Neuropathy can be described as pain, numbness or tingling traveling down the nerves in the extremities, usually the arms or legs. A chiropractor can help find the cause of the neuropathy and treat it to help relieve the pain and keep patients off medication.
What is neuropathy and are there different types?
Dr. Gregg Rubinstein: Neuropathy is really just a Latin definition and it really describes the situation where you are getting pain that is going down, usually in the arms or legs. It is typically a nerve type of pain that is traveling down a nerve pathway in an extremity. And there are a few different types.
The ones that are most common that I see in my office are things like sciatica. That is a neuropathy, where there is a pinch or a pressure on the nerve, and the irritation travels down the nerve path. There are more complex ones. There is diabetic neuropathies which are caused by the disease process of diabetes itself, and so those are a different type, and those are not as easily managed with chiropractic care, but people with diabetes certainly can benefit from chiropractic care, but that wouldn’t be the primary focus.
So there are different types of neuropathies. There are different causes, but really just in a nutshell, very basic neuropathy describes any type of pain or numbness or tingling that is traveling down a nerve pathway. Most often you’ll see it in the extremities.
What symptoms do people experience if they have neuropathy and how does it get diagnosed?
Dr. Gregg Rubinstein: Typically, a neuropathy will be diagnosed when the person has any type of pain, numbness, or tingling traveling down the arm or leg, and I don’t really love it as a diagnosis because it is really just a description of a symptom. And what’s not really talked about there is what the cause is. And I often joke that for chiropractors, our designation is DC, Doctor of Chiropractic, but I often joke that it means Doctor of Cause, because if you go to a medical doctor with a neuropathy, most of the time they’re going to give you a painkiller or an anti-inflammatory or muscle relaxer to try and cover up the symptoms. They are not really addressing the cause of it.
Most often in my chiropractic office, we’ll see that it is the result of a pinched nerve, either in a neck because the nerves from the neck leave and then they travel through shoulder and down into the arm or hand, or a pinched nerve in the lower back, which can travel down the sciatic path or down the back of the leg or down through the hip.
The neuropathies can go in many different areas. They can wrap around, start in the back by where the ribs are and wrap around to the front. That would be a neuropathy. There’s different ways, but you got to figure out what’s causing it. It is really more of a general description of a symptom, not necessarily a diagnosis or a disease process in and of itself. There has to be something causing the neuropathy, whether it be the complications from diabetes or a pinched nerve in the neck or lower back or a pinched nerve in the elbow. Carpal tunnel would be kind of a neuropathy, as well, that is just going from the wrist into the hand.
It is not necessarily a specific diagnosis. It is really more a descriptive of some symptoms, but it usually is coming from something else.
You just touched on this a little, but is neuropathy most common in older people, and are certain people at risk for getting it?
Dr. Gregg Rubinstein: Anyone could be at risk of getting it. A healthy 25-year-old guy who falls snowboarding and injures his lower spine can put pressure on the nerves and get a neuropathy there. As we get older, they tend to be more prevalent, because one of the things that’s interesting, as the spine gets older, you’ll get more degenerative changes. You’ll see arthritis. Some of the ligaments get thicker, and all those different processes contribute to making smaller the holes where the nerve comes out. There’s a fancy name. It’s called the intervertebral foramina. I like to break it down simple, hole where a nerve comes out.
And in the spine, when you start to see thickening or bone spurs or things like that, it can actually make those holes smaller, so even a minor misalignment will have a more profound effect, irritate the nerves more significantly. You’ll see it common in young people and old people, and then as older people have more types of other complications or disease processes, diabetes, heart disease, and things like that, then they can become more prevalent.
It is rare that you’ll see it in infants and children, although it is possible, but typically as we age, they will be more common and pretty much everyone is at risk for getting it if you have trauma or you’re getting older, so pretty much it doesn’t really have a predilection for any specific group. It could happen to anyone.
What treatments are available to help people with neuropathy?
Dr. Gregg Rubinstein: Well, treatments for neuropathy, I touched on that a little bit before. Peripheral nerves do have a great ability to heal, and even though it might take months, recovery can occur. However, in some situations, symptoms of neuropathy might lessen, but might not completely go away. Someone who has a herniated disk, sometimes that disk will be expanded and swollen and irritating, and they might have flare-ups from time to time.
You can start really by figuring out what the cause of the neuropathy is. If it is a pinched nerve from a herniated disk or a misaligned vertebrae, then a chiropractor is typically going to be your best bet. Once the pressure is off the nerves, the nerves have that chance to heal and start to regenerate.
Again, with some of the other more complex neuropathies related to diabetes, you need to make sure that you’re treating the diabetes and managing diabetes properly, which isn’t really the job of a chiropractor. So in that case, you would usually check with your medical doctor, because a diabetic neuropathy is a much bigger fish to fry. You need to be working on reversing the diabetic process to minimize any further damage, and it doesn’t mean that chiropractic can’t be a part of their regular healthcare regime. But it will take time and medical supervision to really make sure that the diabetes is managed properly.
Do you have any lifestyle tips for people living with neuropathy to help manage their symptoms?
Dr. Gregg Rubinstein: Well, you know me, and we’ve talked about this before. I always say stay healthy in the first place and get your spine adjusted, because adjusting the spine will remove the pressure from those misalignments and it will get rid of the cause and hopefully make the spine more resilient. But if there is pressure already on the nerve, it’s always the best idea to get rid of it as soon as possible. And really addressing the cause, because if it is from a pinched nerve, it is going to be important.
Again, taking medications to try and cover up those symptoms, it’s like if I put a rubber band tightly on your finger, you would probably want to take it off after five minutes, which is what I recommend you doing. Not taking aspirin or painkillers to make the pain go away and leaving the rubber band on there. I always tell people try chiropractic first, and if you’re not getting the results through natural health and healing, then drugs and surgical options will always be there. But in most cases, they’re not necessary, as long as you try conservative management first.
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