Chronic Peripheral Neuropathy Pain Treatment Through The Next Generation Of Neurofunctional Pain Management Approach

Peripheral neuropathy, while typically a condition that results from type 2 diabetes and the insulin resistance cycle found in patients with diabetes, is one of the most difficult conditions to treat. Unfortunately, while we are familiar with the condition, that does not mean many people have been able to find an effective or lasting treatment. 

If there is one thing that patients can take away from the long and arduous history of treating peripheral neuropathy, it is that it is difficult to treat. Most patients never get full relief from the pain, and the condition gets worse over time as medications become less effective. Now, with knowledge obtained from ongoing research on the condition, we are now able to specifically target the painful symptoms of peripheral neuropathy with concentrated and effective treatments. 

Patients can take heart in knowing that as medical advancements are made, the options for treatment are also improved. Patients must also keep in mind that because there is a variety for treatment, they not only have the options for choice but the responsibility to make the best choice possible in seeking an effective treatment for chronic peripheral neuropathy.

In this guide, we’ll cover all you need to know about an innovative, non-surgical, and non-invasive treatment for peripheral neuropathy offered at Relatyv: Neurofunctional Pain Management.

The Extent Of Chronic Peripheral Neuropathy Pain

Peripheral neuropathy is a term used to describe a degenerative neurological disease that affects over 20 million people in the US alone. 

This condition causes progressive damage to the nerves belonging to the body’s peripheral nervous system, or the ones located outside of the brain and spinal cord. 

The peripheral nervous system is responsible for transmitting information from the brain to the body’s organs, muscles, and extremities – and vice-versa. When the peripheral nerves are damaged, this transmission is interrupted, which causes symptoms such as numbness, tingling sensations, and pain. 

As the nerve damage progresses, peripheral neuropathy can cause disabling pain and extreme fatigue. It may also lead to complications like ulcers or abnormalities in bodily functions such as the heartbeat, sweating, and digestion. 

The nerves in the peripheral nervous system can become damaged as a consequence of several reasons, including diabetes, infections, traumatic injury, nutritional deficiencies, exposure to toxins, and medications. 

Peripheral neuropathy affects every person differently, and the set of symptoms you’ll experience is directly correlated to what kind of nerves are affected. Let’s look at the different groups of nerves that can become damaged below.

Motor Nerve Damage

Motor nerves are nerves in the peripheral nervous system responsible for transmitting signals relating to muscle movements. These nerve endings are located within the muscle mass and supply information to the brain about muscle contractions, coordination, and the body’s positioning within the surrounding space. 

When these muscles become damaged you may experience involuntary muscle movements – such as spasms, cramps, and fasciculations – as well as impaired coordination and balance. Motor nerve damage can also make falls more likely and, when it impairs muscle movement, can lead to muscle shrinking and atrophy.

Sensory Nerve Damage

The sensory nerves of the peripheral nervous system are responsible for transmitting signals to the brain relating to sensations such as temperature, touch, vibration, and pain. Sensory nerve damage prevents these signals from traveling to and being processed by the brain. 

This translates into numbness and abnormal sensations such as tingling or burning and stabbing pain. 

Sensory nerve damage may also cause several symptoms, including:

• Loss of feeling
• Paresthesia pain (“pins and needles” sensations)
• Hyperesthesia (extreme sensitivity to touch)
• Allodynia (experiencing pain in response to stimuli that should be painless)

The sensory nerves in the fingers, toes, hands, and feet are usually the first ones to be affected.

Autonomic Nerve Damage

The autonomic nerves are responsible for carrying signals to the brain relating to the body’s autonomic functions, or those functions we don’t have direct control over. For example, these nerves regulate processes such as blood circulation, heartbeat, sweating, digestion, and bowel and bladder function.  

When these nerves are damaged, you may develop what’s known as autonomic neuropathy, a serious condition that can lead to irregular heartbeat, digestion problems, excessive sweating, and bowel or bladder dysfunction. 

Patients with autonomic nerve damage may need medical interventions to address their condition, such as the implantation of a pacemaker.

What Do We Know About Chronic Peripheral Neuropathy?

Most patients may live with the condition of peripheral neuropathy, experience its daily inhibiting power, and believe they know all there is to know about their options for treatment because they have only ever talked to one medical provider about it. The reality is that not even the greatest minds who have studied the condition for their entire careers know all there is to know about peripheral neuropathy, and there is more research being published every year on the subject with new and better ideas for therapy.

Below, we’ll look at what we know about diagnosing, preventing, and treating neuropathy.

How Is Peripheral Neuropathy Diagnosed?

As seen above, neuropathy is considered to be a clinically challenging condition to diagnose. This is because there are no definitive diagnostic tests for it and because its “invisible” nature makes symptoms appear subjective at first. 

However, a specialized healthcare provider may use several tools and diagnostic tests to determine the nature, cause, and extent of the nerve damage. Some of these tools include the following:

• A thorough physical examination. This includes an assessment of symptoms and a review of the patient’s medical history.
• Blood tests. Blood tests are used to investigate nutritional imbalances, autoimmune disease, and genetic factors that may be contributing to neuropathy. 
• Electrodiagnostic tests. Nerve conduction tests (NCS) and electromyograms (EMG) are used to assess how well the nerves work based on the strength and signals of the nerve signals. Quantitative Sensory Tests (QST) may also be used to determine how you respond to stimuli such as vibration, pressure, and temperature. 
• Biopsies. Skin samples containing nerve fibers may be collected for examination. These tests are used to determine the nerve count on your hands or feet. 
• Neurological examinations. During a neurological exam, a neurologist assesses your ability to feel pain and control muscle movements. 

Your doctor may also prescribe imaging tests such as MRI and CT scans. These tests are used to exclude underlying conditions and abnormalities that may be damaging or pressing on the nerves in the peripheral nervous system, such as tumors.

Can This Condition Be Prevented?

Some risk factors for neuropathy cannot be fully prevented. These include aging, genetic factors, and hereditary conditions such as Charcot-Marie-Tooth disease. 

However, some lifestyle choices can help you safeguard your nerves from further damage. 

You can reduce your risk of peripheral neuropathy through lifestyle changes, including:

• Avoiding alcohol and tobacco
• Preventing nutritional deficiencies through a balanced diet
• Exercising regularly and leading an active lifestyle
• Monitoring risk factors for diabetes, including obesity
• Preventing exposure to toxins that may damage nerves, such as arsenic

If you have been diagnosed with nerve damage, it is crucial to find an adequate treatment program to slow down or prevent the progression of the disease. Additionally, if you experience numbness and pain, a self-care routine that involves regular exercise, massages, and inspections of your hands and feet can help you reduce the risk of severe complications, such as ulcers. 

What Researchers Say About The Condition

In an article published in May of 2021, Dr. Gordon Sloan et al. raised concerns over the fact that they are still learning about peripheral neuropathy, particularly when it is a result of diabetes which they term as “DSPN” or Diabetic Sensorimotor Peripheral Neuropathy. Dr. Gordon and his associates in their key points note that, “The mechanisms of DSPN are not fully understood but involve downstream injurious pathways associated with hyperglycemia, dyslipidemia and microvascular disease leading to neuronal inflammation, oxidative stress, mitochondrial dysfunction and cell death” (2021). 

Even as doctors attempt to fully understand peripheral neuropathy, the mechanisms involved in the damage caused by the condition are not precisely understood. It is as if a vehicle refuses to start and a mechanic suggests that they know something is wrong with the engine. This is said not to take away from medical providers and researchers–after all, the human body is infinitely more complex than a car–but the analogy serves to prove the point that even those studying the condition struggle to understand it completely and learn more things they did not know before year after year.

It is easy to blame physicians when we think they should have all the answers to our problems and solutions for our pain. Dr. Gordon and his associates seem to understand and share this frustration, especially when confronting the pain of their patients. And while there are those patients who do not experience pain from DSPN, the frustration continues to mount for both doctors and patients. 

Dr. Gordon continues in his analysis to state that “[t]he reasons why some patients develop painless rather than painful DSPN are unknown; however, alterations in the peripheral and central nervous system have emerged as potential explanations”. These “potential explanations” are often all we have to work with when it comes to understanding the mechanisms and treatment of peripheral neuropathy, but patients and doctors should take heart in knowing that the research continues at as fast a pace we can keep.

A Deeper Dive Into Possible Causes Of Peripheral Neuropathy

Even if you have been diagnosed with peripheral neuropathy, understanding what’s causing this condition isn’t always easy. Today, up to 30% of neuropathy cases remain idiopathic, meaning that they have no known cause. Additionally, diabetes – and, in particular, poorly-managed blood sugar – is considered to be one of the main triggers of nerve damage. 

This is because sudden and drastic fluctuations in blood glucose levels can impair the functioning of the blood vessels responsible for supplying nerves with oxygen and nutrients. When this supply is disrupted, nerve endings can become damaged or die. 

According to a 2019 study, over 50% of people with diabetes have neuropathy. 

In the sections below, we’ll look in more detail at the possible causes and contributing factors to neuropathy.

The Relationship Between Diabetes And Peripheral Neuropathy

For the time being, it should suffice to know that peripheral neuropathy is a condition that typically results from diabetes and that managing diabetes will likely contribute to the management of peripheral neuropathy. In an article published in February of 2021, Doctors at the University of Milano-Bicocca surmise that all types of peripheral neuropathy, “. . . are characterized by nerves damage and axonal loss, and they could be classified in hereditary or acquired forms” (2021). 

Patients can imagine that sugar is a crystal structure with non-conforming shapes and edges that rub against everything it touches. Many people have seen a power washer with added sand particles in the water flow to enhance the destructive force of the water by having the sand particles and their sharp edges grind away at a surface like sandpaper. 

Sugar acts largely the same way in our bodies, with concentrations of sugar in the blood creating a directly observable destruction in the body. Insulin is the hormone required to trigger cellular uptake of sugar where it is metabolized. 

Insulin resistance results in cells not responding to the command to take up sugar, and leaving that sugar circulating in the blood, grinding away at everything it touches throughout the body like a power washer with sand in the water flow. 

If the body experiences a higher intake of sugar, more insulin is required to clean the blood and uptake the sugar. Over time, after a meal, the level of blood sugar should decrease to normal levels and the insulin may be lowered to match it, but the damage is done. 

This is a contributing factor to why doctors ask for a fasting blood test. They don’t want to test your blood sugar after you eat because it’s full of sugar. However, if you have not eaten in 8 hours, that blood sugar test has a lot more value to your doctor in learning about your insulin resistance condition. The body is unable to handle a high level of sugar in the blood and damage will result, damage pointed directly to the body’s most sensitive structures like microvascular passages and other delicate tissues. 

Most likely the first noticeable systems affected by this extreme insulin resistance are at the edge or periphery, hence the small delicate microvascular tissues, and directly affecting the peripheral nerves that report sensations and pain. Thus, the term peripheral neuropathy has been used to describe the condition as patients who suffer from it feel it in their fingers and toes where the nerves are at the edge or peripheral of their body.

Acrylamides: A Possible Contributing Factor

Peripheral neuropathy is not only a condition that results from diabetes, but it can result from several factors such as prescription medications, oncology and chemotherapy regimens, and even environmental chemicals including what researchers are calling acrylamide. 

In an article published in the journal Environmental Science and Pollution Research, doctors Bin-Jumah et al. found that, “[a]crylamide is a chemical monomer; its polymer compounds are used in the manufacture of plastic, papers, adhesive tapes, dyes, and food packaging. Lately, scientists found that cooking (mainly roasting, baking, and frying) yields acrylamide” (2021). 

The research continues and suggests that, “[a]crylamide has toxic effects on different body systems [including] genitourinary, reproductive, nervous system, along with being a carcinogenic substance. The neurotoxicity of acrylamide includes central and peripheral neuropathy. In humans, the clinical manifestations include sensory or motor peripheral neuropathy, drowsiness, or cerebellar ataxia”. 

While the effects of acrylamide, including peripheral neuropathy, are indeed terrifying, it is imperative that patients stay optimistic in the face of potential exposure or worsening of their condition.

Other Contributing Factors To Peripheral Neuropathy

While a lot is yet to be understood about the causes of peripheral neuropathy, research is shedding light on risk factors that may be contributing to or aggravating this disease. 

Below, we’ll explore the known causes of nerve damage.

Injuries And Trauma

Direct trauma is one of the leading causes of damage to a single nerve, a condition known as mononeuropathy. Traumatic injuries can interrupt a nerve’s connection to the brain, which can lead to neuropathic pain and numbness. 

Medical conditions such as carpal and cubital tunnel syndrome may also lead to nerve damage. In these cases, the structures around the nerve press on and irritate major nerves that connect the limb to the brain and the spinal cord, thus causing temporary or permanent neuropathy.

Autoimmune Diseases

A 2018 study shows that genetic factors contribute to 1 in every 2500 cases of neuropathy. Additionally, some forms of neuropathy – such as Charcot-Marie-Tooth disease – are hereditary. 

Beyond genetic and hereditary factors, autoimmune diseases may also lead to nerve damage. This is the case of degenerative or chronic inflammatory diseases, such as lupus and rheumatoid arthritis. These conditions are triggered by an overactive immune system, and cause the body to sustain high levels of inflammation for prolonged periods. Such high levels of inflammation can damage nerve fibers and cause neuropathy.

Hormonal Imbalance

Some hormonal imbalances may contribute to neuropathy. You may be at greater risk of nerve damage if your body produces too much or too little of certain hormones, including:

• Estrogen and testosterone. Sex hormones play a role in regulating inflammation levels. A sudden drop in these hormones, which may occur due to health events like menopause, can lead to inflammation-induced nerve damage. 
• Thyroid hormones. Hypothyroidism (having an underactive thyroid) can cause nerve damage by increasing fluid retention, causing the tissue to swell, and causing metabolic dysfunction. 
• Growth hormones. High levels of growth hormones can cause structures of the body (i.e.: bones and joints) to enlarge and press on nearby nerves.
• Progesterone. Progesterone contributes to developing and maintaining the myelin, which is the nerve’s protective sheath. When progesterone levels drop, the myelin is left unprotected, which can lead to a type of nerve damage known as demyelinating neuropathy.

Kidney And Liver Disorders

Kidney dysfunction can cause fluids, water, and waste products to accumulate in the body, which can have a toxic effect on the nerves. This condition is known as uremic neuropathy and affects an estimated 20-50% of people with kidney disease. Diabetes and high blood pressure are two of the leading causes of kidney disorders. 

Neuropathy is also a common complication of advanced liver disease. In this case, nerve damage occurs due to the fact that, when the liver does not work properly, toxins begin to build up in the blood. In some cases, these toxins may travel to the brain and cause a serious condition known as hepatic encephalopathy. 

Alcohol misuse is one of the leading causes of liver disease, alongside obesity and hepatitis infections. Additionally, chronic exposure to high quantities of alcohol can damage the myelin and lead to neuropathy. It is estimated that between 25% and 66% of those with alcohol use disorders also have neuropathy.

Vitamin Imbalances

Some nutritional deficiencies are associated with a higher risk of nerve damage. According to a 2008 study, these nutrients include:

• Copper
• Vitamin E
• Vitamin B12
• Folic acid
• Vitamin B1
• Vitamin B9

Too much or too little Vitamin B6 can also cause neuropathy. 

Some metabolic and digestive disorders may prevent your body from absorbing these essential nutrients. These conditions include Celiac disease and alcohol use disorder.

Infections

Nerve damage may also be caused by the sustained high levels of inflammation the body produces in response to infection. Such high levels of inflammation can damage the myelin, thus leading to peripheral neuropathy. Some infections that may trigger this condition include:

• HIV/AIDS
• Shingles
• Hepatitis B and C
• Epstein-Barr virus
• Diphtheria 

It is estimated that over 50% of people with HIV also have neuropathy.

The Effects Of Peripheral Neuropathy On Daily Life

Being a degenerative disease, peripheral neuropathy often starts with mild symptoms, such as discomfort and numbness in the hands and feet. However, over time, living with neuropathy can lead to an array of complications. 

Hypersensitivity to touch can cause you to experience pain at the lightest touch, which can prevent you from being productive at work or getting a restful night’s sleep. It is estimated that sleep disturbances affect nearly 70% of those with nerve damage. 

Additionally, if you are unable to feel pain, you may inadvertently expose your limbs to extreme heat or cold, or let infected wounds go untreated, which can lead to sores, ulcers, and the death of tissue (gangrene). Amputations due to neuropathy account for up to 75% of all non-traumatic amputations. 

Beyond causing debilitating pain and disability, neuropathy can also affect your mental health. According to a 2020 study, depression and anxiety affect 65% and 73% of people with neuropathy, respectively. 

Nerve damage can also affect your professional life and 43% of people with neuropathy report that their employment status is affected by their condition. 

While the complications of neuropathy can undoubtedly be serious, some treatment options can help you manage your pain and prevent the disease from progressing. Let’s look at these lines of treatment below.

Why Traditional Medications Don’t Work

Neuropathy is commonly treated with medications such as painkillers, non-steroidal anti-inflammatory drugs (NSAIDs), narcotics, anesthetics, and topical drugs.

However, given the chronic nature of this condition, taking medications daily can expose you to a cascade of risks and side effects. Understanding the advantages and risks of each line of treatment can help you make a more informed decision for your health. 

Below, we’ll look at the pharmaceutical treatments traditionally prescribed for neuropathy according to the National Institute of Neurological Disorders and Stroke.

Antidepressants

Antidepressants may be prescribed to manage neuropathic pain and address the mental health complications of neuropathy. This class of drugs works by increasing the activity of the neurotransmitters in the spinal cord that reduce pain signals. 

Some of the antidepressants prescribed for neuropathy include venlafaxine, bupropion, and duloxetine, which belong to a class of drugs known as tertiary-amine TCAs. 

Taking antidepressants regularly can lead to eating disorders, fibromyalgia, insomnia, and digestive issues. They may also increase the risk of heart disease and death.

Anesthetics

Some local anesthetics can help reduce neuropathic pain by blocking nerve conduction and preventing nerve signals from reaching the brain. This line of treatment is often prescribed when other pain-killing medications have not worked. Anti-epileptic medications that work similarly to anesthetics may also be prescribed. 

Headaches, dizziness, blurred vision, and gastrointestinal problems are just a few of the side effects caused by this line of treatment.

Topicals

Some topical pain-killing creams may help reduce the symptoms of neuropathy, especially if nerve damage is a complication of shingles. Some gels, balms, and creams that may be prescribed include:

• capsaicin (the active compound in chili peppers) cream
• Menthol-based counterirritants
• Lidocaine creams
• Topical NSAIDs

Narcotics And Opioids

Narcotics and opioids such as oxycodone may temporarily relieve neuropathic pain by blocking pain signals traveling to the brain. Although these drugs should only be used if other treatments have not worked, a 2021 study showed that nearly 44% of patients diagnosed with neuropathy between 2014 and 2018 were prescribed opioids. 

Narcotics can lead to serious complications, including drowsiness, slowed breathing, euphoria, and addiction.

Why Surgery Isn’t Worth The Trouble

Surgical interventions may be prescribed if the damage and irritation to a nerve is due to enlarged surrounding structures, such as in the case of carpal tunnel syndrome. 

However, the scientific community – alongside the team of specialists at Relatyv – advised against surgical interventions, especially if you suffer from neuropathy caused by diabetes, infection, nutritional deficiencies, or exposure to toxins. 

Even if surgery may appear to be your last resort to ease neuropathic pain, invasive procedures used to repair damaged nerves can further damage the nerves and lead to long and painful rehabilitation periods.

Other Non-Surgical Treatments

Some non-surgical treatments may help you ease the pain derived from neuropathy and prevent further nerve damage. However, these treatments are not equally effective on all patients.

Let’s look at what should be included in a non-invasive treatment for neuropathy below:

• Acupuncture and massage therapy: Acupuncture and massages may help relax the muscles around damaged nerves and stimulate blood flow, thus easing pressure and relieving pain. Massage therapy may also trigger the release of endorphins, which are the body’s natural painkillers. 
• Nutritional supplements: Some supplements may help you prevent or correct nutritional deficiencies that contribute to neuropathy, such as B12 and copper. 
• Quitting drinking and smoking: Avoiding alcohol and tobacco can limit your exposure to toxins that may further damage peripheral nerves. 
• Self-care: Maintaining a structured personal hygiene routine and examining your feet for infected wounds can help you prevent some of the complications of neuropathy, including ulcers. 
• Regular exercise: Regular physical activity can strengthen your musculoskeletal system and prevent muscle mass loss, which may help counteract the symptoms deriving from damage to motor nerves. Staying active can also help you keep a healthy weight and manage your blood sugar, thus reducing the risk of obesity and diabetes, which are risk factors for neuropathy. 
• Managing your blood sugar levels: If neuropathy is caused by uncontrolled diabetes, managing your blood sugar levels can help you prevent further damage to your nerves and stop neuropathy from progressing. 

Lastly, physical therapy may help. With the help of a physical therapist, you may be able to boost your muscle strength, improve your flexibility, and counteract the symptoms of neuropathy. Improving your physical health may also reduce the risk of falls and injuries, which are often caused by neuropathy.

Is There An Effective Treatment For Chronic Peripheral Neuropathy Pain?

Effective treatment options for peripheral neuropathy that don’t involve medications or surgery do exist – but not many patients are aware of them. By educating yourself, you’ll discover lines of treatments for chronic peripheral neuropathy pain based on regenerative medicine and natural therapies, such as Neurofunctional Pain Management.

Relatyv is at the forefront of chronic pain management by implementing cutting edge chronic pain management protocols that relieve pain, restore health, and magnify the quality of life for patients with chronic pain. 

Relatyv has pioneered the field of Neurofunctional Pain Management and created proprietary treatment protocols that stand at the forefront of the next generation of chronic pain management and peripheral neuropathy treatment. 

Neurofunctional Pain Management is a proprietary treatment program offered exclusively by Relatyv. This treatment is a combination of high pulse electrical stimulation and specialized hydration therapy that work together to produce enhanced pain relief that may endure for several months after a patient completes a course of treatment. 

For the most effective and lasting relief from peripheral neuropathy pain, Neurofunctional Pain Management treatments typically last for one hour, twice a week. With the combination of high pulse electrical stimulation which creates a sustained depolarization effect on the pain neurons, while also stimulating tissue regeneration that repairs damaged nerves and damaged microvascular tissues. 

Specialized hydration therapy of vitamins, minerals, and other nutritional components help patients restore health and create a synergy effect on their pain treatment condition. The combination of these two therapies create an enhanced pain relief effect that may endure for months without the need for drugs, surgery or invasive procedures. 

Many patients experience relief after a single treatment session and those who complete their entire treatment plan may experience months and months of pain relief and enhanced quality of life.

The Next Generation Of Peripheral Neuropathy Pain Treatment

If you have been diagnosed with peripheral neuropathy, relying on medications and enduring the side effects of pharmacotherapy may seem like the only options. Fortunately, as research around the causes, symptoms, and treatments for neuropathy progresses, a new option is now available to today’s patients: Neurofunctional Pain Management.

Relatyv understands that with a balance of high pulse electrical stimulation, and effective vitamin mineral restoration treatment to restore general full-body hydration, the treatment outcomes with Relatyv are substantial and constitute a new effective way of treating chronic pain. Neurofunctional Pain Management is really the most effective next generation chronic pain treatment in the medical field. Neurofunctional Pain Management as the next generation in pain management meets the Relatyv mission to relieve pain, restore health, and magnify quality of life while operating as a non-pharmaceutical, non-surgical, non-invasive, and non-chiropractic pain treatment program. Our vision is to be the first thought, first choice, and first step in the journey of chronic pain relief.