Hello, everyone! This is Dr. Bob Salamon with Lowcountry Chiropractic. As always, I hope you’re doing well and staying healthy! The beginning of each year presents an opportunity to reassess our habits and realign with our health goals. The pains of the past are better left in last year and I sincerely hope those of you dealing with chronic or recurring pain find lasting relief this year. This is also the time to check in with ourselves and take an honest look at how we’ve been feeling. Minor symptoms–such as numbness of the hands and feet–though seemingly innocuous can point to underlying conditions. Today we’ll be discussing peripheral neuropathy. What is peripheral neuropathy? How can you spot the signs? What causes peripheral neuropathy? And, of course, how can chiropractic care help address the root cause of peripheral neuropathy? If you’re interested in learning more, you’ve come to the right place!
 
Our peripheral nerves consist of those nerves which extend outside of the central nervous system. The nerves in our brain and spinal cord are considered central nerves, as they are responsible for the execution of every single process and biological activity within our bodies. The nerves which travel outward from the central nervous system–into our arms, legs, fingers, toes, organs and the like–are considered peripheral nerves, as they are suited on the “periphery.” Our peripheral nervous system is split into two subsets: the autonomic nervous system (ANS) and the somatic nervous system (SNS). The autonomic nervous system controls those functions which are involuntary, such as our fight-or-flight response, our blood pressure, our heart rate, the dilation or contraction of our pupils, our metabolism and much more. The somatic nervous system, on the other hand, controls those functions which are mostly voluntary, such as our muscle movements, our reflexes, and our senses. Our SNS nerves help us to recognize when we feel too cold or too hot, recognize textures, and detect light. 
 
As you’ve surely gathered by now, the peripheral nervous system plays a complex and vital role in how we live and operate. When these nerves are damaged, this is what’s known as peripheral neuropathy. Peripheral neuropathy can be caused by any number of conditions or incidents. For example, a traumatic injury can result in nerve damage. An infection or immune disorder can attack the nerves, resulting in peripheral neuropathy. Likewise, metabolic conditions–such as diabetes–are known to cause peripheral neuropathy. In the case of diabetes, diabetic neuropathy is the combined result of high blood sugar (which damages nerves and impedes their ability to send signals), weakened capillary walls (also caused by high blood sugar), and diabetic complications (such as kidney damage). Exposure to toxins–such as lead, mercury, arsenic, and thallium, as well as some insecticides–can also result in peripheral neuropathy. Persistent drug addiction and alcoholism contribute to a higher risk of developing peripheral neuropathy, along with deficiencies in B-1, B-6, B-12, vitamin E, and niacin. If you have a family history of neuropathy, you’re likely predisposed. 
 
Unfortunately, the potential symptoms of peripheral neuropathy are as varied as the potential causes. Peripheral neuropathy is most commonly associated with numbness and tingling in the hands and feet. You might find you’re suddenly sensitive to temperatures, reacting adversely to touch, or feeling pain without a cause. You might experience a decrease of muscle control and a lack of coordination. Instead of numbness, you might experience a burning sensation, or a prickling feeling. You might feel a slight pressure on your limbs, as though you’re wearing gloves and socks, even when you aren’t. You might experience temporary paralysis of certain muscles, sweat excessively, find heat intolerable, or experience sudden bouts of dizziness. Since the peripheral nerves play a part in so many processes, you might experience changes to your bowels, your bladder, or your digestive functions. Many of these symptoms are also common for other conditions, such as menopause or vertigo. What sets peripheral neuropathy apart? 
 
Well, it’s difficult to say. Before being diagnosed with peripheral neuropathy, a medical provider will first perform a physical examination. Then, a neurological evaluation. Both of these exams will help to rule out the existence of an underlying or separate condition, which may be causing or mimicking the symptoms of peripheral neuropathy. If these exams do not yield conclusive evidence, an electromyography might be ordered. An electromyography (also known as an EMG) is used to test the electrical activity of a muscle. If the nerves in your hands or feet are damaged, an EMG will be able to tell. Usually, simultaneously with an EMG, your doctor will conduct a nerve conduction test. In a recent article, I wrote about nerve conduction tests being used to confirm carpal tunnel syndrome. Indeed, carpal tunnel is a form of peripheral neuropathy. There are three kinds of peripheral neuropathy. The first kind is mononeuropathy, in which only one nerve is affected. (In the case of CPS, a mononeuropathy, the median nerve is the only nerve affected.) When two or more nerves are affected, this is known as multiple mononeuropathy. When many nerves are affected, this is known as polyneuropathy. Polyneuropathy is the most common form of peripheral neuropathy. After peripheral neuropathy is confirmed, your doctor may run a blood or urine test to determine if toxins are responsible. 
 
The key to treating peripheral neuropathy is to figure out what’s causing the nerve damage. If there’s a toxin, the toxin needs to be removed from the body and, subsequently, from the diet or environment. If you have diabetes, you’ll need to determine a plan for regulating your blood sugar levels, so as not to exacerbate the issue. If an ongoing infection is the cause, antibiotics will be prescribed. If an immune disorder is the cause, you might be prescribed immunosuppressants, to prevent your body from inflicting further damage on your nerves. Beyond treating the cause of the nerve damage, there aren’t many treatments specifically for peripheral neuropathy. Special shoes can be ordered, to help relieve the pressure placed on these nerves. Over-the-counter pain medications are often recommended to deal with the daily discomfort. When those become insufficient, prescription pain medication might be prescribed. 
 
For those who do not want to be reliant on pain medication, what are their options? Well, that’s where chiropractic treatment comes in. A study published in the Neuroreport in 2018 sought to better understand the association between low-velocity variable amplitude spinal manipulation and the relief of lower back pain (especially in patients with “neuropathic radiating leg pain following peripheral nervous system insult”) by using animal models. The results of the study revealed low-velocity variable amplitude spinal manipulation (i.e. manual therapy) had an analgesic–that is to say pain-relieving–effect on the rats in the study. 
 
As we’ve discussed on this blog before, the primary purpose of chiropractic care is to relieve subluxations. Subluxations are the result of displaced vertebrae placing undue pressure on spinal nerves and thus impeding their function. Chiropractic care, traditionally, clears a path for the body to heal itself by freeing up these nerves. Following this, chiropractic care can be used to mitigate the painful effects of peripheral neuropathy. Once you’ve determined the cause of the nerve damage and enacted lifestyle changes to combat the issue (i.e. medication, diet, exercise), the next step is to formulate a treatment plan with your chiropractic care provider. Spinal decompression treatment allows irritated nerves to heal properly, while massage therapy can stimulate blood flow to the affected areas. 
 
Solving peripheral neuropathy isn’t a three-step process, nor is chiropractic care the cure-all for such a condition. Truthfully, while some cases of peripheral neuropathy can be healed, other cases are irreversible. Around 60% of diabetics will experience peripheral neuropathy at some point in their lives. Further, the physical effects of diabetes on the body make healing those damaged nerves difficult. That said, no one should have to accept a reality of daily pain. While some peripheral neuropathy cases cannot be reversed, they can be mitigated, contained, and alleviated. Send us an email or give us a call. We’ll set you up with an appointment here at Lowcountry Chiropractic and develop a long-term treatment plan to address your peripheral neuropathy. The sooner you begin treatment and lifestyle changes, the better your quality of life will be! It’s certainly a journey–which can take months or even years–but you are not alone. Let Lowcountry Chiropractic help you live a pain-free life. As always, this is Dr. Bob and I have your back covered