The Link Between Acupuncture And Peripheral Neuropathy

Peripheral Neuropathy (PN) is something I treat on a weekly basis. Treating Peripheral Neuropathy with acupuncture has been very effective and the better you understand the condition the easier it is to select appropriate acupuncture points and appropriate method of stimulation to address the underlying cause.

What is it Peripheral Neuropathy?

It is a condition that affects the nerves which carry messages to and from the brain and spinal cord to the rest of the body due to the nerves being damaged or diseased. Over 100 types of Peripheral Neuropathy (PN) have been identified and the majority of PN will affect all three types of nerves – sensory, motor and autonomic (polyneuropathy).
It affects 2.4% of the population but with people older than 55 the prevalence rises to be about 8% and this doesn’t include PN occurring through trauma.

Causes of Peripheral Neuropathy:

There’s a lot of reasons why this condition occurs. It can come from:

• Physical injury (trauma)
• Diabetes: the leading cause of polyneuropathy and is estimated to affect 50% of the diabetic population with up to half being asymptomatic or having numbness as their only symptom and is a result of chronic hyperglycemia causing damage to small sensory fibres
• Chemotherapy: PN reported to occur in 10-20% of cancer patients
• HIV: can extensively damage the central and peripheral nervous system and it has been estimated that 30% of people who are HIV-positive develop PN and 20% peripheral neuropathic pain
• Vascular and blood disorders
• Autoimmune diseases
• Nutritional or vitamin imbalance: Vitamin B12 deficiency best-know and common vitamin related cause 
• Some medications: such as Statins
  (You’d be surprised how many people present in my clinic with symptoms of PN who have B12 vitamin deficiency and Statins use) 

What are the symptoms of Peripheral Neuropathy?

Patients may experience a variety of symptoms including pain, paraesthesia (typically known as ‘pins and needles’) and loss of proprioception. The following symptoms may come and go: 

• Gradual onset of numbness, prickling or tingling in the feet or hands, which can spread upward into the legs and arms.
• Sharp, stabbing, shooting, (knife-like or electrical-like pain) throbbing or burning pain in the nerves affected.
• Extreme sensitivity to touch, pain provoked by a stimulus that is not generally painful.
• Pain during activities that shouldn’t cause pain
• More susceptible to nocturnal pain.
• Loss of balance and co-ordination which may lead to frequent falls.
• Muscle weakness particularly in feet.
• Paralysis if motor nerves are affected

Diagnoses:

Usually, neuropathy can be diagnosed by a doctor, podiatrist or healthcare professional through physical examination and careful questioning with regards to the patients’ medical history and symptoms.

Treatment:

Podiatrists play a key role in the management and prevention of complications associated with PN. Clinical guidelines for the management of PN, however, is problematic, inadequate and only provides short term relief which generally comes with several side effects from the list of recommended medication. Medication is the first line of treatment for neuropathic pain and the use of these medications is purely symptomatic and there is no established pharmacological treatment for neuroregeneration

Complementary and alternative medicine (CAM) has become increasingly popular and are used regularly by patients with chronic neurological disorders. The main treatment that was received by these patients included megavitamins (35%), magnets (30%), acupuncture (30%) and herbal remedies (22%). CAM is used more frequently with diabetic neuropathy than others and the most common reason was inadequate pain control (32%). 

Acupuncture treatment for Peripheral Neuropathy:

The improvement in nerve conductivity in addition to the reduction in pain is a key feature of the effect of acupuncture. Positive effects on motor and sensory parameters have been seen as well as a significant improvement in nerve conduction velocity, vibration perception, temperature perception and a reduction in numbness and spontaneous pain. In 2012, Schroeder et al evaluated the effects of acupuncture on nerve conduction and showed a significant positive effect of acupuncture on motor and sensory parameters when comparing acupuncture to sham treatment. The main difference between the two treatments was the depth of needle insertion and manual stimulation. The acupuncture points were selected from a TCM rationale and details were well documented according to STRICTA criteria and so would be repeatable. Points used included LI-4, ST-40, LI-11, ST-36, and SP-6 bilaterally. 

Does it work?

Between two groups of people (one receiving acupuncture and one the best medical care for PN) 76% in the acupuncture group improved symptomatically and objectively as measured by nerve conductivity score, while only 15% in the medical group improved. 15% of the control group also improved.  

Conclusion

If you’re interested in learning more about PN I have a course on the condition. The course is an evidence-based approach and will allow you a better understanding of PN and the most effective treatment to address the pathophysiology for both electric and manual acupuncture. Find the course here 

Further reading/studies used for this blog:
– Martyn CN and Hughes RAC Epidemiology of peripheral neuropathy. J Neurol Neurosurg Psychiatry. 1997; 62: 310-318
– England LD, Asbury AK, 2004, Peripheral neuropathy. The Lancet. Vol 363 Vol. 9427:2151-2161. DOI:https://doi.org/10.1016/S0140-6736(04)16508-2
– Boulton A. Management of diabetic peripheral neuropathy. Clin Diabetes 2005;23:9–15.
– Forman A. Peripheral neuropathy in cancer patients: incidence, features and pathophysiology. Oncology (Williston Park). 1990;4(1):57-62
– D. R. Pachman, D. L. Barton, J. C. Watson, and C. L. Loprinzi, “Chemotherapy-induced peripheral neuropathy: prevention and treatment,” Clinical Pharmacology and Therapeutics, vol. 90, no. 3, pp. 377–387, 2011
– Brunelli B, Gorson KC, The use of complementary and alternative medicines by patients with peripheral neuropathy. Journ Neurol Sci 2004, 15:218 (1-2):59-66.
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