November 2007

Caring for Peripheral Neuropathy with Chinese Medicine

By Elliot Wagner, O.M.D., L.Ac., Doctor of Oriental Medicine

Do you have foot or hand numbness? Do you find walking more difficult than you used to? Or, do you find you have trouble feeling and holding on to ordinary small objects? You may have the beginnings of peripheral neuropathy. Peripheral neuropathy is a condition of the nerves of the extremities. It often shows up initially as numbness of the hands or feet (or "nulliness" which is a sensation of numbness without a loss of feeling). Because this condition often affects the proprioceptive nerves that have to do with position sense, manipulating and grasping small objects; even drinking a cup of tea, may become more difficult. When it affects the feet and legs, walking — even standing — can produce unsteadiness and vertigo.

Acupuncturists see many people with neuropathy, usually one of two types. The variety that we see most often is known as peripheral sensory neuropathy. Most patients with this condition have a sensation of numbness in their feet or hands, and may feel as though they are wearing socks or gloves, even when they are not. Sensori-motor neuropathy is the other type we tend to see. This condition causes, in addition to sensory symptoms, muscle weakness and a loss of position sense.

Peripheral neuropathy is generally a slow-developing condition that is predominantly caused by injury to the covering of sensory or motor nerves. The patients I have seen over the years have either been diabetic, pre-diabetic, had viral problems such as HIV, were taking certain medication which produced neuropathy as a side effect, or developed the problem late in life, often in their seventies and eighties. In Chinese medicine, it is treated as a circulatory problem, because it is understood that this problem develops when circulation is compromised, often by one of the causes just mentioned.

In traditional medicine it is accepted and understood that there is no cure for peripheral neuropathy, and treatment is symptomatic. Anti-epileptic drugs, such as Neurontin and Dilantin, and antidepressants — Elavil is most commonly prescribed — are the medications of choice for the constellation of neuropathic symptoms; and analgesics are prescribed when there is neuropathic pain. Sometimes topical capsaicin is used to reduce symptoms. It also can help, particularly if used consistently.

In Chinese medicine we use acupuncture and herbs to Move the Blood (stimulate circulation), Tonify the Blood (increase oxygenation and alleviate anemia), Tonify the Chi (increase vitality), and disperse Cold or Heat (increase metabolic activity or reduce inflammation) as needed. Neuropathy is a challenging problem, but people improve with treatment. Many people suffer with this condition not knowing that they can improve with alternative treatment; Chinese medicine in particular.

If you have neuropathy, or suspect you have, and have tried medications or other remedies without significant help, I urge you to try acupuncture and Chinese herbs. One patient of mine, a man in his fifties, began noticing the problem ten years before he was diagnosed with diabetes. He found relief using acupuncture alone — he doesn't like to take pills, including herbs. Although he had the condition for ten years, nothing gave him relief until he tried acupuncture, and even though he is much better than before treatment, he still gets acupuncture once a week, just to be sure it stays that way.