The end is near for 2003, and what a year it has been! Thank you to everyone who reads and comments on this column. I have thoroughly enjoyed answering your questions and providing a chiropractic perspective on a variety of topics this year. It is my sincere hope that the material covered here has been informative and in certain cases empowering for those who have read it and who needed to have a different slant on issues relating to their health. A request came a couple of weeks ago for information regarding a condition known as neuropathy, and here is what I have found.
Neuropathy is a term which describes a condition of dysfunction or pathology (disease) in a nerve. Most often the term neuropathy is used in conjunction with the peripheral nervous system, or the portion of the nervous system which sends messages from the brain and spinal cord out to organs and tissues of the body and messages from the body back to the brain. When this type of nerve is affected, the more complete term is peripheral neuropathy. Symptoms associated with peripheral neuropathy include pain, numbness, tingling, muscle weakness, burning sensations, and paralysis. These symptoms most commonly affect the arms, legs, hands, and feet.
Peripheral neuropathy is not a specific disease itself, but describes a culmination of other disease processes which result in the actual damage to peripheral nerves. Peripheral neuropathy is very frequently associated with diabetes, since approximately 60 percent of those who have diabetes also have some degree of peripheral neuropathy. There are, however, many more causes of peripheral neuropathy and there is even evidence of the presence of neuropathy without any directly assigned cause, especially in people over 60 years of age. This is known as idiopathic peripheral neuropathy. Peripheral nerve damage is often caused by alcoholism, autoimmune disorders, liver failure, one of several infectious diseases like Lyme disease, HIV, hepatitis B and others, kidney failure, and of course, diabetes.
There is another cause of peripheral nerve damage, though, and this is the one that a chiropractor can definitely help. Entrapment syndromes have been known to result in transient (temporary) peripheral neuropathy. Carpal tunnel syndrome, tarsal tunnel syndrome, thoracic outlet syndrome, piriformis syndrome, and other entrapments can result in long-term nerve compression and give the body pathological nerve function. If there is something putting pressure on a nerve and it is moved off the nerve the nerve can then function normally as long as the pressure has not been on the nerve for a long enough period of time to cause permanent damage. Numbness and tingling along with pain in the feet and legs are common symptoms of sciatica, and sciatic nerve pressure is often easily remedied by chiropractic adjustments. Sometimes the bones in the feet are out of proper alignment and cause nerve pressure. A chiropractor who is trained in extremity adjusting can adjust the bones of the feet and restore proper sensation if that is the source of the problem. Very commonly bones in the elbow, wrist, and hand are misaligned and cause nerve pressure which can be very painful. When these bones are realigned the sensation returns to normal if their misalignment is what is causing the paresthesia.
If you are suffering from what you believe is neuropathy and there is no readily apparent disease process associated with the discomfort you are feeling, start the process of elimination to determine the cause of the problem and perhaps find a way to get better. There are several tests that can be performed to help figure out just how badly damaged the nerves in your body are, but some of them can be somewhat invasive procedures. Nerve conduction velocity studies and needle EMG are commonly used. It might be helpful to start with the least invasive procedures first then proceed up to the more complicated ones if the conservative route does not produce results for you. Ask your chiropractor if he or she can work on possible entrapment sites to free the nerve compression and see how much normal function might be restored to the peripheral nerves. You just might be pleasantly surprised and find that what you thought was a serious problem is just another day at the office for your chiropractor. Treat your body well. Merry Christmas and may you have a prosperous New Year.