Complementary And Alternative Medicine (CAM)

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Complementary and Alternative Medicine (CAM) Treatmentsfor Peripheral Neuropathy (PN)(Last Updated august 20, 2015)Most peripheral neuropathy (PN) treatments are centered on pain reduction and improvement infunction. Effective treatment for injured nerves often requires a combination of medicines,exercise and other therapies. It can take some time to find the combination that is right for you.Mild pain may respond to a simple over-the-counter (OTC) drug, like ibuprofen oracetaminophen. Or your provider may prescribe one or more medications for you. Morecommonly used medicines include neuropathic pain agents, most often anti-seizure medicationsor certain anti-depressants. Consult your provider to learn what is right for you.Should you suffer from Diabetic Peripheral Neuropathy (DPN) the most important thing you cando is to manage your blood glucose level which can prevent further nerve damage. Managingyour diabetes plays a critical role in treating DPN, so keep your blood sugar levels in normalrange with frequent testing, proper diet, exercise, medications and/or insulin therapy.In addition to working with your providers, the Neuropathy Action Foundation (NAF) has foundthat some patients find relief by exploring the treatments listed below. Many patients find thatan integrative approach – one that uses both conventional methods and Complementary andAlternative Medicine (CAM) therapies – is the best way to manage their pain and discomfort.Therefore, this brochure was created by the NAF based on what we have heard from patientssince the NAF was created in 2006. Since some CAM therapies, particularly nutritionalsupplements, interact with certain prescription drugs or may not be appropriate for use by somepatients, it is very important to consult with your medical provider before starting a new CAMtreatment.NOTE: This brochure is for educational purposes and not for the purpose of rendering medical advice.Information in this brochure is not intended to replace the counsel of your provider. It is important toconsult your provider before altering your treatment plan. Information provided does not imply medicalrecommendation or endorsement. The NAF does not endorse any medications, products, equipment ortreatments.Absorbine Jr. – This product is applied directly on the pain area typically at bedtime. It is aformulation of menthol combined with natural herb extracts. It is available in most drug stores.Acupuncture/Acupressure – Acupuncture is a method of encouraging the body to function.This is done by inserting needles and applying heat or electrical stimulation at very preciseacupuncture points.Alpha Lipoic Acid (ALA) – ALA, found in all cells of the body, is a vitamin-like chemical calledan antioxidant. Yeast, liver, kidney, spinach, broccoli, and potatoes contain small amounts ofALA. It is also made in the laboratory and has been used since the 1950’s as a dietary1950 Old Tustin Avenue Santa Ana, CA 92705 (877) [email protected]

supplement. ALA is approved in Germany for the treatment of DPN. ALA seems to helpprevent certain kinds of cell damage in the body. There is evidence that ALA can improve thefunction and conduction of neurons in diabetes, may help with regrowth of damaged nerves andmay help limit and treat neuropathy caused by chemotherapy. It is sold in drug stores.Analgesic Creams, Rubs, and Sprays - Topical pain killers, or analgesics, are sprayed on orrubbed into the skin over painful muscles or joints. Although are all designed to relieve pain,different products use different ingredients. Here are the most common ingredients found inproducts available without a prescription. Counterirritants. Ingredients such as menthol, methylsalicylate (oil or wintergreen), andcamphor are called counterirritants because they create a burning or cooling sensationthat distracts your mind from the pain.Salicylates. These same ingredients that give aspirin its pain-relieving quality are foundin some creams. When absorbed into the skin, they may help with pain, particularly injoints close to the skin, such as the fingers, knees, and elbows.Capsaicin Cream. The main ingredient of hot chili peppers, capsaicin is also one of themost effective ingredients for topical pain relief. When first applied, capsaicin creamscause a warm tingling or burning sensation. This gets better over time. You may need toapply these creams for a few days up to a couple of weeks before you notice relief.Aquatic Aerobic Exercise - Water supports your body so your muscles are developed withoutjarring. Exercise programs can be found in gyms with pools or in therapy pools supervised byphysical therapists.B Vitamins - Patients with peripheral neuropathy may be deficient in B-complex vitamins.Many patients have told us over the years that taking B12 daily has helped them. Also,benfotiamine, a fat-soluble, highly absorbable form of thiamine (vitamin B1) might reducediabetic pain and improve nerve conduction velocity. It is important not to take more than therecommended amount of vitamin B6 daily, as this can actually cause neuropathy.Bed Cradle – Supportive treatments like a bed cradle that can keep sheets and blankets fromtouching sensitive feet and legs have been shown to help many patients over the years.Biofeedback - Biofeedback is a technique that trains people to improve their health bycontrolling certain bodily processes that normally happen involuntarily, such as heart rate, bloodpressure, muscle tension, and skin temperature. Patches, called electrodes, are placed ondifferent parts of your body to measure your heart rate, blood pressure, or other function. Amonitor is used to display the results. With help from a biofeedback therapist, they will describea situation and guide you through relaxation techniques. The monitor lets you see how yourheart rate and blood pressure change in response to being stressed or remaining relaxed.Initially, you will use the monitor to see your progress, but eventually you will be able to achievesuccess without a monitor or electrodes. Biofeedback is primarily used to treat high bloodpressure, tension headache, migraine headache, chronic pain, and urinary incontinence.1950 Old Tustin Avenue Santa Ana, CA 92705 (877) [email protected]

CoQ10 – Also known as ubiquinone or ubiquinol. CoQ10 is an antioxidant that is essential fornerve health. Taken as a nutritional supplement, it has been shown to decrease signs ofneuropathy caused by diabetes and chemotherapy, and in some cases, to help with regrowth ofdamaged nerves. CoQ10 is available without a prescription at drug stores.Compounded Pharmacy Medications – Many traditionally prescribed oral medications forneuropathy have side effects and OTC products may not be helpful enough. Therefore, somepatients are taking advantage of specially created medications that combine the activeanalgesic benefits of various products with nerve health supplement ingredients into creams,gels, patches, etc. Traditional pharmacists are not in a position to create such products, butCompounding Pharmacists can work with your doctors to create medication alternatives for you.Diet – Making the right choices in your diet will make a huge difference in your overall health!Limit your refined carbs and sugary drinks; choose water over soda, and drink skim milk insteadof whole milk. Choose baked or broiled foods over fried, and limit your sodium intake. You arewhat you eat, but when you eat is just as important when managing diabetes. Keep regularmeal and snack times to keep your blood sugar levels constant. Also watch your size portions.Ergonomics and Splints – Can be helpful for people suffering from muscle weakness as theresult of PN. Also, making ergonomic changes to one's workplace may reduce the symptoms ofcarpal tunnel and help alleviate the pain from peripheral neuropathy.Evening Primrose Oil – Evening primrose oil is the oil from the seed of the evening primroseplant, and is one of the main sources of the essential fatty acid “gamma-linolenic acid” (GLA).Some people use evening primrose oil for nerve damage related to diabetes. Studies havefound that GLA may help reduce symptoms of diabetic neuropathy.Exercise Classes – Low impact exercise classes can be helpful in strengthening weakenedmuscles, helping restore better balance, relieving pain and depression through the release ofendorphins. It is important that those who suffer from PN keep moving to maximize potentialsfor wellness and minimize our propensity for weakness.Feldenkrais – A form of physical therapy that uses gentle movement and directed attention toimprove movement and enhance human functioning. Some say this technique helped themincrease their ease and range of motion, flexibility and coordination. Feldenkrais teaches thatincreasing a person's kinesthetic self-awareness of functional movement could lead toincreased function, reduced pain, and greater ease and pleasure of movement.Ice Pack – May relieve pain, swelling and inflammation from injuries and conditions such as PN.Icy Hot – For some people, this over-the-counter topical ointment cools down the hot feetand/or warms up cold feet. It may also help with muscle and joint pain.Infrared Light Therapy – Available from a variety of providers, this therapy uses infrared light.It is purported to increase circulation and reduce pain. It is available through podiatrists,chiropractors, and other medical practitioners, as well as machines available for home use.1950 Old Tustin Avenue Santa Ana, CA 92705 (877) [email protected]

Ivory Soap – While some dismiss this product for PN as an urban myth or quackerynonsense, some people are finding that placing a bar of Ivory between the sheets at the foot ofthe bed actually reduces their night time PN feet distress. (Some have used other soaps.)Lidocaine Patches – These are commonly used for severe pain using very high powered painmedications and are available only by prescription. There are also a number of over-the-counterpain patches for lesser levels of pain and containing non-narcotic ingredients.Massage - Massage or massage therapy is a system of structured palpations or movements ofthe soft tissues of the body. The massage system may include, but is not limited to, suchtechniques as, stroking, kneading, gliding, percussion, friction, vibration, compression, passiveor active stretching within the normal anatomical range of movement. It is increasingly beingoffered along with standard treatment for a wide range of medical conditions and situations.Meditation - Meditation is one of the most widely used forms of complementary therapy,particularly as a palliative for chronic illness. Available meditation research is generally of lowto-modest quality, but tends to support this intervention for the reduction of stress and pain, andimproving quality of life in a variety of medical conditions.Neuragen – Neuragen is a topical product that works directly at the site of the pain. Neuragenclaims to reduce the spontaneous firing of damaged peripheral nerves. By calming these firingsat the source, Neuragen has been reported to reduce shooting and burning pains quickly andwithout the side effects of oral medications. Some patients who have used Neuragen havereported sleeping better and being able to walk without pain. Neuragen is a homeopathic painreliever and may be used alone or in with other medications. It is available over the counter inmost local pharmacies either in the diabetic section or the analgesic (pain) section.Nikken – Magnetic, infrared, and other therapeutic products including creams and vitaminsupplements. The magnetic insoles have been helpful for some who find walking difficult.Peppermint Lotion – Cooling and soothing for neuropathic distress. The often used Dr.Scholl’s Peppermint Foot & Leg Lotion version is available at most pharmacies.Physical Therapy – A variety of physical therapies can be helpful for some neuropathyconditions, particularly in relation to restoring balance, increasing lost muscle strength, andrelieving neuro-muscular disorder pain and distress.Reflexology – Reflexology is an alternative medicine (therapy) involving application of pressureto the feet and hands with specific thumb, finger, and hand techniques without the use of oil orlotion. It is based on a system of zones and reflex areas that reflect an image of the body on thefeet and hands, with the premise that such work effects a physical change to the body.Reikii – Reiki is a Japanese technique for stress reduction and relaxation that also promoteshealing. It is administered by "laying on hands" and is based on the idea that an unseen "lifeforce energy" flows through us and is what causes us to be alive.1950 Old Tustin Avenue Santa Ana, CA 92705 (877) [email protected]

Shoes – Orthopedic inserts and specially designed shoes have been reported to help manywho suffer from PN. Find a good shoe store that will consult with you and fit you well. If you arewearing an orthotic, be sure to take it with you to be sure it fits well in your shoe choice.Properly fitting shoes are essential for those with neuropathic distress in their feet and/or withleg and back pain problems. Wear shoes/slippers to protect your feet, even when you are athome. Many insurance programs, including Medicare, can help cover the costs.Sore No More - A pain-relieving gel that begins to work immediately once massaged ontoaffected area. Claims to have unique heating and cooling ingredients made from a specialblend of natural plant extracts in combination with menthol, capsaicin and witch hazel.Tai Chi – Tai Chi is a Chinese martial art practiced for both its defense training and its healthbenefits. Many believe that Tai Chi helps with fall prevention, general healthcare in olderpeople, improving ba