Massage Therapy for the Treatment of Peripheral Neuropathy
Dr. Marc Spitz — Director of the Foot Pain Center

Peripheral neuropathy is a condition whereby the nerves of the feet (and to a lesser extent in the hands), become damaged. This condition which affects 21 million Americans, causes numbness, burning, tingling and other uncomfortable sensations in the feet. In many cases the muscles and tendons in the feet and legs become weakened causing walking and balance problems.

Causes of peripheral neuropathy
There are over 20 known causes of this condition. Some of more common causes are:
• Diabetes
• Chemotherapy drugs for cancer treatment
• Some prescription medications such as “statin” drugs for high cholesterol or prolonged antibiotic therapy
   for infections
• Exposure to environmental toxins such as lead or mercury
• Heredity factors
• Excessive alcohol intake
• Infections including HIV
In about 40% of the cases the exact cause of the neuropathy is not known and this is called idiopathic neuropathy.

Treating Peripheral Neuropathy
In most instances, neuropathy can not be cured as nerve damage is difficult to reverse. Treatments are aimed at making the neuropathy sufferer more comfortable so they can experience a better quality of life. Oral medications and topical products along with therapy treatments are used to treat peripheral neuropathy. Laser and infrared therapy has been helpful in reducing the discomfort of neuropathy. The Foot Pain Center, which specializes in the treatment of peripheral neuropathy, relies heavily on the use of massage therapy in treating this condition.

How massage works in treating peripheral neuropathy
The technical definition of massage is the use of pressure on targeted body structures such as muscles, tendons, nerves, ligaments, joints or lymphatic vessels. Massage can be administered by the human hand or by an electrical massage unit. Massage therapy offers a wide range of benefits which include:
• Pain relief
• Increased circulation to the area being massaged
• Easing of tension and stiffness
• Relaxation
• Promoting of healing

At the Foot Pain Center, massage therapy is used regularly in treating patients suffering from neuropathy. As noted, massage helps increase circulation to affected areas—including damaged nerves. Increased blood flow to damaged nerves helps reduce pain, tingling burning and numbness.

The use of Medi-Rub® Massagers in treating peripheral neuropathy
The Foot Pain Center uses both the foot massager and body massager in treating peripheral neuropathy symptoms. These units are excellent for home use as well, so neuropathy sufferers can “self-treat” at home or at work. The foot massager can provide immediate relief to the entire foot. The body massage is helpful when applied to the feet and legs to soothe sore muscles and to help stimulate circulation.

Ask Dr. Spitz — Director of the Foot Pain Center

Q: Why do my feet feel worse at night?
A: Many people with peripheral neuropathy have more discomfort at night, experiencing more pain, burning, numbness and tingling. The reason for this is twofold: In the evening during “quiet time” away from the distractions of daily chores and work, we are more sensitive and aware of pain and other sensations. Another reason is related to release of a chemical called nitric oxide. Nitric oxide is a chemical which freely circulates in our bodies. It helps increase local circulation. During sedentary periods (at bedtime), it remains bound to the blood cells and is not released as readily when we are active or exercise. This lack of circulating nitric oxide also accounts for worse symptoms in the evening.

Q: Why do diabetics develop peripheral neuropathy?
A: Approximately 50% of all diabetics develop some form of peripheral neuropathy. The primary factor in the development of peripheral neuropathy in the diabetic patient is elevated blood sugar levels. High glucose (sugar) levels, is toxic to the nerves causing destruction of nerve cells.

Q: My feet are numb—how can I protect them from injuries and infection?
A: Here are some guidelines to prevent foot problems:
• Inspect your feet daily
• Wash your feet daily with lukewarm water and mild soap
• After bathing, dry your feet well, especially between the toes
• Keep your skin smooth using a mild moisturizing lotion
• Always trim your toenails straight across
• If you have a toenail problem such as a thickened and discolored nail or an ingrown toenail, see a
  podiatrist for treatment
• Do not use harsh acid medications to remove corns or calluses
• Always wear comfortable shoes that fit properly

Q: My feet feel numb yet they hurt at the same time—how can that be?
A: Nerves can be compared to electrical wire. A wire that is frayed can “short-circuit”, and not conduct electrical current properly. Similarly, nerves that are damaged can not conduct nerve signals correctly. The brain which is our body’s computer, can not adequately process these faulty nerve signals. As a result, a person with peripheral neuropathy will often experience many odd and contradictory sensations.

Q: What are the best exercises for people with peripheral neuropathy?
A: At the Foot Pain Center we recommend different exercises depending on a patient’s general health and life-style. Walking is an excellent exercise since it is low-impact and has many benefits such as helping to lower blood pressure and improved circulation. Some people with neuropathy have balance problems and have a tendency to fall. In these cases I recommend water exercises such as swimming or water aerobics. Biking outdoors or using a stationary bike is also beneficial with reduced risk of injury from falling.

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