Treating Neuropathy: A Fortunate Series of Events
FEATURE
Todd G. Singleton
DC
While usually well versed in the general symptoms and causes of neuropathy, most chiropraetors aren’t seeking to treat it specifically. Millions of people in the United States have some form of neuropathy, but the majority have some variation of a peripheral neuropathy, which is linked to being prediabetic or diabetic. While this is not always the case, statistics show that many of the patients who come to you with this problem will fall into that category.
My goal wasn’t ever to become a doctor who treated neuropathy specifically, but as I expanded my practice to include nutrition and weight loss, I found that a large part of my patient pool suffered from the symptoms of neuropathy. As I researched its causes, I discovered that in spite of its seemingly idiopathic origins, most cases are connected to malnutrition, although not the kind you find in third-world countries, but the kind that brings patients into a weight loss clinic. It’s surprisingly common for those who are overweight.
Because so many people have some form of this condition, I have found that being able to address it greatly increases my patient pool. Following are the steps I have learned to take when dealing with neuropathic patients. (Since each case is different, this is not intended to be the only course of action. Please exercise caution when dealing with symptoms that vary from the following list):
"Following are the steps I have learned to take when dealing with neuropathic patients."
Step 1
A patient comes to your office complaining of tingling, numbness, sharp pains, or burning. He or she may also have ulcers (most commonly on the feet), cramping, or twitching. Some are unable to perform normal functions with closed eyes because their reflexes are damaged. Dizziness, fainting, and irregular heartbeats may also ensue. Generally, some very common triggers catalyze the manifestation of these symptoms. Check for infections, autoimmune disorders, excessive alcohol consumption, trauma, or repetitive stress. You may also want a history of cancer, kidney disorders, liver disease, or exposure to environmental toxins. Lastly, because most diabetic patients develop some level of neuropathy, ask for diabetic history.
Step 2
At this point, I explore the options the patient has and help him or her feel like there is hope (which there is!). Too often, my patients will express frustration at the lack of help they receive from other doctors who only want to put the proverbial
Band-Aid over the problem.
Many MDs will suggest drags, such as those used for epilepsy patients, antidepressants, or opioids. NSAIDS are also commonly prescribed, but are only a temporary fix—how discouraging to believe you must take them forever to feel normal! The importance of helping patients see other possibilities cannot be overstated. A patient who leaves the office with renewed hope and a boosted morale will surely be a lifelong patient who refers others to your practice.
Step 3
Depending on the patient and the symptoms, including severity, consider suggesting any combination of the following. Lifestyle changes can make a huge difference in a patient’s symptoms, often expelling them altogether.
Address contributing causes that are conspicuous and can be immediately addressed, such as environmental toxins, infections, or compression on a part of the body experiencing symptoms. These may indicate that the neuropathy may be short term and will be corrected somewhat straightforwardly.
Pay attention to blood glucose levels. Because high blood sugar can harm the fibers of nerves, keep sugar at a distance. It will make the walls of the blood vessels weaker,
■ "Patients with pain in their feet should wear loose cotton socks and shoes with extra padding. JJ
which supply nerves with the nutrients they need, as well as oxygen. I have found that when patients kick their soda habit, especially their diet soda habit, the results are astounding. Diet sodas contain an ingredient that inhibits blood flow and can dramatically worsen circulation in neuropathy patients.
Take special care of the feet. Since feet are such a common place for peripheral neuropathy symptoms to manifest, they should be checked often for ulcers, blisters, or lesions. Patients with pain in their feet should wear loose cotton socks and shoes with extra padding. Feet should be gently washed and inspected regularly.
Get rid of cigarettes and alcohol. These affect circulation and prohibit the body from being able to heal itself properly. Exercise, but gently! Moving is a huge help to the body. In addition to burning calories and building muscle, it gets blood moving. Exercises such as yoga, swimming, walking, and tai chi can have great effects with minimal impact. There are also in-office treatments that work to increase blood flow and circulation. I’ve found a high-volt, low-amp to be the safest treatment. Another great treatment is a circulatory cream followed by a wrap to help increase blood flow and lymphatic drainage in the lower extremities.
And lastly, the biggest difference will be made through diet. Getting the proper nutrition will work what most consider to be miracles. Work with your patient to come up with a twoweek meal plan, a list of “can eat” and “cannot eat,” or a plan that strictly includes or excludes certain foods or ingredients. Different patients will be partial to different kinds of plans, but the important thing is getting them to do it.
a. They should eat mostly vegetables, whole grains, and lean proteins. Some doctors advocate for a vegan diet, but this should be decided between you and the patient.
b. Lots of leafy greens. There is no other food in the world that is cited more for its rich nutrient content than the catchall phrase, “leafy greens.” This can include various types of lettuces, chards, spinach, kale, or aragula.
c. Make sure the patient is getting plenty of vitamin B12 and E. Correcting vitamin deficiencies is vital, and most neuropathic patients are deficient in their vitamin B12 intake. This can come from lean organic meats, fish, or eggs. Vitamin E will improve insulin activity and improves glucose tolerance. Encourage clean, organic foods to minimize trace hormone and pesticide ingestion.
d. Before a patient comes in for treatment, have them take a high-quality form of 1-arginine and 1-citrulline to help with nitric oxide release.
e. Cut out all sodas and other sugary foods.
Step 4
Stay connected with your neuropathic patients; they need one-on-one care and support. The previous list represents a lifestyle vastly different from what the majority of Americans live. They will need encouragement and milestones. You may consider assigning a staff member to make daily phone calls to patients to check on their goals and progress. While it will take a few weeks to see significant results, every day will count as they change their diet and other habits. Our profession is extraordinary; one that affords us the tools and the vision to help our communities along in their wellness journeys.
*see also “Have You Considered Using Nutrition to Help Patients with Neuropathy?” by Dr. Todd Singleton, The American Chiropractor, Nov. 2012
Dr. Todd Singleton, DC, is an author, speaker, and consultant who has been a practicing doctor for more than 25 years. He ran the largest MD/DC/PT clinics in Utah before switching to an all-cash nutrition model in 2006. He created a very successful cash practice in Salt Lake City and now spends his time speaking, teaching, consulting, and visiting other offices all over the United States. For more information on implementing nutritional protocols in your clinic, call 801-917-0900 or visit www.ArticlesByDrSingleton.com
