NeuropathyDR® clinician who can help you develop a therapy plan that will get results.
If you are living with diabetes, chances are you are no stranger to neuropathy. While some (even those who do have nerve damage) might experience no symptoms at all, about 60 to 70 percent of diabetics experience pain, soreness, loss of sensation, tingling in the extremities, and even digestive problems—or other conditions related to organ complications—all symptoms of peripheral neuropathy. Diabetes is, in turn, one of the most common causes of neuropathy overall.
Risk of developing diabetes-related neuropathy actually increases with age and extenuating health considerations (such as being overweight), partially because people who have problems with glucose control for extended periods of time—25 years or more—are more susceptible.
So what causes people who have diabetes to develop neuropathic symptoms? Research is occasionally unclear on the subject, but it is generally agreed that exposure to high blood glucose (high blood sugar) has a negative effect on nerve condition. Of course, this is in addition to other conditions or lifestyle factors commonly associated with causing or exacerbating neuropathy, such as injury, metabolic inconsistencies, inherited traits, or substance abuse.
Sometimes Called Pre-Diabetes Metabolic Syndrome is rampant in our society...
There are a few kinds of neuropathy associated with diabetes, the most common being peripheral neuropathy (this is the type usually referred to when people simply say “neuropathy;” but we’ll get to the other types in a moment). Peripheral neuropathy is characterized by pain, numbness, tingling, and loss of motor function, among other sensation-related symptoms. This type is written about extensively, and can greatly impact quality of life for its sufferers. The good news is, most treatment and therapy for neuropathy addresses this kind, and many are very effective!
Focal and proximal neuropathy result in muscle weakness and pain, and typically target a specific nerve grouping. These types of neuropathy are commonly characterized by weakness in the legs, causing difficulty standing and walking.
Autonomic neuropathy, as the name implies, causes changes in autonomic bodily functions. These include bowel and bladder functions, sexual responses, and digestion. Autonomic neuropathy can be life-threatening in extreme cases, as it also affects nerves that serve the heart, lungs, and eyes. Especially troubling to diabetics is the resulting condition of hypoglycemia unawareness, which can obliviate the symptoms most diabetics associate with low glucose.
A comprehensive foot exam is recommended at least once a year for diabetics, to check for peripheral neuropathy. Once diagnosed, the need for more frequent exams becomes important. Additional to diabetic amputation concerns, your doctor will want to test your protective sensation by pricking your foot with a pin, or running monofilament across your skin. If you have lost protective sensation, you could be at risk to develop sores that might not heal properly, leading to infection.
For other types of neuropathy, a NeuropathyDR® clinician will perform a check of heart rate variability to detect how your heart rate changes in response to changes in blood pressure and posture, or even an ultrasound, which can detect whether other internal organs such as the kidneys and bladder are functioning properly.
Tight blood sugar control and a healthy diet is the best way to control diabetic neuropathy, as well as other diabetic conditions. Even if you don’t have symptoms of neuropathy, checkups with a NeuropathyDR®-trained clinician can help spot warning signs of factors that could endanger your nerve function or even be life-threatening. In addition to dietary considerations, your clinician can also help any symptoms by prescribing appropriate medication for pain you might experience.
If you have diabetes, you are at risk! If you have symptoms, or think you might, don’t let it go unchecked. Remember, the sooner neuropathy is diagnosed, the easier it will be to treat and to slow the progression of this degenerative condition. Your NeuropathyDR® clinician is trained to identify the various types of neuropathy and recommend the treatments that will help you retain your quality of life. If you are not already in-touch with a NeuropathyDR® doctor, contact us to find one in your area!