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.
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
Today's post from sciencedaily.com (see link below) is yet more evidence of how the nervous system is being closely studied and better understood. In this case, a class of nerve cells called microglia are the centre of attention. Previously these cells (about 10% of all cells in the brain and spinal cord) had only been thought to provide a supporting role to other cells but now it's emerged that they are vital components of the messaging system which forms the basis of a healthy nervous system. It's beginning to look as though we're at the beginning of exciting times in nerve cell research - so many new avenues to explore with so many potential benefits for neuropathy patients at the end of it. However, don't expect major breakthroughs just yet - these things take years and sometimes decades before research bears fruit. That said, neuropathy patients are a long-suffering and patient bunch!!
New findings about mechanisms underlying chronic pain reveal novel therapeutic strategies Date:May 26, 2015 Source:Canadian Association for Neuroscience
Chronic pain affects hundreds of millions of people worldwide and is a major cause of disability, causing more disability than cancer and heart disease. Canadian researchers, including Michael Salter at SickKids are shedding light on the molecular dynamics of chronic pain. They have uncovered a critical role for a class of cells present in the brain and spinal cord, called microglia, in pain. They have found microglia-to-neuron-signaling to be crucial in the development of pain hypersensitivity after injury, but also for one of the paradoxical effects morphine and other opioids sometimes produce, called hyperalgesia, which is an increase in pain sensitivity. The identification of these key players in the development of chronic pain helps identify important targets for the development of novel therapeutic avenues. Dr. Salter presented his latest results at the 9th Annual Canadian Neuroscience Meeting, on May 26th 2015 in Vancouver, British Columbia.
"We're developing a new understanding of the control of microglia-neuron interactions that may be critical for individualizing pain therapies" said Salter.
Pain is a complex experience. The International Academy for the Study of Pain, IASP defines it as, "an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage." While acute pain can be useful, as a signal that protects us from injury or even death, and inflammatory pain can protect us during healing, chronic neuropathic pain, which is a disease of the nervous system, is pain that persists after an injury is healed, serves no useful function and is a major cause of disability.
Work done in Dr. Salter's laboratory has helped to gain understanding of the changes in the nervous system, and to uncover the key molecules that form the cascade of events that lead to chronic pain. A class of cells called microglia play a central role in this cascade. Microglia constitute about 10% of the cells of the adult brain and spinal cord (also known as the central nervous system). Initially thought to have simply a role in supporting neurons (the term glia derives from the same root as glue), microglia were later shown to have an important role in the spinal response that follows nerve injury.
"Exciting new discoveries indicate that microglia not only play a critical role in disease states but also in the normal development and functioning of the brain and spinal cord," Salter explained. "We are looking at these cells in an entirely new light."
More recently, microglia have been shown to have a much more active role in the healthy central nervous system, and to be highly active in surveillance and rapid response -- microglia monitor and control the activity of neurons in the healthy nervous system. Within the dorsal horn of the spinal cord, the area through which pain signals travel to the brain, microglia block the inhibition of pain transmitting neurons, making transmission of the pain signal more efficient. This can lead to allodynia, which is defined as pain due to a stimulus that does not normally provoke pain.
Nerve injury activates a receptor on microglia, called P2X4, which, in turn causes the release of a molecule called Brain Derived Neurotrophic Factor, or BDNF. BDNF has been shown to have a role in learning in the motor cortex, where its release results in enhanced motor performance. Dr. Salter proposes that when microglia-derived BDNF facilitates the output of the dorsal horn pain-transmitting network, the result is enhanced pain. When BDNF facilitates this network, it is as if neurons had "learned" pain, and they become more efficient in the transmission of pain signals.
Morphine and other opioids are sometimes prescribed to treat chronic pain when other treatments do not work. While these drugs can be very efficient to relieve pain, some patients develop a paradoxical effect, called hyperalgesia. Paradoxical hyperalgesia is an increase in pain caused by drugs prescribed to alleviate pain. Dr. Salter's research shows that microglia-to-neuron-communication is crucial for the development of this effect.
Research done by Dr. Salter and his colleagues shows how the experience of pain can change the nervous system to make it more sensitive to further painful experiences, to feel pain in response to events that do not cause pain in most people, and how opioids can paradoxically cause more pain. Dr. Salter anticipates that by targeting the signaling pathways identified in these studies new therapeutic strategies for chronic pain will be developed
Story Source:
The above story is based on materials provided by Canadian Association for Neuroscience. Note: Materials may be edited for content and length.
http://www.sciencedaily.com/releases/2015/05/150526132353.htm
Today's excellent post from healthperfection.co (see link below) is the article you wish you'd read when you first found out you had neuropathy. It would have saved months of personal research, visits to the doctor, trial and error treatments and unpleasant surprises. For that reason, it's recommended reading for all people living with neuropathy. For the 'experts' you may learn something you didn't already know and for the 'beginners', you certainly will learn something you didn't already know. Worth a read.
By admin On March 5, 2016 In Health News
Have you ever learned a piece of valuable new information about neuropathy and thought to yourself, “I wish I would’ve known that when I was first diagnosed.” If you’re anything like me, this is a somewhat frequent occurrence. The reality is that while a lot has been (and is being) discovered about neuropathy in the scientific and medical communities, our understanding of it is an evolving process. Compared to a decade or two ago, we know considerably more now than we did – but even so, there is much that is yet to be fully understood about this silent but painful nerve condition.
As I look back on all I’ve learned about neuropathy over the years – from causes to treatments and everything in between – there is a lot I wish I’d been told about sooner. As with any battle against a chronic condition – knowledge is power. The more you know about your neuropathy – including its potential causes and the steps you can take to most effectively treat it and prevent it from spreading – the better your chances are of reducing your neuropathy related symptoms and preventing further nerve damage.
With that said, here are 11 things I wish I’d known about neuropathy when I was first diagnosed:
There are many potential causes – including medications
Some of the known causes of neuropathy include diabetes, chemotherapy, exposure to toxins, surgery, injury or trauma, vitamin B12 deficiency, excessive amounts of vitamin B6, autoimmune diseases, nutritional imbalances, excessive alcohol consumption and even medications. Knowing the cause of your neuropathy is one of the most important factors in determining how to treat it.
MORE: 7 Potential Causes of Your Neuropathy
In some cases, the cause of neuropathy will remain a mystery even after thorough testing and investigation. This is referred to as idiopathic neuropathy, meaning the cause is unknown. In most cases, however, doctors should be able to arrive at a cause (or number of causes).
Some Causes Are Reversible
One of the dreaded realities we often associated with neuropathy is that the damage is irreversible – that you’re stuck with the pain, tingling or numbness forever. While in many cases the damage and symptoms may last indefinitely, there are cases in which the damage may be reversible. This largely depends on the cause of your neuropathy and how quickly you catch it and take steps to reverse it (obviously, the earlier the better).
Among the causes in which damage has the potential to be stopped and even reversed are diabetes, vitamin B12 deficiencies, nutritional deficiencies, heavy alcohol consumption and medications. Of course, to have any hope of stopping or reversing the damage one must determine the cause of the damage and take immediate steps to remedy the problem.
For those with diabetes or nutritional deficiencies, managing blood sugar and improving diet is key to reversing the damage. Those with vitamin B12 deficiencies should work with their doctor to determine ways to eliminate the deficiency through diet or supplementation. Finally, those with neuropathy caused by alcohol or medications should restrict or eliminate the use of the substance causing the damage.
Nerve Damage Can Spread If Underlying Cause Isn’t Addressed
The peripheral nervous system is comprised of nerves running from the brain and spinal chord to other parts of the body. Damage to the peripheral nerves typically manifests itself first in our extremities – usually the hands or feet. What many neuropathy patients don’t realize is that over time these symptoms can spread to other parts of the body – including the arms, ankles, legs and more – if the underlying cause isn’t addressed. This is why both early detection and treatment are so critical.
Look Out For Early Indicators of Peripheral Neuropathy
The earlier you can catch neuropathy the better your chances of preventing the symptoms from spreading. Some of the early signs of neuropathy to watch out for include:
Gradual numbness or tingling sensations in the feet or hands (which may spread into the legs and arms)
Sharp, stabbing pains
Intense burning pain
Extreme sensitivity to touch
Loss of balance or coordination
Muscle weakness, loss of motor skills
Restless Leg Syndrome (RLS)
Neuropathy Can Affect Muscle Control
Within the peripheral nervous system there are three types of nerves: motor, autonomic and sensory. While the most recognizable symptoms of neuropathy are related to the sensory nerves (i.e. pain, tingling and numbness) – nerve damage can manifest itself in other ways as well. When neuropathy damages the motor nerves, it disrupts the nerves ability to relay messages from the brain and spinal cord to various muscle groups. This can result in difficulties such as loss of balance, difficulty walking, loss of dexterity, cramps or spasms, muscle weakness and loss of muscle control.
Neuropathy Can Affect Autonomic Functions
Another group of nerves that can be affected my neuropathy is the autonomic nerves. The autonomic nervous system is a division of the peripheral nervous system that influences various internal organs such as the heart, stomach, liver, adrenal gland and more. Damage to the autonomic nerves disrupts the signals sent from the brain and spinal cord to these various organs – sometimes resulting in a disruption to the involuntary functions these organs are involved in.
Here are the most common organs affected by damage to the autonomic nerves and the symptoms generally associated with them:
Pain Medications Only Mask the Pain
There are a number of prescription medications available to help cope with neuropathic pain. These medications have been a lifesaver for many sufferers (myself included) as they help take the edge off the pain and make it more manageable. Unfortunately, their purpose is simply to help mask the pain rather than help correct the underlying problem. In addition, there can be negative side effects associated with any prescription medication – so one must be aware of the risks.
Understanding that these prescription medications would not necessarily stop or reverse my nerve damage – but merely mask the symptoms – helped me to recognize the importance of trying various approaches to help address the underlying causes of my neuropathy.
Natural Herbs & Supplements May Help
While prescription medications typically only mask the symptoms, nutritional supplements and herbs may help both relieve symptoms and address underlying causes. By addressing underlying causes or problems, they may help to slow or even stop the nerve damage from spreading. Some of the best supplements and herbs for nerve pain include:
Vitamin B12
Vitamin D
Magnesium
Alpha Lipoic Acid
CoQ10
Acetyl-l-carnitine
Vitamin B12 is especially important for nerve health. It helps build up and support the myelin sheath – a protective coating around the nerves that shelters them from damage and infection. Studies have shown that high doses of vitamin B12 can promote nerve regeneration of damaged nerves.
MORE: Top 10 Herbs & Supplements for Nerve Pain
Alternative Therapies Can Help (but be patient)
Like a lot of people, I was hesitant about alternative therapies and skeptical about the promised results. However, alternative therapies have proven to be very beneficial in both helping me to manage my pain as well as improving my overall health. That said – there is no miracle therapy or treatment that is going to relieve my nerve pain overnight. I’ve found that with alternative approaches, the results are gradual – but they tend to be lasting results.
Alternative therapies for neuropathy range from low-impact exercises like yoga or tai chi to ancient practices like acupuncture. Here is a good list of popular approaches you may want to explore if you are suffering from neuropathy:
Acupuncture
Massage
Yoga
Tai Chi
Walking or stationary bike
Biofeedback
TENS therapy (Transcutaneous electrical nerve stimulation)
MORE: 10 Little Known Ways to Relieve Nerve Pain
Diet Could Be Helping or Hurting Nerve Pain
Something else I wish I’d known was the impact that diet can have on the symptoms of neuropathy. There are certain foods that can aggravate nerve pain as well as ones that can help boost nerve health. Knowing which foods or ingredients fall into which category can make a big difference!
Among the foods that can make neuropathy worse are casein-based products (commonly found in dairy products), artificial sweeteners, gluten, added sugars and refined grains. When consumed excessively, alcohol can also harm the nerves and block the absorption of essential vitamins like B12.
MORE: 4 Nutrient Deficiencies That Are Killing Your Nerves
Foods that promote healthier nerves include ones rich in B-complex vitamins such as B12 & B2. Other important vitamins and nutrients for strong nerves include vitamin D, vitamin E, Magnesium and Zinc.
Joining a Neuropathy Support Group Can Help
They say that experience is the mother of all wisdom, so what better way to learn about neuropathy than to join others who have been living with it for years? Joining a support group or online forum can give you insights into living with neuropathy that you might not find elsewhere. They are also safe environments to ask questions and learn what experience others have had with various medications, treatments and therapies.
To find a support group near you, the Neuropathy Support Network has a usefulsupport group search tool. In addition to local support groups, there are a handful of online support groups or forums. For finding information and support online, check out these 10 Resources Every Neuropathy Sufferer Should Bookmark.
Life with neuropathy can be painful, overwhelming and frustrating. As with anything, the more experience one has the more wisdom and insight he or she will gain into how to better cope with the hand that has been dealt. For me, the process has been gradual and frustrating (of course) – but I’ve learned many things that have resulted in small yet meaningful changes to make the road a little smoother. What things do you wish you had known about neuropathy when you were first diagnosed?
http://healthperfection.co/11-things-doctors-dont-tell-you-about-neuropathy-2/
