Chilli Patches Do They Help Or Not

Today's short post from neuropathydoctor.com (see link below) is written by Dr. Brandt R.Gibson, whose work has been featured on this blog before. Although it's from february 2012 and the story is not new, I'm publishing it in response to recent questions about both capsaicin cream and the capsaicin patches from NeurogesX. Do they work? Well, the American FDA says that the evidence is not sound enough to rate their approval, especially for people with HIV-related neuropathy but looking around the forums, it's clear that some people's (but by no means all) symptoms have been helped by using capsaicin (chilli pepper) derivatives, so as the doctor says; why deny yourself some relief if something genuinely helps! Watch out though; the cream must never get in your eyes or mouth, it can be very painful. Using thin, disposable, rubber gloves is advised. Similarly, the patches need to be administered by someone who knows what they're doing (a nurse or doctor) and although they can provide relief for some period of time, initially they will be painful. You should discuss this with your doctor before going ahead, in the knowledge that capsaicin will not 'cure' your neuropathy but may help to relieve the symptoms.

Chilli Pepper Patch May Not Work For HIV Neuropathy

by Brandt R. Gibson, DPM on 9 February 2012


A pain patch from NeurogesX Inc., made from chilli pepper has been questioned on efficacy by the FDA. This drug was designed for HIV patients with associated peripheral neuropathy. There is approximately 1.1 million people in the United States infected with HIV. Of these, approximately 1/3rd present with peripheral neuropathy either from the virus itself of the drugs utilized to treat it. According to the FDA, however, the efficacy was not shown yet in any of the studies, so it may not get approved until additional studies are done.

This is a big blow to the company, but a positive for HIV sufferers if the medication really has no efficacy. The problem I have with limiting access to drugs that may help is that peripheral neuropathy in other forms may benefit from this medication even when HIV associated neuropathy is not helped. Neuropathy varies with the causes and therefore varies with the treatment options. All neuropathy patients deserve a medication that can decrease or resolve the associated pain that can be very debilitating.

One small side note, Zostrix or Capsaicin creams are similarly made from red peppers and have been shown to be effective in peripheral neuropathy by overstimulating the nerves and creating a resolution of pain for a period of time. Although these treatments have not been shown to resolve neuropathy, they are valuable in the treatment of the pain in many individuals. If the drug made by NeurogesX Inc. were effective even in some respects it may be worth putting it on the market as an option.

Just my personal opinion…..

http://neuropathydoctor.com/http:/neuropathydoctor.com/chill-pepper-patch-may-not-work-for-hiv-neuropathy

To Cane Or Not To Cane For Neuropathy

Today's article from neuropathy.org (see link below) examines a problem that many people living with long-term neuropathy eventually have to face and that is whether to take advantage of walking aids like canes. It's very often a matter of pride. You don't want to be seen needing a walking cane and you put it off as long as possible while running the constant risk of misstepping or losing your balance. Most people who invest in a cane see the benefits immediately. It's like having a third leg that helps to stabilise you whilst walking and before you know it you forget that people may be looking at you differently. Certainly the benefits can outweigh what you may see as stigma.

Coming Around to Using a Cane
By Elizabeth Byleen June 2013

"The amazing thing about the cane is that it is teaching me to walk differently. With the cane, I have loosened up. My stride has become longer and more relaxed. It takes less effort to walk, so I walk more. I have become physically stronger. This new strength and my more relaxed gait carry over even when I’m not using the cane."

Support Your #1 Cause: The Fight
Against Neuropathy!

My inherited peripheral neuropathy has me walking in my father’s footsteps. Just like him, it’s difficult to stay on my half of the sidewalk. In fact, as I walk to work, many people don’t pass me on the sidewalk, but walk out in the street around me. My gait is unpredictable; I wobble and weave, and my balance is a problem. My proprioception (or perception of knowing where I am in space) is off, especially when I’m in low light. But just like my dad, I keep moving. I’m ambulatory, and that feels great.

Several years ago, when I lost my balance and fell in my bedroom— pushing my hand through a glass window and bruising my face on the nightstand—a friend suggested I use a cane at night. “Oh, not me! Not even in the privacy of my own home,” I said to myself. A few years later, when my doctor suggested a cane, I was insulted, even though I careened off a wall as I left his office. A cane was a symbol of giving up and admitting defeat. I was in my early fifties, and not willing to send out that message.

The summer after my doctor suggested a cane, I stopped in to visit with my 90-year old neighbor, Hazel, who was sitting on her front porch. Rather exhausted after a long walk, I shared with Hazel that I was discouraged by how I walked; in fact, two people along the way had asked me if I was okay. She offered to let me borrow one of her canes for a while and see how it worked for me. Out of politeness, I said I would.

On the short walk home, even though the cane was not the correct height, I noticed immediately how helpful it was. I didn’t lean into it, but with just a light touch, I got more feedback about where I was, making it much easier to navigate. That week, my daughter and I took long walks in the evenings. I walked straighter and taller. I was more confident, and I didn’t obsess about every crack in the sidewalk that might trip me up.

The amazing thing about the cane is that it is teaching me to walk differently. Because of the fear of falling, the fear of running into people, and the fear of being perceived as drunk or somehow not quite right, over the years I had developed a real tightness to my walk. I tensed everything up: my mind, my shoulders, my arms, my hips, and my legs. With the cane, I have loosened up. My stride has become longer and more relaxed. It takes less effort to walk, so I walk more. I have become physically stronger. This new strength and my more relaxed gait carry over even when I’m not using the cane.

Our resistance can be so fierce. While I once thought a cane was only a symbol of my decline, it’s proving to be a very helpful tool, especially in crowds, unfamiliar places, and over long distances. Having that extra point of contact—basically acting as a tripod—provides me much more stability. An unexpected benefit is that my cane sends a quick visual signal to others to give me more space and time to maneuver. I had to overcome incredible resistance to eventually arrive at something that works so well for me.

http://www.neuropathy.org/site/News2?page=NewsArticle&id=8393