Trouble buttoning your shirt or opening a ziplock bag, pain with walking on a cold floor, balance issues- these are just some of the things people living with mild peripheral neuropathy can struggle with on a daily basis. Unfortunately more severe cases can be debilitating, causing chronic pain and leaving people unable to walk without a walker or cane.
Peripheral neuropathy is a result of damage to peripheral nerves, or nerves that are not part of the brain or spinal cord (central nerves). Peripheral neuropathy can be caused by injury, autoimmune diseases, diabetes, and as a result of neurotoxic medication such as several chemotherapies. Sometimes it is labeled as idiopathic if providers are unable to locate the cause of someone’s neuropathy symptoms.
Subjectively, people tend to experience different sensations with peripheral neuropathy. The most common presentation is gradual onset of numbness or tingling sensation in the fingers or toes that progresses over time into the hands and feet and potentially into the extremities if left untreated. People can feel primarily numbness, or pins and needles sensation, or sometimes pain or feeling like their feet are really cold or burning hot even though they are normal temperature to the touch. Sometimes people can experience sharp or electric feeling pain sensations, hypersensitivity to touch or trouble finding comfortable shoes for walking as their feet are so sensitive. Due to numbness and effects on motor nerves, people with neuropathy can experience reduced grip strength and drop things, struggle to complete tasks with their hands or have a tendency to trip or lose balance potentially leading to falls.
So what can be done? Peripheral neuropathy can be tricky to treat. Western medicine doesn’t have a lot of treatment options other than certain nerve pain medications like gabapentin or lyrica, or certain antidepressant medications like duloxitine. However, these medications only mask the pain and tingling associated with neuropathy, and don’t necessarily help the nerves heal or change the numbness or motor function. These drugs can also have adverse side-effects that may outweigh the benefits for some people. Identifying the cause is important, as treating underlying diseases such as diabetes or autoimmune dysfunction can help improve symptoms and more importantly, hopefully help slow or stop the progression of nerve damage.
Acupuncture is one of the few treatments that has been shown to help improve symptoms and nerve function, helping people feel better but also promoting healing. Studies on diabetic peripheral neuropathy showed improvements in clinical symptoms and also objectively showed improvements when testing nerve conduction (1). Studies have also shown improvement in chemotherapy-induced peripheral neuropathy with acupuncture (2, 3). Acupuncture points used are usually on the arms and legs with points on the hands and feet, usually between each finger and toe.
We see a lot of patients in our clinic who are struggling with peripheral neuropathy of all kinds. Carli Gaines, who specializes in supportive cancer care with acupuncture, sees patients frequently to treat chemotherapy-induced peripheral neuropathy in particular. Carli sees the best results when acupuncture is started early on in chemotherapy when someone is getting a neurotoxic drug such as Taxol, oxaliplatin, or vincristine, even before neuropathy develops. “Chemotherapy-induced peripheral neuropathy can be a delayed symptom, starting mid-way or even at the end of someones chemotherapy treatment. This is different than other symptoms like nausea or fatigue which usually start after the first dose of chemo. Because of how these drugs affect the nerve cells, damage starts later and lasts longer, so the earlier we start treating patients regularly, the easier it is to start treating neuropathy while it is mild, and the more successful acupuncture will be at treating the neuropathy with the goal of preventing permanent nerve damage and chronic neuropathic symptoms.”
Early acupuncture treatment is essential for all peripheral neuropathy regardless of the cause. The nerve cells can regenerate, but in our clinical experience we find that it is much more likely to do so when symptoms are more mild versus when neuropathy is felt into the legs and arms. If you are experiencing any numbness or tingling in your hands and feet, we would suggest meeting with your doctor to identify the cause, then scheduling with an acupuncturist early on to help treat the neuropathy. Acupuncture can help you manage neuropathy symptoms so you can stay active, have less pain, and continue to live your life without restriction.