Showing posts with label diabetic. Show all posts
Showing posts with label diabetic. Show all posts

Tuesday, January 15, 2013

Treatment Modalities in Managing Peripheral Neuropathy



peripheral neuropathy
Peripheral neuropathy is condition where the nerves of the peripheral nervous system get damaged. There are different signs and symptoms of peripheral neuropathy, but the more common ones are numbness, sensitivity to touch, tingling sensation, or muscle weakness on the arms, legs, hands and feet. In some cases, patients experience paralysis or burning pain.

Fortunately, there are ways to effectively control and manage these symptoms. There are many treatment modalities that neuropathy patients choose and seek out the right treatment that works for them.

Thiamine 

Thiamine deficiency is a very common cause of peripheral neuropathy. Thiamine or vitamins B1 have various roles in keeping the body working properly. Lack to thiamine can cause tingling sensations, burning sensation, sharp pain or numbness to the hands and feet. To counter this, a neuropathy supplement with thiamine and other nutrients and vitamins are needed like cobalamine (vitamin B12), DHEA and alpha lipoic acid.

Medications

Over the counter pain relievers can sometimes relieve mild symptoms of peripheral neuropathy. For nerve pain, physicians usually prescribe anti seizure medications like garbapentin and phenytoin. Some anti depressants like amitriptyline has also properties to relieve pain. Lidocaine patches can be applied to the painful area. Tramadol is an opiate based painkiller reserved for patients who do not respond to any other treatment.  All drug based medications might have side effects so be aware if any of these products have serious adverse results.

Injection Therapy

This involves injecting a numbing agent like lidocane to the affected area. This technique provides instant but temporary relief. Lidocane or other anesthetic agent blocks the nerve impulses from reaching the brain. Injection therapy is usually done with other treatment modalities like physical therapy.

Physical Therapy

Physical therapy is essential to improve blood circulation, strength and function in areas affected by peripheral neuropathy.  This involves active and passive exercises.  Stretching and passive range of motion exercise are done to maintain range of motion. Muscle strengthening includes active and resistive and isometric exercise.

Surgery

Surgery is done for certain conditions that may cause peripheral neuropathy. Carpal tunnel syndrome and a nerve compressing tumor are good examples that cause peripheral neuropathy and the only effective treatment is to surgically remove the compressing entity. In this case, the carpal ligament is permanently cut and the tumor is removed both of with relieve pressure to the nerves.

Reversing thiamine deficiency with thiamine supplement  is a well known and often highly successful way to nutritionally manage peripheral neuropathy.

Saturday, January 5, 2013

Diabetic Foot



Diabetes mellitus or more commonly referred to as diabetes is a condition where the body cannot produce enough insulin therefore increasing blood sugar. Insulin is a hormone responsible for the absorption of sugars into the cells. It is mainly produced by the pancreas. Among the other diseases diabetes can cause, the most common problem affecting the lower extremities is diabetic foot.

Normally, the pancreas produces insulin after meals to regulate carbohydrates and sugars that are absorbed in the gut. In case of diabetes, these regulatory processes fail or are insufficient.

There are two types of diabetes mellitus. Type I diabetes or juvenile diabetes starts from birth, caused by the destruction of the insulin producing cells in the pancreas. For this reason, these patients are insulin dependent. Medications, more particularly the injectable insulin are given for the patient to survive. 

Type II diabetes or adult onset diabetes is the most common type of diabetes accounting for 90% to 95% of all diabetics. In type II, there is high blood sugar but there is less insulin being produced or insulin is not efficient enough to decrease blood sugar. Usually, this is initially treated with dietary modifications and exercise. Insulin medication is used only when diet and exercise fail to decrease blood sugar.

If diabetes is not managed properly, high sugar levels over time can lead to fatty deposits in the blood vessel walls. This can affect blood flow and ultimately get obstructed. When blood vessels are obstructed the peripheral nerves especially on the hands and feet die out. This is why it is important for diabetics to observe foot care.

Due to nerve destruction, a diabetic may have decreased sensation on one foot or both feet. This can hinder a patient from sensing minor injuries to the foot such as cuts or blisters. Coupled with poor blood circulation, these cuts can lead to an infection because of poor wound healing. In some cases, injuries of the foot like sprain, strains, or a fracture can go undetected because the patient cannot feel any foot or heel pain. If these conditions are left undetected, then foot deformities can occur or a foot infection can worsen leading to an amputation.

For this reason, diabetics should learn how to inspect and observe their foot. If a decrease in sensation is noticed, seek medical attention as soon as possible. The key to stopping any foot complications due to diabetes is prevention.

For more information about foot complications due to diabetes and proper foot care, please visit the Family Foot and Leg Center in Naples or Contact Dr. Kevin Lam at (239) 430-3668.