Knocking Out Neuropathy
OVIEDO, Fla. (Ivanhoe Newswire) - About 20 million people in the United States, including more than half of all diabetics, suffer from neuropathy. It can cause weakness, numbness, and pain in hands and feet. Now, a new therapy is helping people back on their feet.
For some it's like electricity or pins and needles. Others feel like their feet are on fire.
For Eddie Jeffcoat, just walking across the street was almost impossible.
Eddie has neuropathy. Damaged nerves in his feet have left him homebound for the last three years.
"It came to where I couldn't stand. I couldn't walk," Eddie Jeffcoat told Ivanhoe.
However, now he's walking his dog, bear, and even enjoying his treadmill time. He's done it all in 90 days.
"It's incredible, most people start seeing results literally with the first treatment," Dr. Marc Ott, DC, Chiropractic Physician at Integrative Physical Medicine, told Ivanhoe.
Dr. Marc Ott said the new treatment for feet and hands centers around an electric stimulator called The ReBuilder. It measures how a person's nerves are abnormally firing, then sends an electrical frequency to get the nerve back into a normal firing pattern.
"So, for each patient the way the unit actually fires is different. It builds a pattern that's specific to you," Dr. Ott explained.
The therapy includes exercises on a vibrating platform to help restore balance and neurological control.
"It's pretty astonishing to watch the results these patients experience and the lifestyle changes that it makes for them," Dr. Ott said.
While Eddie's still not up to full speed, he's lost 40 pounds and his pain level's been cut in half.
"Ninety days ago the pain was a ten. It hurt real bad. I'm at a five," Eddie said.
This home unit could help reduce the pain even more. In the meantime, Eddie said The ReBuilder has made life a lot more bearable.
Dr. Ott said almost all of his patients see a change with the therapy. He tells us the degree of improvement depends on the individual. The ReBuilder treatment is available across the country. It is covered by Medicare and most insurance plans.
BACKGROUND: Peripheral neuropathy is a disorder of the peripheral nerves, the sensory, motor, and autonomic nerves that connect the spinal cord to skin, muscles, and internal organs. It usually affects the feet and hands. Peripheral neuropathy can come and go, progress slowly over the years, or it can become severe. If it is caught early enough then, it can often be controlled. It is a common condition. An estimated 20 million Americans have it and it can occur at any age, but is most common among the elderly. (Source: www.neuropathy.org)
CAUSES: There are more than 100 known types of peripheral neuropathy, each with their own symptoms, pattern of development, and prognosis. However, the most common symptoms are tingling, numbness, abnormal sensations, and pain in the feet. Over time it can spread to the legs and hands. There are many different causes of neuropathy. However, about 30 percent are "idiopathic," or of an unknown cause. In another 30 percent of cases, the cause is diabetes. Other causes can include tumors, autoimmune disorders, infections, toxins, or nutritional imbalances. (Source: www.neuropathy.org)
TREATMENT: The main goal of treatment is to manage the condition that is causing your neuropathy. If it is corrected, then the neuropathy can improve on its own. Pain relievers, anti-seizure medications, capsaicin, lidocaine patch, and antidepressants are all used to help relieve the pain of peripheral neuropathy. Transcutaneous electrical nerve stimulation may help to relieve symptoms. Adhesive electrodes are placed on the skin and an electric current is delivered through the electrodes at various frequencies, but it has to be applied regularly. (Source: www.mayoclinic.com)
NEW TECHNOLOGY: An alternative to drugs for pain relief and numbness is an electric stimulator called "the ReBuilder." It works by stopping the nerve signals from getting to the brain. It can treat the pain associated with diabetic peripheral neuropathy, idiopathic neuropathy, polyneuropathy, and chemo induced neuropathy. It can also treat pain from conditions like MS, restless leg syndrome, MD, Charcot Marie-Tooth, and piriformis entrapment syndrome. The ReBuilder was proven 96 percent effective in a study with over 3,000 doctors each treating one of their own patients that did not respond to any of their previous treatments. It is the primary system used in cancer hospitals like The Cancer Treatment Centers of America, the Rockefeller Cancer Center, the Cleveland Clinic, John Hopkins, and Sloan Kettering for their patients suffering from peripheral neuropathy. The ReBuilder combined with lifestyle changes, like a personalized nutrition plan and exercises is a promising new treatment option for patients. (Source: www.rebuildermedical.com)
Dr. Marc Ott, DC, Chiropractic Physician with Integrative Physical Medicine, talks about a breakthrough helping patients with peripheral neuropathy.
So we are talking about peripheral neuropathy. Can you talk about how big of a problem this is in the US?
Dr. Ott: It is epidemic with diabetes growing at the rates it is growing at and cancer rates being what they are. Neuropathy is a side effect to both of these diseases. With cancer, it is a post problem with chemotherapy patients often times, and with diabetics, of course, it is one of the primary problems as their disease progresses; one of the huge complicating factors. So, it is growing at epidemic rates in the United States right now.
What exactly is it and what are the symptoms?
Dr. Ott: Neuropathy can be characterized by a spectrum of possible symptoms. For some patients it is things like pain, burning; for other people it is numbness and tingling. In severe cases it is things like ulcers, non-healing wounds, and even amputations. So, it can go from real mild symptoms and generally progresses to the symptoms nobody wants to talk about.
Like you said, the causes can vary, right?
Dr. Ott: Yes. There are causes that for some patients are unknown, and then in other cases it is things like diabetes or they have had chemo for cancer and the chemotherapy has actually caused nerve damage. For some people, it has been injuries, like herniated discs that have actually put pressure on the nerve and are now causing a peripheral neuropathy. There are a number of possible things that can cause it.
What are the treatment options for these patients?
Dr. Ott: Yes. Typically what these people end up with is medication to sort of modulate the pain. The common ones are drugs like Lyrica. Some of the medications that are being used now are off label medications that have been used for depression, for example. So, some of these meds are effective at helping patients at least manage the pain, but there has really been nothing for a long, long time that has been able to help a patient reverse some of the symptoms or even start to get feeling back in their feet or in their hands. It has been a tough disease to manage for a long time for patients.
So, can you explain the breakthrough?
Dr. Ott: Well, there have been a number of huge breakthroughs. First of all, some people are using things like cold lasers now and they have the ability to cause RNA replication, the part of your cells that essentially causes tissues to regenerate. It can speed that replication process up dramatically. Some folks are using those kinds of therapies. There are electrical stimulation therapies now that help to get the wave form of a nerve firing pattern back to a normal pattern. Really neuropathy is when that normal action potential or nerve wave form gets altered. It is an aberration from what it should be and you do not have normal sensation or you have hyper sensation. So, these new electro stimulation formats help to re-pattern that nerve back to a normal form. Then there are a lot of things in the nutritional world now that can be used to give the body the tools and the building blocks it needs to help nerves heal and regenerate. We have the ability to use things like nerve blocks to give patients some relief while we are doing the work in the background that is helping them get as close to normal as possible. There are a number of therapies that have sort of come together over the last bunch of years that when used in conjunction can really cause dramatic results for people.
The electrical stimulation is actually helping people regenerate the nerve, correct?
Dr. Ott: Yes. It helps with nerve regeneration to a degree, but what it really helps with is actually repatterning a nerve back into a normal firing pattern; that is really what matters most. For example, have you ever seen an EKG where you watch a heart go through its normal rhythm? A nerve has that same kind of a rhythm. There is a wave form that is characteristic of a healthy nerve. That wave form can break down due to vascular issues where the nerve is sort of starved and does not get enough nutrition, or it is damaged by chemicals or whatever. When that pattern is not what it should be, you end up with a person who is not feeling things or functioning the way they should. You can have the sensory part of the nerve, the part that feels stuff, or the motor part of the nerve, the part that moves muscles, not function and neuropathy can affect either or both. Getting that back to a normal pattern is really what matters most.
How soon do patients see results?
Dr. Ott: Most patients start to see results with the first treatment. We will have people breakdown and cry in the treatment room because they start treatment and on that first day they say, "I have not felt my feet in 2, 3, 4, 5 years and I can actually feel that." They are so excited they can for the first time in years actually have sensation again. It is pretty exciting. Then we put them into some of the other therapeutic things we do in the office, like the vibration platforms and things of that nature, that help with rebuilding muscles and retraining the nerves into patterns so they get muscle mass back again. It is pretty astonishing to watch the results these patients experience and the lifestyle changes it makes for them.
What is that like for you to be able to see those changes and to be there?
Dr. Ott: It is exciting. I think this is why people become physicians; you want to see people get better and to help them. It is always exciting to watch someone make a huge leap in their health, whether that is in a physical complaint or some other area. This is one of those lifestyle issues that until you have neuropathy, you do not realize how debilitating it is from a lifestyle standpoint. These people generally become couch potatoes. They cannot drive anymore and they lose their independence because they cannot feel the pedals so driving is no longer safe. You cannot walk down the street because you cannot feel your feet and do not know if you stepped on something or in a hole. It leads to a really sedentary lifestyle where there is a total loss of independence and they need people to do everything for them. So, getting that independence back is huge for these people.
In a worst case scenario, can patients actually lose a limb?
Dr. Ott: Yes. That is really the end result with neuropathy, particularly with diabetic neuropathy. Tissues start to die and do not heal properly anymore, and over the long haul even things like antibiotics and all these great tools we have to work with in healthcare do not work for these people anymore and they do end up losing toes, whole feet, or sometimes complete limbs.
So how does it work?
Dr. Ott: So the way this works is that the pads are the things through which the current passes. We give the patients a unit that they are going to use at home on a daily basis and then we use a unit in the office which is a little more powerful; we use that for the period of time while we are treating in office. The way it works is it sends an electrical current from the foot all the way up to the spinal cord, back around and then back down the leg to the foot to the unit again. That first one is what figures out what that individual's nerve firing pattern is; essentially it reads it. Once the unit reads what that firing pattern is the next bunch of electro stimulations are designed to take their wave form and put it back into the normal form. For each patient, the way the unit fires is different; it builds a pattern that is specific to you. That is essentially a watered down version how the technology works and why it is so effective.
It basically measures what the electrical stimulation pattern should be inside of your body naturally and then it figures out how yours is going wrong, correct?
Dr. Ott: Right. It knows a normal nerve firing pattern is the same for everyone. Just like if you put 3 people on an EKG monitor who have normal hearts, that pattern will look the same for everyone. There is a specific way the wave form should look and the unit is programmed with that information, so when it does that first read on you it figures out where are you in relation to that and then builds its future stimulations based on taking you from where you are back to the normal pattern. If you have a flat line and that is where you wanted things to be but your pattern was below the line, what you would want electrically is to put a stimulus in that is a mirror of that but above the line because the net of those two is the middle. I am over simplifying; it is certainly a sophisticated process, but that is essentially what it is doing.
Where does a nerve block come in?
Dr. Ott: The nerve blocks are used for patients because most of these people are so uncomfortable that it is very difficult to get them into some of the therapies they need to be doing to get well. For example, when you have someone who has neuropathy and you have vascular issues, they do not have good blood flow to the extremities but you have to get these people moving. These people need to be doing things physically that cause what is called angiogenesis, which is new blood vessels forming to bring blood flow and nourishment to that area of the body. If you cannot get them physically active because they are in so much pain, you really cannot get the results you want. The nerve blocks are used with these patients, but not with all of them. The blocks give us windows of time where we can get a patient pain free because the nerve has been anesthetized for a 1 to 3 week window where we can do this work with them and it is not causing them agony. It is more for patient ease and the ability to get the work done that we really need to do.
Is it kind of like if your foot falls asleep and then you feel that pain when you are trying to get it to work again? Is it almost like that, but on a higher scale?
Dr. Ott: For some people, it is that pins and needles almost electric kind of feeling. For some people it feels like they are stepping on thumbtacks all the time and for others it feels like their foot is on fire. It can be any number of sensations depending on the patient. The bottom line is, regardless of what those sensations are, if it is painful enough that the patient is sedentary then we have to do something to allow them to get mobile while we are working in the background to actually fix the problem; that is really what the nerve blocks do. They provide us with a window of opportunity to do that work with the patient without putting them into a place where they are suffering through treatment.
This is an integrative approach; so where does the nutritional part come in?
Dr. Ott: It depends on the patient. In some cases nutrition is used extensively and in others it is not used much at all. With a diabetic for example, we know the underlying cause of the neuropathy is generally uncontrolled blood sugar. So, we are going to work with those patients so they understand we can do all this work to help fix a neuropathy, but if they don't deal with the underlying issue causing it in the first place they're going to end up right back where they started. We know now from all of the research that there are certain nutrients that really help to regenerate nerves, like B-12 for example. It is well documented that B-12 helps build what is called the myelin sheath, the covering on the nerve. With some of these patients we will use B-12 injections if their blood work shows that they are deficient in those areas. There are even some topical creams you can use with compounds in them that help with the healing and inflammatory process. Whatever needs to be done to help not only the healing process but address an underlying issue, whether it be a nutritional deficiency or just a poor diet in the case of a diabetic, we'll do because it is not enough to just treat the problem.
Isn't it true in cases of neuropathy, if you do treat the cause, a lot of times everything will sort of fix itself? Isn't that what the human body does?
Dr. Ott: That is the case in a lot of things. Unfortunately with neuropathy, and this is why it is such a challenge, is that nerve tissue heals so poorly in the body. It is the slowest healing tissue in the human body and so even when you fix everything else, it often times will not just turn around on its' own; you need to give it an extra push.
Can you talk about Eddie's case specifically? What type of program you have him on?
Dr. Ott: Yes. With Eddie what we did is a very straightforward, standard treatment protocol. We did not use nerve blocks with Eddie because it was not required and he was not in such agony that we could not get him mobile. He was still somewhat mobile but very limited in how much he could do, so we just slowly worked with him to build him up. He came into the office 2 to 3 times a week initially to start working together. We used the electrical repatterning that we do with the in-office unit. We also did some really specific rehab work with him out on the floor of the clinic to help build up some musculature and to get that blood flow back to the extremities. Then we also did some work with him from a spinal perspective. It was really an all-encompassing treatment plan, but we did take out certain pieces that we did not feel were necessary in his case.
The spinal perspective, was that from the injury he had sustained from years earlier?
Dr. Ott: Yes. The spinal cord and those peripheral nerves obviously are interrelated and we want to make sure all of that stuff is talking the way it should, so in his case we addressed some of those issues as well.
Just through like chiropractic kind of stuff, correct?
Dr. Ott: Yes, we used chiropractic. We used some rehab protocols with him as well. We gave him some therapies to do at home and he probably will talk to you about it a little bit. We supported him also because he had been sedentary for so long that he was really deconditioning. We used bracing to help give him some structural stability in the short run so that he could get mobile and moving again. I think he probably shared with you the difference in how mobile he is now versus what he was able to do before.
How long does this treatment last?
Dr. Ott: It really depends on the case. We have had people who had complete and total resolution of the complaints and there are other people. It is all dependent on how much damage was done to begin with. If you have a patient who has a ton of damage and it has gone on for years and years, it is unlikely that you will get them perfect, but if you take someone like Eddie from a 10 to a 5, that is livable.
What is the typical treatment then?
Dr. Ott: It really depends on the patient. There are some patients that it is much shorter. You have some people that come in and it bothers them enough at a 5 that they do not want to live with it. Eddie was one of these guys that just grinned and beared it for so long. He had a high threshold for pain and kind of came to accept it. We have other people who say I won't deal with a 3, I do not want my feet to hurt at all. With those people it does not take as long. You do not have to put in the amount of work with them that you do with someone like Eddie.
What would you say for people at home if they do start to notice some of these things happening? What is the point where they may need to get it checked out?
Dr. Ott: Any kind of persistent neurological change. If a person is seeing any change in sensation and it is not just a sporadic thing where it happens once for 2 seconds and then goes away, they really need to see their physician about it. Nerve issues are not things that you want to sit on for very long; it is not like a sore muscle. You can kind of wait a sore muscle out for a few days or a couple of weeks and generally it will pass. However, if you have an area of the body where sensation starts to change or you start to notice motor deficits where you cannot control muscles the way you should and it's not a one-time thing, you really need to see your physician about that and get checked to see what's going on because it is not usually indicative of something good.
Do you have any statistics or anything that go along with the treatment?
Dr. Ott: We have probably almost 100% of patients see some change. It is very rare that we have a person that has no change at all if they do the treatment. The amount of change is the part you cannot really come up with a specific quantifiable number because each patient's resolution is so different, but almost everybody sees some progress from where they were at to where they are. For most of these people, any progress at all is pretty welcome.
The therapy is covered by insurance?
Dr. Ott: Yes, almost everything we do in the office is covered by most of the major insurance carriers.
FOR MORE INFORMATION, PLEASE CONTACT:
Dr. Marc Ott, DC
Integrative Physical Medicine of Oviedo