can apple cider vinegar help with nerve pain?

Apple Cider Vinegar for Pain Relief

What is peripheral neuropathy?

This blog is refer to use apple cider vinegar for Peripheral neuropathy for some problems with nerves. These nerves send messages in the central nervous system, both the brain and the spinal cord into the rest of the human body.

The peripheral nerves tell your system when, as an example, the hands are cold. It may result in tingling, prickling, numbness, and muscle weakness in various parts of the human body.

Peripheral neuropathy can affect a variety of various nerves, so that it may affect many different locations in various way’s shoes for neuropathy. It may impact a single nerve or several nerves in precisely the same moment.

It is also associated with a range of different underlying health conditions. Sometimes there is not any identifiable cause.

It affects some 20 million people in the United States (U.S.).

What is peripheral neuropathy

Symptoms of Peripheral Neuropathy

Symptoms of peripheral neuropathy vary according to the types of neuropathy.

Sensory neuropathy

The person could have:

Tingling and numbness

Pins and needles and hypersensitivity

Increased pain or inability to sense pain

Loss of capability to detect changes in heat and cold

Loss of coordination and proprioception

Burning, stabbing, lancing, dull, or shooting pains, which might be worse during the night

It may also result in leg and foot ulcers, disease, and gangrene.

Motor neuropathy

This affects the muscles.

Symptoms include:

Muscle weakness, resulting in unsteadiness and problem performing small movements, such as buttoning a shirt.

Muscle wasting

Muscle twitching and cramps

Muscle paralysis

In the event the nerves are affected, there might be problems with sweating, heat intolerance, bowel or bladder problems, and changes in blood pressure, resulting in dizziness.

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Bragg Organic Apple Cider Vinegar With...

Bragg Organic Apple Cider Vinegar With...

Fairchild's Organic Apple Cider Vinegar...

Lucy's Family Owned - USDA Organic...

Bragg Organic Apple Cider Vinegar With...

Bragg Organic Apple Cider Vinegar With...

Fairchild's Organic Apple Cider Vinegar...

Buy on Amazon

Buy on Amazon

Buy on Amazon

Buy on Amazon

Last update on 2022-04-28 / Affiliate links / Images from Amazon Product Advertising API - Details

Causes of Peripheral Neuropathy

Various types of neuropathy are”idiopathic,” of unknown cause, but a range of conditions could activate it.

Diabetes is the most frequent cause of chronic peripheral neuropathy. This happens when high blood sugar levels damage the nerves.

Additional medical conditions and injuries include:

Chronic kidney disease: when the kidneys aren’t working normally, an imbalance of salts and chemicals can cause peripheral neuropathy.

Injuries: Broken bones and tight plaster casts can place pressure directly on the nerves.

Infections: Shingles, HIV disease, Lyme disease, and others may result in nerve damage.

Guillain-Barré syndrome: This is really a specific kind of peripheral neuropathy, triggered by disease.

Some autoimmune disorders: Include rheumatoid arthritis and systemic lupus erythematosus (SLE).

Other causes Peripheral Neuropathy of include:

Excessive alcohol intake

Some drugs, as an example, chemotherapy and HIV therapy

B12 or folate vitamin deficiencies

Poisons, such as insecticides and solvents

Some kinds of cancer, such as lymphoma and multiple myeloma

Chronic liver disease

Disorders of the small blood vessels can decrease blood supply to the nerves, resulting in nerve tissue damage.

Neuromas, benign tumors that affect nerve tissue, may result in neuropathic pain.

Diabetic neuropathy

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The most frequent cause of peripheral neuropathy is diabetes. Approximately 60 to 70 percent of individuals with diabetes have some degree of dementia.

High blood sugar levels cause damage to the walls of the small blood vessels that supply oxygen and nutrients to the nerves at the ends of their hands and toes, and also the essential organs within the body, such as the eyes, kidneys, and heart.

As a result, not only does your skin becomes damaged, but also the loss of sensation further increases the risk of damage.

In the U.S., diabetic neuropathy is the principal cause of foot problems and ulcers in people with diabetes. Approximately half of the people with diabetes are thought to have diabetic neuropathy.

Apple Cider Vinegar Assist with Neuropathy

Can Apple Cider Vinegar Assist with Peripheral Neuropathy?

Nerve pain is among the most troublesome types of pain to manage, especially because it has the inclination to become chronic. While nerve treatments and spine surgery are our specialties in Yashar Neurosurgery, we wish to enable you to seek instruction and information regarding nerve health by yourself as well. Our clinic is designed to especially assist you with all nerve pain you might be feeling.

Many patients really like to explore house remedies, searching for ways to ease their unrelenting nerve pain in the home in between appointments. Some turn into apple cider vinegar to get neuropathy as a natural remedy.

History of Apple Cider Vinegar and Neuropathy

An article published by Medical News Today suggests apple cider vinegar’s curative properties return several years. In reality, it may be traced back to the debut of apple cider vinegar itself.

Lots of people and cultures attest to its therapeutic properties, also it is frequently used in home remedies. Aside from heart problems, apple cider vinegar is also used to alleviate symptoms of:

Arthritis

Infection

Soreness

Which are the properties which compose apple cider vinegar to create it such a curable instrument? If you are stuck at home without access to a physician straight away, you may be interested in exploring the properties of apple cider vinegar to neuropathy yourself. Let’s have a look!

Active Ingredients for Apple Cider Vinegar

What exactly is in apple cider vinegar which makes it so very good in relieving our symptoms of nerve pain? You will find a surprising number of minerals within this vinegar, such as magnesium, calcium, and potassium, which can be natural anti-inflammatories.

While those minerals are located in several distinct substances, especially in the wholesome foods we consume, there’s a significant difference when it’s implemented in a concentrated volume. By using apple cider vinegar onto your nerve pain, then it may, in fact, decrease the swelling caused by the nerve disease itself.

It is not a cure, but it could definitely alleviate pain when you are in rough situations.

How Apple cider vinegar cure Peripheral Neuropathy?

This harm of nerves presents from the human body using all the following signs and symptoms cause of peripheral neuropathy:

Nerve pain (neuralgia),

Numbness,

Weakness,

“Pins and needles” sensation in the extremities.

These signs and symptoms usually affect the hands and toes [Peripheral Neuropathy].

How does Diabetes Lead to Peripheral Neuropathy?

Uncontrolled high blood sugar levels damage the nerves and contribute to their own bad function causing Diabetic neuropathy best shoes for neuropathy.

Lots of factors surrounding Diabetes result in Peripheral Neuropathy as a result of the destruction of nerves and blood vessels.

This Is Important…

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Role of Apple Cider Vinegar at Peripheral Neuropathy

Role of Apple Cider Vinegar at Peripheral Neuropathy

1. Treatment Of Neuralgia

In diabetic neuropathy, the nerves become debilitating. Remedy with pharmacotherapeutic agents could be expensive and with good side effects.

Apple Cider Vinegar in neuropathy role includes fighting neural pain. The Apple Cider vinegar achieves a decrease of neuralgia in 2 processes

1 mechanism is by eliminating toxins from the body which may be exacerbating the pain (detoxification )

Another method is by ingestion of valuable elements in the apple cider vinegar. These elements include Potassium which reduces nerve pain.

2. Potassium And Sodium Elements

Apple cider vinegar contains the elements potassium and sodium

In each 100 gm of ACV, there are 5 milligrams of sodium and 73 milligrams of potassium. Apple cider vinegar role is effected because of these elements.

The health benefits of potassium and sodium comprise the electric conductivity of the nervous system and also from the positive operation of the nerves within the body.

The Apple cider vinegar should be taken in a spoonful form at each meal and also positive results follow after a couple of days. This helps decrease symptoms.

3. Insulin Sensitivity Enhancement

Apple Cider Vinegar promotes insulin sensitivity into the cells allowing absorption of glucose to cells.

This, in the long term, prevents high blood glucose that makes the embryo much less imposing. The symptoms decrease increased consumption until the difficulty ceased.

Lucy's Family Owned - USDA Organic...

Bragg Organic Apple Cider Vinegar With...

Bragg Organic Apple Cider Vinegar With...

Fairchild's Organic Apple Cider Vinegar...

Lucy's Family Owned - USDA Organic...

Bragg Organic Apple Cider Vinegar With...

Bragg Organic Apple Cider Vinegar With...

Fairchild's Organic Apple Cider Vinegar...

Buy on Amazon

Buy on Amazon

Buy on Amazon

Buy on Amazon

Last update on 2022-04-28 / Affiliate links / Images from Amazon Product Advertising API - Details

How To Take Apple Cider Vinegar In Peripheral Neuropathy?

You are able to take apple cider vinegar by mixing 2-3 tablespoons of it with water. Most folks like it hot. To enhance the taste, you can add your treasured all-natural sweeteners, such as honey or agave nectar.

Apple Cider Vinegar and Salt: for Sciatica (Nerve Pain)

Consuming it is totally harmless, and in actuality, it’s very beneficial for you. Other home remedies to temporarily alleviate pain include hot tea, yoga, and Epsom salt.

Healthline also recommends cayenne pepper, hot baths, as well as long naps to provide your body a rest. Nerve pain may be excruciating, and it may take a toll on your physical and psychological strength. Dr. Yashar certainly recommends home remedies to soothe your pain as you’re scheduling a consultation with us.

How To Take acv

Schedule Your Nerve Pain Exam Today!

In the office of Dr. Yasharwe take good care to assess your personal nerve pain and ascertain the source of your harm. Nerve pain may occur anywhere on your system, and for almost any reason. Although this amount of annoyance might seem impossibly frustrating and hard to live through, we’re here in order to give actual solutions and treatments so you can get your life back in your hands. Our state of the art center is designed to help you not only handle your nerve pain however seek long-term and permanent treatments.

The nervous system is a complex region of the human body, but experts such as Dr. Yashar will help the body get set on the ideal path. To learn more about home remedies, or whether you’re trying to invest in one of the successful procedures, please do not hesitate to reach out to us. You may contact us online or give us a call at -LRB-424-RRB- 361-0923 to create an appointment straight away.

The causes of neuropathy are many, but you don’t have an equal number of treatments. Most doctors will target the underlying disease and try to treat it.

For some unlucky ones, there’s no treatment, and all they can do is manage symptoms and prevent further nerve damage.

That brings us to today’s topic- apple cider vinegar for neuropathy – a hot topic of discussion!

Many people report benefits when they take apple cider vinegar for nerve pain. Many websites and even hospitals recommend the vinegar as home remedies for neuropathy. But is there any evidence apple cider works?

Let’s find out. 

P.S.– We are not going into what is neuropathy and its symptoms. You most probably already know that and now wondering if what you read about apple cider vinegar is true! So here’s the truth exclusively for you. 

Apple Cider Vinegar for Neuropathy: Fact Vs. Fiction

Are those articles you read on the wonderful benefits of apple cider true?

As we found out, apple cider vinegar does have some remarkable health benefits-

It kills germs

Keeps your heart healthy

Reduces weight

Controls blood sugar

The vinegar also comes with antioxidants and minerals like magnesium and sodium. 

Now, can the health benefits of apple cider extend to neuropathy?

Well, there’s no research on the topic, so it’s hard to make any conclusions. But several trusted sources like neurosurgery clinics and hospitals recommend the vinegar. We will check out if the claims hold out to facts, but one thing is sure-

Apple Cider Vinegar is Not a Cure for Neuropathy

You may use apple cider vinegar for neuropathy, but never expect it to treat your condition. The best way to treat neuropathy is to visit a doctor. He will be able to diagnose your underlying cause and device a treatment plan.

 

You should also seek medical advice if you keep feeling a tingling sensation, numbness, or muscle weakness for over a week. 

Using apple cider vinegar for nerve pain may have some logic. However, it is not a treatment for neuropathy. Always keep that in mind. 

Additionally, we have no clinical trials or studies to fall back on. So, how does vinegar from apple cider help you in neuropathy?

Apple Cider Vinegar for Managing Symptoms of Neuropathy

You can try apple cider to manage the symptoms of neuropathy or nerve damage. As we said earlier, some clinics and hospitals do suggest the vinegar, so no harm in trying out. 

Let’s take a closer look at how you may benefit from apple cider vinegar. 

1. May Help in Neuralgia

Some suggest apple cider vinegar can help in neuralgia. It’s a condition where sharp and stabbing pain originates from a damaged or irritated nerve and follows the nerve’s path. 

Apple cider may help you reduce the pain, but not the condition. 

The antioxidants in the vinegar may remove toxins that are causing the pain. You can call it a detoxification effect that may temporarily relieve the pain. 

The nutrients present in the vinegar may also ease nerve pain. Potassium especially plays a beneficial role in reducing nerve pains. People who have low levels of potassium often experience weakened nerve signals that lead to tingling or numbness. 

So, having potassium may improve nerve health and reduce neuropathy symptoms. 

 

2. May Improve Nerve Functions

Potassium and sodium ensure our nerves function the way they are meant to. The two salts play a big role in keeping a healthy signaling system that drives our peripheral nervous system. 

In fact, the elimination of potassium from your diet will cease all electrical activity of your nervous system. It will just shut down!

Apple cider vinegar is built on this case. As the vinegar contains both potassium and sodium, drinking it can lead to a healthy nervous system. 

As a result, you will get some relief from your neuropathy symptoms. 

3. May Help in Diabetic Neuropathy

Diabetes is a leading cause of neuropathy. Patients with diabetes have high levels of blood sugar or glucose, which is harmful to nerves. You can develop nerve injuries throughout your body due to diabetic neuropathy.

Now, you will need to follow the treatment plan suggested by your doctor to control diabetes. Along with that, you can explore the benefits of apple cider vinegar caused by diabetes. 

How does apple cider do the job?

Research suggests apple cider vinegar to slow down the absorption of carbs we eat. This can help your body produce less glucose and keep blood sugar in check. 

Naturally, lower levels of glucose will mean less risks of developing diabetic neuropathy. You may also use apple cider vinegar for nerve pain that follows and lower your symptoms. 

A single study using a combination of acetic acid did notice a reduction in diabetic neuropathy in rats. However, no other studies or animals or humans exist. So, don’t make any conclusions based on this single piece of research. 

 

Summary of Benefits

Apple cider vinegar for neuropathy is only useful to address the symptoms. Never believe anyone who says vinegar is a cure for your neuropathy. 

Vinegar can work like testosterone that helps improve your mood, but not your depression. Or, it can be like fish oil that improves overall heart health but doesn’t treat cardiovascular diseases. 

You can take apple cider vinegar for nerve pain, but not as a cure for neuropathy. Here’s a summation of benefits of apple cider vinegar for neuropathy-

Less pain

The antioxidants in the vinegar can clear toxins and bring down nerve pain. You may also be able to reduce inflammations that result in pain and discomfort. 

Additionally, potassium may have beneficial effects on pain associated with nerves.

Less numbness or tingling

Along with pain, apple cider vinegar may give relief from the constant numbness or cramp. You may be able to get rid of your symptoms temporarily. 

Some experts say apple cider vinegar neutralizes a toxin called guanidine produced as a byproduct of metabolism. By reducing this chemical, apple cider reduces nerve pains associated with guanidine.

Improved nervous signaling

Sodium and potassium ensure your nerves have optimum electrical connectivity. This may also help you reduce pain and uncomfortable symptoms.

How to Take Apple Cider Vinegar for Neuropathy

Let’s your creativity run wild or be as simple as a rustic when taking apple cider vinegar!

We will start with the most simple way-

Mix 2 – 3 tablespoons of apple cider vinegar in warm water (or cold)

Drink the vinegar

If you like some flavors, you may add a bit of honey or any natural sweetener. 

Now, there’s no end of ways you can have apple cider vinegar creatively. Google for dishes using vinegar and sprinkle a spoonful on your salads and dressing. You can add it to anything you seem fit! 

That’s one reason why apple cider is one of the best home remedies for neuropathy. 

 

Apple Cider Vinegar for Neuropathy Foot Soak

A foot soak may be a wonderful idea to get relief from nerve pain. You don’t really need to suffer from neuropathy to benefit from this effect of vinegar.

Here’s how to go about-

Take a small bucket of warm water

Put 500-ml of apple cider vinegar

Keep your feet submerged for 10 -15-minutes

Rub feet with a towel

Things to keep in mind:

Take your foot soak 1-hour before sleeping

Cover your feet with a blanket while you sleep (keep them warm)

Don’t walk barefoot next morning

You can get splendid results from any kind of nerve pain by taking this foot soak. Aim to take your foot soak at least 3 – 4-times a week. 

Final Thoughts

Apple cider vinegar for neuropathy is beneficial only for treating the symptoms. You can’t cure your nerve damage or injury with any type of vinegar.

What it can do is reduce the pain, numbness, and discomfort you feel as a result of your neuropathy. For treatment, you should always visit a doctor and follow his treatment plan. 

You can use apple cider vinegar for neuropathy along with your medications. It’s generally safe unless you overdose on the vinegar. You can have your vinegar with warm water or sprinkle on your favorite dish. 

The foot soak is also another popular home remedies for neuropathy symptoms. Apart from that, apple cider vinegar has a number of health benefits. You can check out our recommended apple cider vinegars that are truly exceptional and pure. 

FAQs

Can apple cider vinegar reduce nerve pain?

Apple cider vinegar contains antioxidants, potassium, and sodium. These three may help lower your nerve pain. However, apple cider vinegar will not cure the underlying cause that is causing the pain. You need to visit a doctor and get yourself checked for that.  

What is the best treatment for neuropathy patients?

The best treatment for neuropathy is only available from a professional medical professional. You get proper medicines that treat the actual disease. Things like apple cider vinegar only help you lower your symptoms, nothing more. 

 

What is the best home remedy for neuropathy?

You can try an apple cider vinegar foot soak to get relief from neuropathy pain. However, you can’t treat your neuropathy properly unless you know what’s causing it. Talk to your doctor for an efficient treatment. You can try walking and taking care of your feet as home remedies for neuropathy.

What foot soak can I use for neuropathy?

A warm foot soak can help lower the pain of neuropathy. You can add salts like sodium and magnesium. Epsom salts are suitable and may bring relief from nerve pain. You can also try soaking your feet in warm water mixed with apple cider vinegar. 

Can I use Vicks Vapor Rub for neuropathy?

Ointments or balms, like Vicks, may reduce nerve pain for a temporary period. They will not treat the cause of your neuropathy. You can use them only for short-term relief.

How long does it take to cure neuropathy?

The underlying cause of your neuropathy will determine how long it will take to cure. Peripheral nerve injuries can take months to heal completely. However, not all nerve injuries can be cured. Your doctor is the best person to tell you if your neuropathy can be cured or how long it will take. 

How can I heal nerve injuries naturally?

Not all nerve injuries can be treated. If your nerve injury is treatable, then walk a lot. It boosts your endorphins that lower nerve pain naturally. Plus, you will need to take good care of your feet with foot soaks and massages. Additionally, keep your blood sugar in check. 

Can ginger help with nerve damage?

Indians have long used ginger and turmeric for a number of chronic conditions that cause pain. Ginger can lower pain due to its inflammatory properties. You can make ginger tea to help heal nerve damage. 

Can cinnamon treat neuropathy?

Cinnamon may help you regulate blood sugar levels and turn out to be beneficial for diabetic neuropathy. You may not have the same results for other types of neuropathy. Also, not all people get results from cinnamon. 

Can you cure nerve damage?

You generally won’t be able to undo the damage already done to your nerves. You can treat the cause and stop any more nerve damage. Sometimes, your damage may heal based on the cause and location of your damage.

Research shows that apple cider vinegar contains magnesium, phosphorous, calcium and potassium. These are all necessary for dealing with nerve pain. Likewise, apple cider vinegar has strong anti-inflammatory properties. These two reasons account for why apple cider is used in the treating neuropathy.

Apple cider vinegar often comes up on the list of alternative treatments and home remedies for neuropathy.

While no scientific evidence backs up the benefits of ACV for neuropathy, many patients’ testimonials claim that it does help reduce nerve pain and reduce peripheral neuropathy symptoms.

So, how can apple cider vinegar help with neuropathy? What does science say exactly? Is it safe to use? How much ACV should you take for neuropathy and how often? Should you drink it or soak your feet in it?

All of your questions about apple cider vinegar for neuropathy are answered below!

Benefits

Side effects

How much to take

ACV gummies

ACV foot soaks

Apple cider vinegar for neuropathy

Does Apple Cider Vinegar Help With Nerve Pain?

Apple cider vinegar (ACV) is made from apple juice to which yeast and bacteria are added. The yeast turns the sugar from the apples into alcohol. This is the fermentation process. The bacteria then turn the alcohol into acetic acid which gives the vinegar.

You may drink apple cider vinegar itself or dilute it in water, use it as a condiment, or find ACV capsules or gummies.

Apple cider vinegar is believed to have numerous health benefits and may help with neuropathy by reducing nerve pain.

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Health benefits of apple cider vinegar

ACV is a popular home remedy used in traditional cooking and medicine for centuries. In ancient times, it was widely used to treat coughs, infections, sore throat, and wounds.

In recent years, people have claimed numerous health benefits of apple cider vinegar for a wide range of conditions. It’s believed to help lower blood sugar levels, reduce cholesterol, boost weight loss, calm acid reflux, improve heart health, treat dandruff, and reduce nerve pain among other things.

ACV indeed has healthful properties. The “mother”, the cloudy and murky part of unfiltered vinegar, is packed with natural probiotics that help boost the immune system and improve gut health. It also has natural antimicrobial and antioxidant properties.

However, science has not backed up the benefits of apple cider vinegar for any specific condition. Little research exists and more studies must be conducted before ACV can be medically recommended.

That being said, ACV has very few side effects. It’s cheap and mostly considered safe if taken in a reasonable amount. Some people suffering from peripheral neuropathy claim it considerably helps relieve nerve pain. So, it’s probably worth the try if you’re looking for alternative treatments for neuropathy.

Does ACV help with neuropathy?

Peripheral neuropathy is a painful condition where the nerves of the body extremities are permanently damaged. It’s most often caused by diabetes, chemotherapy treatments for cancer patients, alcoholism, and other factors. Symptoms are commonly found in the feet, sometimes the hands, and include numbness, tingling, pricking, burning, sensitivity to touch, loss of sensation, cramps, sharp pains, and more.

Nerve pain caused by peripheral neuropathy can be extreme and debilitating. Unfortunately, medications and pharmaceutical treatments frequently fail to provide relief. Many neuropathy sufferers then turn to alternative ways to manage nerve pain.

Apple cider vinegar has recently come up as a new alternative treatment for neuropathy pain. While no scientific evidence backs up the benefits of ACV for neuropathy, many patient stories and testimonials claim that it works and actually helps reduce the pain.

Apple cider vinegar and peripheral Neuropathy Treatment

The reason may be found in the great amount of minerals like magnesium, calcium, phosphorus, and potassium in apple cider vinegar. As a natural anti-inflammatory ingredient, ACV may also help reduce the inflammation caused by damaged nerves. When added to a foot soak, it may also help reduce foot swelling often associated with diabetes.

According to the Earth Clinic, apple cider vinegar helps reduce nerve pain by alkalizing the body, removing toxins, and delivering a variety of vitamins and minerals to the body to restore nutrient deficiency that can increase nerve pain. 

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Apple cider vinegar is no cure for neuropathy

Science has not found any cure for diabetic peripheral neuropathy yet. The nerves damaged by high blood sugar levels are permanently damaged. The only effective and scientifically backed-up way to prevent neuropathy from getting worth is to control blood glucose levels. 

Not being able to repair damaged nerves does not mean you can’t ease the pain. Treatments to reduce nerve pain are numerous and go from strong pharmaceutical painkillers to alternative solutions such as foot massages, transcutaneous electrical nerve stimulation, topical pain creams, acupuncture, essential oils, and others. 

Apple cider vinegar is one of them. The results are based on the individual. It might work for some and do nothing for others. But because it’s a mostly safety use, you can test it out for yourself. 

Warning: neuropathy is a serious condition that can lead to severe complications. Always ask for your doctor’s advice before starting any treatment at home.

Risks and side effects

Apple cider vinegar is mostly safe to use and probably won’t hurt you if taken in a moderate amount. However, before trying ACV for neuropathy, you should be aware of a few potential side effects. With a pH of 2 or 3, apple cider vinegar is very acidic and may cause some damage if used in large amounts.

When taken orally, ACV may damage the tooth enamel and lead to cavities. It may also lower your potassium levels, cause irritations, burns to the digestive tract, or allergic reactions. When applied to the skin, it may cause chemical burns, skin irritations, or allergic reactions. 

ACV potentially interacts with some medications such as laxatives, diuretics, blood thinners, or heart disease and diabetes medications. Always ask for your doctor’s advice before taking ACV on a regular basis. 

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How to Use Apple Cider Vinegar for Neuropathy?

The most common way to take apple cider vinegar for neuropathy is to incorporate it into a healthy diet and use it in cooking. As a home remedy for neuropathy pain, you can either drink apple cider vinegar diluted in water, use it as a condiment, have capsules or gummies, or add it to your footbaths. 

How much ACV to take for nerve pain? 

Like with any home remedies, it’s always best to start with small doses and gradually increase depending on the effects and potency you’re looking for. 

Common dosage range from 1 to 4 teaspoons (5 to 20 mL) of AVC per day diluted in a large glass of water. ACV can have a strong sour or bitter taste. If you don’t like the taste of it, dilute it in juice or other water-based beverages. You can also use it as a condiment and add it to your salad dressings, sauces, or foods. 

To benefit the most from ACV’s health properties, prefer using organic, unpasteurized, unfiltered apple cider vinegars with the “mother”. The “mother” of vinegar is the cloudy gelatinous film at the bottom of the bottle. It’s composed of cellulose and acidic acid bacteria. It’s the part of ACV that has the most benefits for health. 

Bragg is the most popular brand in the USA. It’s a raw, organic, unfiltered apple cider vinegar of high quality.

Bragg apple cider vinegar with the mother

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How often do you take apple cider vinegar for neuropathy?

Because apple cider vinegar is not a regulated treatment for neuropathy but rather a home remedy which effects are not backed up by science yet, there are no specific recommendations about how much and how often you should consume it.

ACV is considered mostly safe and people who use it for neuropathy take it daily. The best way to add ACV to your lifestyle is to follow a stepwise dosing procedure. Start with a low dosage every two other days and gradually increase until you find the right dosage for you.

People respond differently to apple cider vinegar. It might not have any effects on you and may not reduce your nerve pain. If you don’t feel any effects after taking normal doses of ACV for a few weeks, do not increase the dosage. Apple cider vinegar is highly acidic and taking too much of it could harm you. 

If you start noticing any side effects or discomforts, immediately stop taking ACV and ask for your doctor’s advice. 

Apple cider vinegar gummies and capsules

If you don’t like the taste of ACV or don’t feel comfortable with the dosage, a simpler way to take it for neuropathy is getting apple cider vinegar gummies or capsules. The advantage is that the suggested use is straight forward and you know exactly how much you’re taking. 

Make sure you’re getting apple cider vinegar capsules or gummies that are made with pure ACV from the “mother”. Here are the best and most popular ones:

Nutrivein apple cider vinegar capsules

Nutrivein ACV Capsules

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All natural apple cider vinegar gummies for neuropathy

Essential Elements ACV Gummies

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Apple cider vinegar and CBD

Apple cider vinegar infused with Cannabidiol (CBD) is a new popular wellness supplement. The synergy between the two can be interesting for neuropathy pain management, as CBD is the newest natural ingredient found to effectively relieve nerve pain ( backed up by science!).

ACV’s health benefits combined with CBD’s pain-relieving and relaxing properties make a great combo for those looking for natural ways to manage neuropathy symptoms.

Zatural and CBDFX, two of the best CBD companies in the USA, now offer great products that blend apple cider vinegar and cannabidiol.

Zatural CBD and Apple Cider Vinegar Tincture for blood sugars

Zatural ACV + CBD Tincture

Visit Zatural

CBDFX ACV + CBD Gummies

CBDFX ACV + CBD Gummies

Visit CBDFX

More about Cannabidiol (CBD):

The Best CBD Creams for Neuropathy Pain 

CBD for Diabetes: Benefits & Dosage

10 Sugar-free CBD Gummies for Diabetics

Does Soaking Your Feet in Apple Cider Vinegar Help Neuropathy?

Foot soaks can help reduce diabetic foot pain caused by peripheral neuropathy. Warm foot baths are proven to relieve pain, reduce stress, relax muscles, and boost blood circulation. 

Soaking your feet is also a great opportunity to add pain-relieving and sooting ingredients known to be beneficial for neuropathy. Many neuropathy sufferers liven up their foot soaks with Epsom salts, essential oils, medicinal herbs, or cannabidiol products for example. 

But what about apple cider vinegar? Can soaking your feet in ACV help with neuropathy pain? 

Vinegar foot soaks are known to have beneficial effects and improve overall feet health. Vinegar has anti-fungus properties and helps eliminate foot odor by killing the bacteria. It can also help soothe dry and cracked feet. 

Regarding neuropathy, there is no evidence that soaking your feet in apple cider vinegar helps with the pain. However, it’s popular among patients and many claim it helps reduce the pain. You’ll have to try it for yourself and see if it works!

Caution though: vinegar is very acidic and can damage or burn your skin. Never soak your feet in pure apple cider vinegar. Always dilute it in water. One part of ACV for 2 or 3 parts of water is a safe ratio. 

Soaking your feet is a popular homes remedies for neuropathy, but it has to be done with caution. Learn more in this article:

The Best Foot Soaks for Neuropathy

 

Warning: diabetes and neuropathy are dangerous for the feet. Never start a treatment without your doctor’s advice. Any foot issues can lead to serious complications and must be addressed by your healthcare team.

Nerve pain tends to be chronic, making it one of the most difficult types of pain to deal with. There are traditional treatments and surgeries that may help with nerve pain, but often these can be ineffective, leaving people to deal with the symptoms in the best way they can. People who prefer natural remedies that don't have the risk of dangerous side effects often turn to apple cider vinegar (ACV) as a way to decrease the painful symptoms of nerve pain, or neuropathy. ACV is not a cure for neuropathy, but it can help manage the symptoms.

Because drinking liquid ACV can have harmful effects, it may be advantageous to choose another form of apple cider vinegar. For example, apple cider vinegar gummies are very popular on the market. There are a wide variety of companies offering ACV gummies as a solution, but if you want to get the best deal, you should try Nutratrek's Apple Cider Vinegar Gummies. Compare them to two other leading brands by price:

Brand

Nutratrek

Goli

Garden of Life

Price per Bottle

$14.02

$19.00

$19.99

Price per Gummy

$0.23

$0.31

$0.33

Clearly, Nutratrek ACV gummies are the best deal you can find. Continue reading to learn how ACV can help reduce nerve pain and learn more of the advantages of choosing Nutratrek Apple Cider Vinegar Gummies.

Why should I use apple cider vinegar for neuropathy?

If you're wondering if apple cider vinegar can help with nerve pain, there are some professionals who suggest it can. Neuralgia is a sharp, stabbing pain that follows the path of a damaged or irritated nerve. The antioxidants in ACV may help remove the toxins that could trigger the pain. This is a situation where ACV may help reduce the symptoms, but it won't cure the condition.

The same pain can be addressed by the potassium that is found in ACV. People with low levels of potassium can experience weakened nerve signals that lead to uncomfortable tingling or numbness. This means the extra potassium in ACV could also benefit people with this type of neuropathy.

In addition, potassium and sodium are required to keep nerves functioning the way they are supposed to. These two salts play a big role in keeping the signaling system that drives our peripheral nerve system healthy. Because ACV contains both potassium and sodium, logic indicates that it could lead to a healthier nerve system, thus providing relief from neuropathy symptoms.

One of the leading causes of neuropathy is diabetes. The high levels of blood sugar (glucose) often found in people with diabetes is harmful to the nerves. Injuries to your nerves throughout your body may develop if you have diabetic neuropathy. Fortunately, apple cider vinegar is known for its ability to help lower blood sugar. Naturally, this can lead to a reduced risk of developing diabetic neuropathy.

While apple cider vinegar is not a cure for neuropathy (and never believe anyone who tells you it is), it may help to reduce symptoms like nerve pain, numbness, and tingling. It may also help improve nerve signaling.

APPLE CIDER VINEGAR GUMMIES

Experience The Sweet Side Of Apple Cider Vinegar!

Love the benefits of Apple Cider Vinegar but HATE the taste?

Then our ACV gummies, jam-packed with superfoods such as beetroot and pomegranate, as well as Vitamin B6 and B12, are exactly what you need.

What is the best apple cider vinegar for neuropathy?

You've already seen that Nutratrek is the best deal financially as far as ACV gummies go, but does it have everything you need in an ACV gummy? Actually, it does. For starters, it is certified non-GMO, vegan-friendly, gluten-free, hormone-free, and organic. It's made with certified Good Manufacturing Practices in an FDA-registered facility. And our ACV gummies include the real “mother,” which is the part of apple cider vinegar that contains all of the nutrients that may help to decrease nerve pain.

Nutratrek Apple Cider Vinegar Gummies have a delicious apple flavor and never leave a sour, vinegary aftertaste. You'll never think you were consuming vinegar when you chew them, and they don't do any harm to your teeth, throat, or stomach as liquid ACV can. Our gummies are made from the purest, most potent plant-based sources and have only 12 calories per gummy. We have also added vitamins B6 and B12, folic acid, and pomegranate juice powder and beet juice powder for additional health benefits. You really can't go wrong with Nutratrek's Apple Cider Vinegar Gummies.

Where can I get the best ACV gummies for neuropathy?

If you're looking to use an all-natural method to help relieve the pain of neuropathy, it's time to give Nutratrek's all-natural apple cider vinegar gummies a try. While they can't cure neuropathy, they may be able to relieve the nerve pain that comes with the condition. Order the best ACV gummies online today and say goodbye to nerve pain and discomfort.

There are more than 100 kinds of nerve damage and many causes behind the condition (via WebMD). Nerve pain can be caused by autoimmune diseases, nutritional deficiencies, trauma, and slipped discs. This type of pain can be very distressing and you may be willing to do anything to make it go away. 

Experts believe apple cider vinegar can be helpful in treating neuropathy. Board-certified neurosurgeon Dr. Pharam Yashar says that the vinegar can help reduce nerve pain, either by applying it directly to the affected area or drinking a mixture of it with water. According to the Earth Clinic, apple cider vinegar minimizes nerve pain by removing pain-inducing toxins, and may also provide essential nutrients you might be missing. The vinegar contains vitamins C, B1, B2, B6, biotin, folic acid, and niacin, as well as a small number of minerals, according to MedicineNet.

No evidence suggests that apple cider vinegar can be used to treat or reduce nerve pain. However, Healthline concludes it is mostly safe in moderate amounts, so you can test it out and see if it works for you. 

Apple cider vinegar has been lauded by many through the years for its beneficial properties as a lice killer, weight loss catalyst, and even as a hemorrhoid healer — but, spoiler alert, it won't help with those pesky bumps (per On Health). Weight loss is one of the biggest reasons people drink apple cider vinegar daily, as it helps boost fat loss, but only a bit. As for killing lice, you might want to skip the apple cider vinegar and head to the doctor or pharmacist.

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While some people swear by the store-bought vinegar for many ailments, science says it can only help with a few. The Cleveland Clinic claims that the apple tincture has been used in healing for centuries, specifically for sore throats and infections. While the vinegar mixed with honey might help soothe your throat, there is not enough research to support those claims.

Another apple cider vinegar remedy rumor is that it can minimize nerve pain, which WebMD says an estimated 20 million Americans live with on a regular basis, but is this true?

Try apple cider vinegar and decide for yourself

Albina Gavrilovic/Shutterstock

There are more than 100 kinds of nerve damage and many causes behind the condition (via WebMD). From autoimmune diseases and nutritional deficiencies to trauma and slipped discs, nerve pain can occur at any time. If you have experienced this kind of pain, you might be willing to try just about anything to help it subside. 

There are some experts who say that apple cider vinegar can help with neuropathy. Board-certified neurosurgeon Dr. Pharam Yashar says that the vinegar can help reduce nerve pain, either by applying it directly to the affected area or drinking a mixture of it with water. According to the Earth Clinic, apple cider vinegar minimizes nerve pain by removing pain-inducing toxins, and may also provide essential nutrients you might be missing. The vinegar contains vitamins C, B1, B2, B6, biotin, folic acid, and niacin, as well as a small number of minerals, according to MedicineNet.

There is no evidence that suggests apple cider vinegar is effective for treating or reducing nerve pain. However, Healthline concludes it is mostly safe in moderate amounts, so you can test it out and see if it works for you. 

Read More: https://www.healthdigest.com/617740/can-apple-cider-vinegar-help-with-nerve-pain/?utm_campaign=clip

From being a culinary agent, a dietary supplement, and now regarded as a natural remedy to a range of health problems, apple cider vinegar’s versatility grants its many titles. We have seen it rise from the pantry cabinet to the medicine box, so one can deduce that its many health benefits are not merely an internet culture invention.

Thus, it makes us wonder whether the recent claim of using apple cider vinegar for neuropathy is of any significance? Let us delve into the matter further using scientific evidence and specialists’ answers to find out.

Apple Cider Vinegar for Neuropathy

Many apple cider vinegar benefits are not mere claims by proponents, but they derive from a history of credibility. The father of medicine, Hippocrates, was known to utilize ACV’s healing properties to treat wounds and injuries.

Today, studies have proven that it is a great medium for general-purpose skincare or weight loss diets. Apple cider vinegar for acid reflux, gout, and treating conditions like kidney stones and UTIs are also popular medicinal applications for ACV.

Such versatility gives us reason to believe that perhaps ACV and neuropathy could be a productive combination.

What is Peripheral Neuropathy?

Peripheral neuropathy refers to the damage within the peripheral nervous system (PNS) that connects the nerves from all areas of the body to the brain or spinal cord. These nerves manipulate what signals are sent back to the brain, including physical sensations, malfunctions in the system, and essential body processes.

Damage to one of these nerves or their system is called peripheral neuropathy. Such damage largely interrupts the functioning of the system as a whole. It halts processes such as blood circulation, digestion, urination and may send false signals or sensations to the brain.

Read More: Best Time to Drink Apple Cider Vinegar

Causes of Neuropathy

It’s difficult to pinpoint one single disease that leads to neuropathy. Nerves are sensitive, and many different conditions can weigh them down and cause a negative impact.

Autoimmune, Infections, or Inherited Diseases: Disorders like Sjogren’s syndrome, arthritis, Guillain barre syndrome, or lupus cause the immune system to affect the nerves. Other infections like chickenpox, shingles, Lyme disease, hepatitis, etc., may all contribute to neuropathy.

Vascular or Bone Marrow Diseases: Blood circulation is critical for proper nerve functioning. If inflammation, blood clots, or other blood vessel problems deprive blood flow to the nerves, damage or destruction is inevitable.

Diabetes: At least 70% of neuropathic cases in the United States derive from diabetes. Approximately 50% of diabetics will eventually develop some form of neuropathy.

Trauma: Compression of nerves or physical trauma due to fractures or sports accidents may also lead to neuropathy.

Types of Neuropathy

Neuropathy can be broadly divided into four categories, depending upon the type of nerve damage in the body. (1, 2)

Peripheral: Nerve damage that frequently affects the feet and legs, but sometimes the hands and arms. This is often associated with the “pins and needles” or tingling

Autonomic: Damage to vital nerves controlling the functioning of internal organs, which may lead to problems with the heart, blood pressure, bladder, digestive health, or sex organs.

Proximal: A rare and disabling form of nerve damage impacting the buttock, thigh, and hip region. The damage typically affects one side of the body.

Focal: Nerve damage occurs in single nerves, most often in your leg, hand, head, or torso. A common form is carpal tunnel syndrome.

Warning Signs of Neuropathy

The type of nerves affected and their location in the body influence the kind of symptoms emerging beforehand. The type of neuropathy also affects the extent of warning signs given. In acute neuropathy, symptoms are sudden with little time for action, while chronic neuropathy develops slowly over time.

Apple Cider Vinegar Cured Me of Excruciating Arthritis in Two Weeks!

Here are a few of the warning signs or symptoms commonly experienced:

Numbness or sharp pain in the damaged area

Changes in temperature or pressure

Muscle cramps or twitching

Paralysis

Digestion or urination problems

Sweating

Problems with sexual functions

Muscle weakness

Twitching

Can Apple Cider Vinegar Help with Nerve Pain?

There is little direct scientific evidence to back the claim of using apple cider vinegar for nerve pain. However, its nutrient-rich composition may support its anti-inflammatory response.

One such example is a 2017 research trial that discussed the anti-inflammatory properties of acetic acid vinegar. The animal trial concluded positive results on inflammation, alleviating obesity, and controlling gut microbe composition. (3)

The Journal of Obesity and Metabolic Syndrome established an association between body fat and diabetic peripheral neuropathy. Fortunately, apple cider vinegar is touted as a remarkable weight loss agent. For instance, a trial imposed a 12-week ACV diet on participants, each of which reported a reduction in BMI and body weight. (4, 5)

More Reading: Does ACV Break a Fast?

Apart from autoimmune diseases and physical trauma, chemicals and toxins also pose a dangerous threat to neuropathy. The elimination of these toxins from the body could help alleviate the pain and make room for recovery. Apple cider vinegar for detox can help eliminate these foreign invaders due to ACV’s antimicrobial and antifungal nature. (6)

Drinking ACV

Does drinking apple cider vinegar help neuropathy? Apart from the indirect research discussed above, the results will vary based on the individual. Since it’s a very safe nutrient-dense food, it’s likely worth a shot if your doctor agrees, and if you stay within the daily dosage.

You can use the following recipe to make an ACV and honey drink at home:

Take a cup of hot water and mix in a tablespoon of raw, organic apple cider vinegar.

Add in a sweetener of your choice, preferably honey or a stevia-based sweetener.

Gently stir the mixture and consume!

Foot Soak

Does soaking your feet in apple cider vinegar help neuropathy? So far, the evidence is scant. All benefits of soaking feet in ACV point to its antimicrobial capacity or dermatological capabilities.

A 2006 study on vinegar’s medicinal properties identified it as a potential anti-infective agent. This could prove beneficial for inflammation of the feet or handling autoimmune diseases that may worsen nerve pain. (7)

With that said, soaking your feet in apple cider vinegar may be more beneficial for fungal infections like athlete’s foot, not necessarily nerve pain.

Other Ways to Get More ACV

You can take an apple cider vinegar bath instead of only soaking your feet to enjoy its rich dermatological advantages. Moreover, you can adopt many different approaches apart from drinking ACV well. Here’s how:

Mix ACV with natural herbs like turmeric or essential oils to make a salad dressing.

Include a small quantity in your marinade recipe.

Make ACV gummies or ACV pills a part of your supplement routine.

Mix it into your morning or evening tea.

Use it as a skincare product for the area where nerve damage has occurred.

Home Remedies for Nerve Pain

In the early stages of neuropathy, the focus is to minimize the pain and discomfort. For this purpose, many painkillers are utilized, but natural remedies like apple cider vinegar can be equally effective.

Turmeric: One of the primary turmeric benefits is its high anti-inflammatory properties that may help reduce nerve pain. You can add it to your diet as a turmeric supplement or take it with warm milk.

Vitamins: Vitamin deficiency is a common cause of nerve pain. Include foods rich in vitamin B and D in your diet or consume them as a supplement.

Warm bath: Soak yourself in a warm bath regularly to stimulate the blood supply to the damaged area.

Exercise: Body movement and vigorous exercise help utilize natural painkillers called endorphins. The movement also helps keep blood sugar levels in control and combat nerve pain.

Final Thoughts on ACV and Neuropathy

The final verdict remains positive. Even if no evidence directly backs up the claim, none directly deny it either. Thus, one could rely upon history and personal experiences to test the efficiency of ACV for nerve pain.

Learn: pH of Apple Cider Vinegar

With so many benefits to consider, ACV makes a great addition to any diet or personal health regimen. Remember to always consult with a doctor or certified medical professional before using apple cider vinegar, or any dietary supplement.

How do you test for nerve damage?

What is a nerve conduction velocity test?

A nerve conduction velocity (NCV) test — also called a nerve conduction study (NCS) — measures how fast an electrical impulse moves through your nerve. NCV can identify nerve damage.

An illustration of a nerve conduction velocity test

During the test, your nerve is stimulated, usually with electrode patches attached to your skin. Two electrodes are placed on the skin over your nerve. One electrode stimulates your nerve with a very mild electrical impulse. The other electrode records it. The resulting electrical activity is recorded by another electrode. This is repeated for each nerve being tested.

The speed is then calculated by measuring the distance between electrodes and the time it takes for electrical impulses to travel between electrodes.

A related test that may be done is an electromyography (EMG). This measures the electrical activity in your muscles. It is often done at the same time as an NCV. Both tests help find the presence, location, and extent of diseases that damage the nerves and muscles.

Why might I need a nerve conduction velocity test?

NCV is often used along with an EMG to tell the difference between a nerve disorder and a muscle disorder. NCV detects a problem with the nerve, whereas an EMG detects whether the muscle is working properly in response to the nerve's stimulus.

Diseases or conditions that may be checked with NCV include:

Guillain-Barré syndrome. A condition in which the body's immune system attacks part of the peripheral nervous system. The first symptoms may include weakness or a tingling sensation in the legs.

Carpal tunnel syndrome. A condition in which the median nerve, which runs from the forearm into the hand, becomes pressed or squeezed at the wrist by enlarged tendons or ligaments. This causes pain and numbness in the fingers.

Charcot-Marie-Tooth disease. An inherited neurological condition that affects both the motor and sensory nerves. It causes weakness of the foot and lower leg muscles.

Herniated disk disease. This condition occurs when the fibrous cartilage that surrounds the disks of your vertebrae breaks down. The center of each disk, which contains a gelatinous substance, is forced outward. This places pressure on a spinal nerve and causes pain and damage to the nerve.

Chronic inflammatory polyneuropathy and neuropathy. These are conditions resulting from diabetes or alcoholism. Symptoms may include numbness or tingling in a single nerve or many nerves at the same time.

Sciatic nerve problems. There are many causes of sciatic nerve problems. The most common is a bulging or ruptured spinal disk that presses against the roots of the nerve leading to the sciatic nerve. Pain, tingling, or numbness often result.

Nerve conduction studies may also be done to find the cause of symptoms, such as numbness, tingling, and continuous pain.

Other conditions may prompt your healthcare provider to recommend NCV.

What are the risks of NCV tests?

The voltage of the electrical pulses used during an NCV is considered very low.

Risks depend on your specific medical condition. Be sure to discuss any concerns with your healthcare provider before the procedure.

Certain factors or conditions may interfere with the results of NCV tests. This includes damage to the spinal cord, severe pain before the test, and body temperature.

Tell your healthcare provider if you have a cardiac defibrillator or pacemaker, as precautions may need to be taken.

How do I get ready for an NCV test?

Your healthcare provider will explain the procedure and you can ask questions.

You will be asked to sign a consent form that gives your permission to do the procedure. Read the form carefully and ask questions if something is not clear.

Generally, you will not need to fast or get sedation before the procedure.

Normal body temperature must be maintained before and during the procedure, as low body temperature slows nerve conduction.

Tell your healthcare provider of all medicines (prescription and over-the-counter) and herbal supplements that you take.

Dress in clothes that allow access to the area to be tested or that are easily removed.

Stop using lotions or oils on your skin for a few days before your procedure.

Based on your medical condition, your healthcare provider may request other preparation.

What happens during the NCV test?

An NCV procedure may be done on an outpatient basis, or as part of your stay in a hospital. Procedures may vary depending on your condition and your doctor's practices.

The NCV is done by a neurologist. This is a doctor who specializes in brain and nerve disorders. A technologist may also do some parts of the test.

Generally, an NCV procedure follows this process:

You will be asked to remove any clothing, jewelry, hairpins, eyeglasses, hearing aids, or other metal objects that may interfere with the procedure.

If you are asked to remove clothing, you will be given a gown to wear.

You will be asked to sit or lie down for the test.

A neurologist will locate the nerve(s) to be studied.

A healthcare provider will attach a recording electrode to the skin over your nerve, using a special paste. He or she will then place a stimulating electrode away from the recording electrode, at a known distance.

A mild and brief electrical shock, given through the stimulating electrode, will stimulate your nerve.

You may experience minor discomfort for a few seconds.

The stimulation of the nerve and the response will be displayed on a monitor.

What happens after an NCV?

The paste used to attach the electrodes will be removed from your skin.

After the test, you may return to your previous activities, unless your healthcare provider advises you differently. Your healthcare provider may instruct you to avoid strenuous activities for the rest of the day.

Your healthcare provider may give you other instructions after the procedure, depending on your situation.

Can a xray show nerve damage?

Question: Can Damaged Nerves Be Seen On An X-Ray?

Answer: Damaged nerves cannot be seen on a regular X-ray. They can be seen on CAT scan or MRI, and in fact, MRI is recommended for examining details of the spinal cord. For example, MRI can demonstrate tumors of the spinal cord and nerves that extend from the spinal cord called nerve roots.

In general, MRI is more useful for examining nerves and a CAT scan is better for evaluating bone.

Is Tramadol good for nerve pain?

Tramadol Relieves Neuropathic Pain

Clinical Question

Is tramadol (Ultram) safe and effective for the treatment of neuropathic pain?

Evidence-Based Answer

Tramadol is an effective treatment for neuropathic pain. One out of four patients who take the medication achieves at least 50 percent pain relief.

Practice Pointers

Tramadol is a unique pain reliever that is thought to work via a weak effect on opioid receptors and by limiting reuptake of serotonin and norepinephrine, an effect occurring with many antidepressants. This systematic review identified six randomized controlled trials of tramadol for the treatment of neuropathic pain. Four studies (337 total patients) compared tramadol with placebo. All four studies were double-blinded, and three of the four studies (including 302 of the patients) adequately concealed allocation from participants and accounted for patients lost to follow-up.

The review found a clinically significant benefit with tramadol (number needed to treat to achieve at least 50 percent pain relief = 3.8; 95% confidence interval [CI], 2.8 to 6.3). One small, unblinded study (21 total patients) found no difference between tramadol and clomipramine (Anafranil). Another study (40 total patients) found no clear difference between tramadol and morphine in patients with cancer-related pain. However, these studies were too small and too poorly designed (i.e., unblinded with many dropouts) to draw firm conclusions.

Between 5 and 15 percent of patients discontinued the study medication because of adverse effects. In the two studies that provided adverse effects data, the combined number needed to harm was 7.7 (95% CI, 4.6 to 20). Although no life-threatening adverse effects were reported, tramadol can lower the seizure threshold and should not be given to patients with a history of seizure. An evidence-based guideline from the Institute for Clinical Systems Improvement recommends tramadol as a treatment option for neuropathic pain,1 and an expert panel recommends it as a first-line treatment.2

MARK EBELL, MD, MS

SOURCE

Hollingshead J, et al. Tramadol for neuropathic pain. Cochrane Database Syst Rev. 2006;(3):CD003726.

REFERENCES

1. Institute for Clinical Systems Improvement. Assessment and management of acute pain. March 2006. Accessed February 22, 2007, at: http://www.icsi.org/pain_acute/pain__acute__assessment_and_manage-ment_of__3.html.

2. Dworkin RH, Backonja M, Rowbotham MC, Allen RR, Argoff CR, Bennett GJ, et al. Advances in neuropathic pain: diagnosis, mechanisms, and treatment recommendations. Arch Neurol. 2003;60:524–34.

How fast does gabapentin work for nerve pain?

1. How it works

Gabapentin may be used for the treatment of certain seizure disorders or nerve pain.

Experts aren't sure exactly how gabapentin works, but research has shown that gabapentin binds strongly to a specific site (called the alpha2-delta site) on voltage-gated calcium channels. This action is thought to be the mechanism for the way it relieves nerve pain and lowers the risk of seizures.

Gabapentin enacarbil (brand name Horizant) is a prodrug of gabapentin that has been designed to overcome the limitations of gabapentin, such as poor absorption and a short duration of action. Gabapentin enacarbil is effective for restless legs syndrome (RLS) and postherpetic neuralgia (nerve pain that occurs following Shingles).

Gabapentin belongs to the group of medicines known as anticonvulsants.

2. Upsides

May be used in addition to other medication to reduce seizure frequency in adults and children aged three and older with partial-onset seizures.

May be used in the management of postherpetic neuralgia (persistent nerve pain following Shingles infection) in adults.

Gabapentin enacarbil (brand name Horizant) may be used to relieve restless legs syndrome (RLS) or nerve pain associated with postherpetic neuralgia. This prodrug of gabapentin only requires once-daily dosing.

Gabapentin is available as a generic; however, not all generics are interchangeable with some branded versions of gabapentin.

Gabapentin may be used off-label (this means for an indication that has not been approved by the FDA but may still have a place in therapy) for some other indications such as fibromyalgia, persistent hiccups, migraine prevention, and hot flashes.

3. Downsides

If you are between the ages of 18 and 60, take no other medication or have no other medical conditions, side effects you are more likely to experience include:

Dizziness, drowsiness, tiredness, fever, and nystagmus (a rapid and uncontrollable movement of the eyes). Drowsiness caused by gabapentin may affect your ability to drive or operate machinery. Alcohol and other drugs with sedative properties enhance this effect.

May cause behavioral problems, hostility or aggression, or thought disturbances when used to treat epilepsy in children aged three to twelve years.

Other side effects may include blurred vision, amblyopia (lazy eye), dry mouth, peripheral edema (fluid retention in the feet and hands), tremor, sexual dysfunction, and gastrointestinal disturbances.

Best titrated up slowly to reduce the risk of side effects; however, this may delay the onset of an effect.

Similar to other anticonvulsant medicines, gabapentin may increase the risk of depression and suicidal thoughts, particularly in young adults under the age of 24.

Gabapentin has been associated with a discontinuation syndrome when abruptly stopped. Symptoms include anxiety, insomnia, nausea, pain, and sweating. It should be tapered off slowly under a doctor's advice.

The dosage of gabapentin needs to be reduced in kidney disease.

Rarely do hypersensitivity reactions occur. Symptoms may include fever, rash, swollen lymph nodes, swollen facial features, or throat swelling.

May interact with some other medications including antacids, hydrocodone, morphine, and other drugs that cause sedation or dizziness. May also cause false-positive results on some urinary protein tests.

There have been some reports of gabapentin misuse and abuse, particularly in people with a history of drug abuse. Be alert for this possibility.

Gabapentin requires three times daily administration because of its short duration of effect. Gabapentin enacarbil (brand name Horizant) only requires once-daily dosing.

Only effective for partial-onset seizures, not other types of seizure disorders.

Some branded and generic forms of gabapentin are not interchangeable.

Note: In general, seniors or children, people with certain medical conditions (such as liver or kidney problems, heart disease, diabetes, seizures) or people who take other medications are more at risk of developing a wider range of side effects. View complete list of side effects

4. Bottom Line

Gabapentin may be used in the treatment of partial-onset seizures and nerve pain but is likely to cause dizziness or drowsiness. Gabapentin enacarbil (brand name Horizant), a prodrug of gabapentin that can be taken once daily, may be used in the treatment of RLS and postherpetic neuralgia.

5. Tips

The Neurontin brand of gabapentin can be taken with or without food. If you break a 600mg or 800mg Neurontin tablet in half, be sure to take the other half at your next dose or within 28 days.

The Gralise brand of gabapentin cannot be substituted for other gabapentin products due to different administration requirements (once daily versus three times daily for other products). Gralise should be taken with food at the evening meal. Gralise tablets should be swallowed whole; do not cut, crush, or chew.

Horizant (gabapentin enacarbil) tablets should be swallowed whole and taken with food. For restless leg syndrome, take at roughly 5 PM. Do not cut, crush, or chew the tablet. Do not interchange Horizant with other gabapentin products.

Use a manufacturer-provided or pharmacist-provided measuring cup calibrated for liquid formulations when measuring liquid doses of gabapentin. Do not use a kitchen measuring device or teaspoon because these may be inaccurate.

For dosage schedules of three times daily do not allow more than 12 hours between doses.

Monitor for mood changes and report any evidence of new or worsening mood or depression to the prescribing doctor.

Do not take gabapentin at the same time as antacids such as Maalox or Gaviscon. Separate administration by at least two hours. Take exactly as directed by your doctor, do not increase or decrease the dose without his or her advice.

Avoid operating machinery, driving, or performing tasks that require mental alertness if gabapentin makes you drowsy or impairs your judgment.

The side effects of gabapentin, such as dizziness or drowsiness, may increase your risk of falling. Remove any fall hazards from your home if possible (such as loose rugs), and be careful when ascending or descending stairs.

Talk to your doctor if you experience any worsening of your mood or if you develop any suicidal thoughts.

Do not stop taking gabapentin without your doctor's advice as it may precipitate a withdrawal reaction (symptoms include agitation, disorientation, confusion). When the time comes to discontinue gabapentin your doctor will tell you how to taper it off.

Seek urgent medical advice if you develop a rash, fever, difficulty breathing, or facial swelling while taking gabapentin.

6. Response and effectiveness

Peak concentrations of gabapentin (immediate-release) occur within 2 to 3 hours. Although gabapentin may improve sleep problems due to nerve pain within a week, it may take up to two weeks for symptom relief from nerve pain to occur. A reduction in seizure frequency is usually apparent within a few weeks.

Gabapentin enacarbil (brand name Horizant), a prodrug of gabapentin, is rapidly absorbed by nutrient transporters along the gastrointestinal tract and then quickly hydrolyzed to gabapentin. This means gabapentin enacarbil only needs to be given once a day. However, symptom relief from RLS or postherpetic neuralgia may take several days or weeks to develop.

Immediate-release gabapentin capsules require three times daily dosing (except in kidney disease).

7. Interactions

Medicines that interact with gabapentin may either decrease its effect, affect how long it works for, increase side effects, or have less of an effect when taken with gabapentin. An interaction between two medications does not always mean that you must stop taking one of the medications; however, sometimes it does. Speak to your doctor about how drug interactions should be managed.

Common medications that may interact with gabapentin include:

antacids, such as those containing aluminum and magnesium

anti-anxiety medications, such as diazepam, lorazepam, and flunitrazepam

antidepressants, such as amitriptyline, citalopram, fluoxetine, paroxetine

antihistamines, such as chlorpheniramine, promethazine

antipsychotics, such as aripiprazole, chlorpromazine, haloperidol

buprenorphine

narcotic pain relievers, such as oxycodone and morphine

propoxyphene

sedatives or sleeping pills

tramadol.

Alcohol may worsen the side effects of gabapentin such as drowsiness and dizziness.

Note that this list is not all-inclusive and includes only common medications that may interact with gabapentin. You should refer to the prescribing information for gabapentin for a complete list of interactions.

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Natural solutions for chronic nerve pain and neuropathy

References

Gabapentin. Revised 09/2021. Westminster Pharmaceuticals, LLC. https://www.drugs.com/pro/gabapentin.html

Horizant (gabapentin enacarbil) [Package Insert]. Revised 09/2021. Arbor Pharmaceuticals Ltd. https://www.drugs.com/pro/horizant.html

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use gabapentin only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

What is the fastest way to get rid of neuropathy?

Peripheral neuropathy has many potential causes. Besides a physical exam, which may include blood tests, diagnosis usually requires:

A full medical history. Your doctor will review your medical history, including your symptoms, lifestyle, exposure to toxins, drinking habits and a family history of nervous system (neurological) diseases.

Neurological examination. Your doctor might check your tendon reflexes, your muscle strength and tone, your ability to feel certain sensations, and your posture and coordination.

Tests

Your doctor may order tests, including:

Blood tests. These can detect vitamin deficiencies, diabetes, abnormal immune function and other indications of conditions that can cause peripheral neuropathy.

Imaging tests. CT or MRI scans can look for herniated disks, pinched (compressed) nerves, tumors or other abnormalities affecting the blood vessels and bones.

Nerve function tests. Electromyography (EMG) records electrical activity in your muscles to detect nerve damage. A thin needle (electrode) is inserted into the muscle to measure electrical activity as you contract the muscle.

At the same time your doctor or an EMG technician obtains an electromyogram, he or she typically performs a nerve conduction study. Flat electrodes are placed on the skin and a low electric current stimulates the nerves. Your doctor will record your nerves' responses to the electric current.

Other nerve function tests. These might include an autonomic reflex screen that records how the autonomic nerve fibers work, a sweat test that measures your body's ability to sweat, and sensory tests that record how you feel touch, vibration, cooling and heat.

Nerve biopsy. This involves removing a small portion of a nerve, usually a sensory nerve, to look for abnormalities.

Skin biopsy. Your doctor removes a small portion of skin to look for a reduction in nerve endings.

Is Ginger good for nerve pain?

Essential oils contain concentrated plant extracts. Aromatherapy with some essential oils may help relieve neuropathic pain.

Neuropathy is a general term for conditions that develop as a result of nerve damage. One of the most common forms of neuropathy is diabetic peripheral neuropathy, which occurs in up to 50 percentTrusted Source of people with diabetes.

Peripheral neuropathy typically affects a person’s hand and feet. It can cause pain, tingling, and numbness. Other types of neuropathy can also develop in people with diabetes.

Research suggests that some essential oils may help reduce pain resulting from inflammation and nerve damage. However, much of the available research comes from animal models and individual case studies.

In this article, we look at some essential oils that may relieve neuropathic pain as well as the supporting evidence.

We also describe how to use the oils, risks and considerations, other treatments, and causes and symptoms of neuropathy.

Ginger

Using ginger oil may help reduce neuropathic pain from inflammatory conditions.

A 2014 study compared the effectiveness of Swedish massage using aromatic ginger oil with traditional Thai massage in 140 older adults who had chronic lower back pain.

Although both treatments improved the symptoms, Swedish massage with aromatic ginger oil was more effective than Thai massage in reducing pain and disability.

Ginger oil contains a compound called zingibain, which possess potent anti-inflammatory properties. Zingibain, therefore, may help reduce neuropathic pain that results from inflammatory conditions.

However, researchers have not yet investigated the use of ginger oil for the specific treatment of neuropathic pain.

Many ginger essential oils are available to purchase online.

Chamomile

Borneol, a compound in chamomile and lavender essential oils, may help reduce pain and inflammation that relates to neuropathy.

A 2015 study found that borneol reduced pain sensitivity in mice with neuropathic pain. However, confirming the effect in humans will require further studies.

Many chamomile essential oils are available to purchase online.

St. John’s wort

St. John’s wort, or Hypericum perforatum, is a traditional remedy for depression and anxiety. People also use extracts to treat burns, inflammation, and nerve pain.

According to a 2017 case report, a person with trigeminal neuralgia — a type of nerve pain that affects the face — found that a homeopathic preparation of St. John’s wort helped relieve the symptoms.

The authors of the report concluded that St. John’s wort “may be a promising therapeutic option” for treating this pain, but further research is necessary.

Aromatherapy products containing St. John’s wort essential oils are available to purchase online.

WERBUNG

Lavender

Some studies suggest that lavender oil may help reduce pain and anxiety.

Inhaling lavender essential oil may help promote relaxation and reduce pain and anxiety.

A 2016 study looked at the effectiveness of aromatherapy during peripheral venous cannulation, which involves the insertion of a tube with a needle into a peripheral vein.

After recruiting 106 people who were due to undergo the procedure, the researchers randomly assigned the participants to receive either aromatherapy with lavender essential oil or a placebo.

Following the cannulation, those in the lavender group reported significantly less pain and anxiety than those in the placebo group.

However, a 2014 studyTrusted Source found that lavender oil aromatherapy had no effect on reducing pain in people undergoing open-heart surgery.

A range of lavender essential oils are available to purchase online.

Holy basil

Holy basil, also known as tulsi or tulasi, is an aromatic plant that grows throughout the Indian continent and Southeast Asia. Practitioners of Ayurvedic medicine have long used it to treat a range of conditions, including nerve pain.

A 2015 study found that holy basil extract significantly reduced sciatic nerve pain in rats. However, confirming these findings in humans will require further research.

People can purchase holy basil essential oils online.

Peppermint

Peppermint oil has antimicrobial, anti-inflammatory, and antioxidant properties. It may also help regulate the immune system and reduce muscle spasms.

The findings of a 2019 systematic reviewTrusted Source suggest that peppermint oil may help relieve gastrointestinal pain from irritable bowel syndrome, or IBS. However, researchers have yet to establish whether peppermint oil can help treat nerve pain.

A number of peppermint essential oils are available online.

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How to use

People either inhale essential oils or use them as a massage oil.

A person can try adding a few drops of essential oil to a diffuser, bath water, or soft furnishings, such as pillows.

When using essential oils in a massage, always dilute them in a carrier oil, such as almond or olive oil. Gently massage the mixture into the affected area.

Risks and considerations

The Food and Drug Administration (FDA) class most essential oils as cosmetic products, which means that it does not regulate their quality or safety. It is therefore advisable to only purchase essential oils from reputable manufacturers and to carefully read any labels or directions.

Aromatherapy involves using essential oil, either in a diffuser or a massage.

Pure essentials oils are very concentrated, and some can be toxic, so people should not ingest them.

It is also important to dilute essential oils in a carrier oil before using them directly on the skin. Manufacturers often provide instructions on dilution and safe usage.

Essential oils can cause skin irritation or allergic reactions in some people, so it is advisable to perform a patch test before using a new oil.

A patch test involves applying the diluted oil to a small area of skin, such as the back of the hand or part of the forearm. Do not use the oil if the skin becomes itchy, red, or dry.

Essential oils may interact with certain medications, such as antidepressants and stimulants. People taking prescription medications should seek advice from their doctor before using an essential oil.

Consider pets, children, and pregnant women before diffusing essential oils.

Other treatments for neuropathy

Medical treatment for neuropathy generally depends on treating the underlying cause. For example, good control of blood glucose levels may help reduce symptoms in people with diabetic neuropathy.

Medication

Doctors may prescribe medications to help relieve pain in people with neuropathy. These can include:

tramadol, codeine, and hydrocodone

alpha-2 adrenergic agonists, including clonidine and tizanidine

antidepressants, such as amitriptyline, imipramine, and duloxetine

anticonvulsants, such as gabapentin and lamotrigine

topical pain relievers, such as lidocaine patches, sprays, and ointments

Transcutaneous electrical nerve stimulation

Transcutaneous electrical nerve stimulation (TENS) is a therapy that uses electrical currents to treat pain and relieve muscle spasms.

TENS therapy involves placing electrodes on the affected areas of the body. These connect to a small device that delivers mild electrical current to the nerves. People can use a TENS device at home.

The authors of a 2017 systematic review were unable to come to a definite conclusion about whether TENS can relieve neuropathic pain. They attributed this to the low quality of available evidence and pointed to the need for further studies.

Some people report pain relief with TENS therapy, and it is a relatively safe approach. When using a TENS unit, it is essential to follow the manufacturer’s instructions.

Various TENS units are available to purchase online.

Physical therapy

Regular physical therapy can help reduce neuropathic pain. Physical therapy for neuropathy focuses on improving muscle strength, flexibility, and balance.

A specialized physical therapist or other healthcare professional will work closely with a person to develop a tailored exercise routine.

Causes and symptoms of neuropathy

Stress may cause a person to have neuropathy.

There are many causes of neuropathy. Some of these include:

stress

heavy alcohol use

exposure to toxic substances, such as lead or arsenic

a vitamin B deficiency

chemotherapy

HIV

celiac disease

lupus

rheumatoid arthritis

shingles

Guillain-Barré syndrome

Charcot-Marie-Tooth disease

Neuropathy can cause a wide range of symptoms, depending on which nerves the condition affects.

Symptoms of neuropathy can include:

numbness, tingling, or burning sensations in the extremities, such as the hands and feet

reduced or extreme sensitivity to touch

muscle weakness

difficulty walking

muscle spasms

digestive issues

excessive sweating

difficulty swallowing

Summary

Neuropathic pain is a type of pain that results from conditions that affect the nerves. Peripheral neuropathy is common in people with diabetes and can cause pain, tingling, and numbness in the hands and feet.

Limited research suggests that certain essential oils may help to relieve certain types of pain and inflammation. However, many of the studies were in animals or did not specifically investigate the effects of essential oils on neuropathic pain.

Does drinking water help with nerve pain?

It’s not every day that you think about the food you put in. It’s easier to not care about certain ingredients or daily serving sizes when the stomach is calling. However, this relaxed way of thinking needs to change if the body has any hope of feeling good. 

Good nutrition plays an integral role in how you fight off certain illness, recover faster and ward off unnecessary pain. 

It’s time to think about what you put in your body and how it helps or hurts you more than you think. Here is a look at healthy nutrition habits to incorporate for a more well-balanced and pain-free life. 

Consume heart-healthy fats

It can be a struggle for many patients living with diabetic nerve pain to maintain a healthy cholesterol level. The goal is to aim for a well-balanced diet that is rich in heart-healthy fats such as olive oil, canola oil, nuts and seeds. 

Take in vitamin B12

Neuropathy patients can often find themselves with lower levels of B12. It’s important to eat foods high in B12, such as eggs, milk or cheese. Feel free to talk with a physician about B12 supplements as an added dose of support. A physician may recommend a blood test to check B12 level for a healthy diagnosis. 

Go gluten-free

How often have you heard this before? I’m sure far too many, but, the truth is maintaining a gluten-free diet is healthy and ideal to reducing nerve pain. Gluten can affect the stomach, skin and even the brain. It can be difficult to eat foods with gluten (i.e. pastas, breads, oats). Aim to eat plenty of legumes, eggs, vegetables, nuts, and fruits to get your daily dose of nutrients. 

Eat fruits and vegetables

Fill your plate with as many bright colors and leafy greens to satisfy your hunger craving. Fruits and vegetables are rich in antioxidants, vitamins and minerals. They provide a nutritious balance to fight nerve pain and even control diabetic symptoms. Aim to eat at least five servings of fruits and vegetables a day. 

Drink lots of water

Water should be a staple in any diet, and even more so for those looking to reduce nerve pain. It’s critical to stay hydrated throughout the day to reduce inflammation and avoid triggering pain receptors. Aim to drink eight 8-oz. of water each day. 

Talk with your doctor before starting any new diet. It’s important to maintain a healthy and well-balanced diet that not only improves your nerve pain, but keeps you going throughout the day.

How do you repair damaged nerves?

The nervous system is a complex and wide-reaching network of nerve cells called neurons. Their connections, called synapses, reach all areas of the body. The nervous system receives and relays sensory information like vision, sound, smell, taste, touch and pain.

The nervous system is fragile. It can be damaged, and it heals with great difficulty, if at all. This affects the brain's ability to communicate with your muscles and sensory organs. Nervous system injuries can be painful, and cause weakness, tingling, numbness and even changes in blood circulation.

All the neurons in your body start and end in your brain or spinal cord. The brain and spinal cord make up the central nervous system, which is usually what first comes to mind for many people.

The peripheral nervous system, on the other hand, connects the central nervous system with your internal organs, muscles and sensory tissues. These nerves fire muscles; sense temperature; and control your heart, lungs and other involuntary functions essential to life. To put it simply, neurons are like electrical wires that are lined on the outside by special cells that provide insulation. Each neuron has a head called the cell body and a long tail called an axon. The head is connected to the spinal cord or brain, and the tail connects to a muscle or organ.

Central nervous system injuries

Injuries to the spinal cord or brain can happen in an instant. They can be caused by an auto accident, sports injury, fall, stroke, ruptured brain aneurysm, lack of oxygen, gunshots or an explosive blast. These injuries are often called traumatic brain injuries or traumatic spine injuries.

Injured nerve cells in the central nervous system typically do not regenerate. However, this part of the nervous system can reorganize in response to an injury. This is called "plasticity." Luckily, the brain has a lot of built-in redundancy. Simply put, when one area loses function, other undamaged areas of the brain can take over. For example, if a stroke causes an area of brain damage, other parts of the nervous system can take over the lost function of the damaged area. The chance of recovery is greatest in patients 40 and younger after a traumatic brain injury.

Neurosurgeons can't alter the primary injury suffered by the brain or spinal cord, but they can prevent secondary damage from occurring. Surgical procedures can relieve pressure on the spinal cord and brain. This prevents damage from progressing to other areas.

Peripheral nervous system injuries

Injuries to the peripheral nervous system can happen slowly over time or in an instant. Accidents, falls and sports can cause injuries. Repetitive microtrauma, such as carpal tunnel syndrome, also can cause nerve damage. Other causes of nerve injury include diabetes, radiation, alcoholism, viral illnesses, birth trauma, surgery, autoimmune reactions and certain hereditary conditions.

Three types of peripheral nervous system injuries are:

Neuropraxia

This is the mildest and most common type of nerve injury. The nerve itself is intact and merely stunned. Any resulting numbness, weakness or loss of function is temporary, and most people make nearly a complete recovery with rest and time. Surgery is rarely needed.

Axonotmesis

This is a partial nerve injury. The outer nerve sheath is intact, but the neurons within are damaged. Nerve cells can regenerate and grow back at a rate of about an inch a month, but recovery is typically incomplete and slow.

Neurotmesis

This is a complete nerve injury, where the nerve sheath and underlying neurons are severed. If there is an open cut, a neurosurgeon can see the cut nerve ends at surgery and repair this. If the gap is less than 2 centimeters, the nerve ends may be sutured together, provided they come together easily. Larger gaps may need artificial conduits or nerve grafts to fill the defect. Surgery is almost always needed.

Stretch injuries are the most encountered pattern of nerve damage. These may result from a fall, a birth injury, a motor vehicle accident, a surgical procedure or workplace injury. All three types of nerve injuries detailed above also can occur or in combination with one another. Most people improve within three to six months, but surgery may be needed based on the lack of clinical improvement and other tests, including an ultrasound and electromyography.

The chance of nerve regeneration is greater within the peripheral nervous system. This is because these neurons have a different lining, or sheath, made up of Schwann cells. The central nervous system does not have these cells. Schwann cells can help damaged nerves regenerate and restore function. On average, damaged nerves can grow back at a rate of about 1 inch per month or 1 millimeter per day.

Surgery is needed if there is significant scar tissue or a gap between cut nerve ends. Neurolysis is a surgical procedure that removes scar tissue from around and sometimes from within the nerve to improve its function. Direct nerve repair or primary neurorrhaphy involves suturing cut nerve ends together with ultrafine sutures or glue. Nerve grafting repairs larger gaps that are bridged with nerves harvested typically from the patient's leg, cadaver nerves or synthetic conduits that may be lined with biological factors to enhance nerve regeneration.

Neurotization or nerve transfers involve sacrificing a healthy nerve by severing it and using it as a source of neurons to hot-wire a more important damaged nerve close to its entry into the paralyzed muscle. This bypasses scarring at the level of injury and reduces the time taken to reenergize the muscle. A neurosurgeon can use one or more procedures to repair damaged nerves.

Nerve surgery isn't right for every patient. These procedures are most successful in younger patients who are in good overall health. Patients who are obese; smoke; or have diabetes, poor circulation or undergone radiation therapy previously fare worse.

Complex regional pain syndrome

This is a rare but severe form of chronic pain that affects a limb. The pain is out of proportion to the severity of the initial injury.

Type 1 complex regional pain syndrome may occur after an injury that did not directly damage the limb or nerves therein, such as after a stroke or heart attack. Type 2 complex regional pain syndrome occurs after a crush injury to a limb and direct nerve damage there. This poorly understood condition likely involves inflammation and hypersensitivity at the level of the peripheral and central nervous systems.

Symptoms include extreme burning or throbbing pain, sensitivity to touch, changes in skin color, skin temperature and swelling. Physicians aren't sure why this occurs in some people and not others. A multidisciplinary team of health care professionals is needed to treat this rare and agonizing condition.

Peripheral nerve injuries can be treated nonoperatively with rest, physical therapy, desensitization techniques and medications to numb the pain while allowing the nerve to grow back. Surgical procedures have evolved over the years and produce excellent results in carefully selected patients with paralyzed muscles, pain, numbness and lost function.

Manish Sharma, M.B.B.S., is a neurosurgeon in Albert Lea, Mankato and New Prague, Minnesota.

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Is banana good for the nerves?

Forget the three cups of coffee or chocolate bar. Reach for a banana instead, which gives an instant, sustained, and substantial boost of energy. Bananas contain three natural sugars – sucrose, fructose, and glucose combined with fiber. And research has proven that just two bananas provide enough energy for a strenuous 90-minute workout.

Yet, energy isn’t the only way bananas can help you keep fit. Eating bananas can also help overcome or prevent a substantial number of illnesses and conditions when added to your daily diet. Take a look!

9 Healthy Reasons To Eat Bananas

Anemia: High in iron, bananas can aid in the production of hemoglobin in the blood which helps prevent anemia.

Constipation: High in fiber, bananas can help restore normal bowel action, helping to overcome the problem naturally without the use of laxatives.

Depression: According to a recent survey undertaken by MIND amongst people suffering from depression, many felt much better after eating a banana. This is because bananas contain tryptophan, a type of protein that the body converts into serotonin, known to make you relax, improve your mood, and generally make you feel happier.

Heartburn: Bananas have a natural antacid effect in the body. When suffering from heartburn, try eating a banana for soothing relief.

High Blood Pressure: This unique tropical fruit is extremely high in potassium yet low in salt, making it perfect to help manage high blood pressure. So much so, the U.S. Food and Drug Administration has just allowed the banana industry to make official claims for the fruit’s ability to reduce the risk of high blood pressure and stroke.

Morning Sickness: Snacking on bananas between meals helps keep blood sugar levels up and avoid morning sickness.

Nerves: Bananas are high in B vitamins, which help calm the nervous system.

PMS: The vitamin B6 that bananas contain regulates blood glucose levels, which can affect your mood.

Strokes: According to research, eating bananas as part of a regular diet can cut the risk of death by strokes by as much as 40%!

What is end stage neuropathy?

The 5 Stages of Peripheral Neuropathy

Conditions, Neuropathy / By Justin ModFXMedia

Peripheral Neuropathy is a condition that stems from damage to the Nervous System. Neuropathy affects more than 20 million Americans every year, yet many people are reluctant to seek treatment. This condition can be difficult to pinpoint because it can be anywhere in the body, but there are several common symptoms that are characteristic of neuropathy. The most common symptoms are extreme pain in the hands and feet, along with feeling weakness and the sensation of pins and needles. Neuropathy does become worse over time if left untreated, and there are several stages of this condition, each one becoming worse if left untreated. Here, we will break down the stages to better help you understand your symptoms, and help determine if you need to seek treatment. 

 

Stage 1: Numbness and Pain 

In the beginning stages of neuropathy, you will experience some pain and numbness. These symptoms won’t be persistent, but you will notice them coming and going. These first symptoms of pain and numbness may be subtle, but you will recognize that they are there. For example, you may notice some slight tingling or numbness in your hands and feet, but it eventually goes away. Another early sign of neuropathy may be that you notice your balance and reflexes are a little out of tune compared to what they normally are. Oftentimes, the first symptoms recur every few weeks, and grow to become more consistent. It is common for people to ignore the first signs of neuropathy because they are so subtle.  

 

Stage 2: Regular and Persistent Symptoms

The second stage of peripheral neuropathy occurs when your pain and numbness become more regular and consistent. It is difficult to pinpoint exactly when a patient’s neuropathy progresses into the second stage, but it will become obvious when the pain and numbness is felt more often than in the past. In the second stage, it becomes more difficult to ignore the pains, numbness, and other symptoms that are present. This is the stage in which many people recognize that something may be wrong, and seek help from a doctor. In most cases, if neuropathy is caught and treated by the second stage, the chances of curing the nerve damage is high, but if left untreated past the second stage, nerve damage is often permanent.    

 

Stage 3: Debilitating Pain 

In the third stage of neuropathy, your pain is occurring daily, or almost every day. In this stage, the pain begins to affect your daily activities, and prevents you from going about your day as you would normally. At this point, you may realize that over the counter pain medications are not working anymore, and you can’t find a way to alleviate your pain. This is because in the third stage of neuropathy, you are likely experiencing other pains and symptoms of nerve damage. In the third stage, there is still a chance that some of the nerve damage can be reversed, but in many cases may be permanent. 

 

Stage 4: Constant Numbness

In the fourth stage of neuropathy, your legs and feet will become very numb. This is due to the lack of healthy nerves that are able to carry signals to your brain. You may notice an increase in numbness and a decrease in your pain, but this is not a good thing. When this happens, it is a sign that the nerves are dying and a good majority of the nerve fibers have disintegrated. At this point, the larger nerve fibers are beginning to become irreversibly damaged. In this stage, it is likely that your balance is affected, and it may become difficult to walk and keep your balance. In the fourth stage of neuropathy, your nerve damage is permanent, and much of the numbness will be irreversible. At this stage, it is urgent to seek treatment in order to prevent worsening numbness that cannot be reversed. In the fourth stage, there is still a chance for improvement, but it may be slight.

 

Stage 5: Complete Loss of Feeling 

This is the final stage of neuropathy, and it is where you’ve lost any and all feeling in your lower legs and feet. You do not feel any pain, just intense numbness. This is because there are no nerves that are able to send signals to your brain. At this stage, walking has become very difficult, and your balance is severely affected. You may become so unsteady that you have to use a wheelchair. It is absolutely necessary that you seek immediate medical attention if you reach this stage of neuropathy, and are experiencing a complete loss of feeling in your lower extremities. In stage five, your nerves are permanently damaged, but it may be possible to regenerate some of your nerve fibers.

 

When it comes to Peripheral Neuropathy, the most commonly affected areas are the hands and feet, but symptoms may be felt in many other areas, such as the back, legs, and face. If you are experiencing any of the symptoms or feelings that are listed above, contact your doctor immediately. To learn more about Select Health and the treatment options we offer for your Neuropathy, click here! Visit our Facebook page for all of the latest updates and information about us and our services. 

Can you live with neuropathy?

Living with neuropathic pain can take a huge toll on your quality of life. Even straight forward neuropathic disorders often require some trial and error to find the most effective treatment to manage your symptoms. Whether you’re newly diagnosed or have failed to achieve relief in the past, there are treatment options that can help you get your life back.

Visiting experts like the board-certified interventional pain management physicians at Pain Management Specialists is a wise first step. Our team will perform a comprehensive neuropathy evaluation and create an individualized treatment plan to ease your pain and best manage your neuropathy.

Peripheral neuropathy: Mayo Clinic Radio

Living with neuropathy

Neuropathy is the result of damage to nerve cells that send messages from the brain and spinal cord to the rest of the body. People with neuropathy experience abnormal sensations, such as tingling, numbness, burning, and pain, usually in the legs, feet, and hands, although it can occur anywhere in the body.

Roughly 20 million Americans are living with neuropathy. Living with daily pain and discomfort can be challenging. People with neuropathy are at a higher risk for depression and anxiety than those without a neurological disorder. The good news is treatable, and a pain management specialist can help.

Achieving relief from neuropathy

Pain management physicians Stuart Hough, MD, and Ramani Peruvemba, MD have access to various tools to help you achieve relief and live well with neuropathy. Treatment depends on the type of nerve damage and symptoms.

Here are some of the ways we help patients get relief from neuropathic pain:

Medication

A class of medications called serotonin-norepinephrine reuptake inhibitors to increase chemicals in the brain that reduce incoming pain signals. Another class of drugs called anticonvulsants tamp down nerve signals. These medications are commonly used to manage neuropathic pain. 

Spinal cord stimulation

Spinal cord stimulation (SCS) provides significant pain relief for those who respond to it. SCS involves placing a small device along the spine. The device sends electrical signals to your spinal cord, changing the way your brain perceives pain. It’s similar to a pacemaker and comes with a hand-held remote that enables you to adjust the settings.

People with neuropathy pain who respond successfully to SCS experience at least a 50% improvement in pain and quality of life. 

Dorsal root ganglion stimulation

Some areas of the body such as the hand, foot, knee, and chest are harder to manage with available treatment options such as SCS. If you have neuropathy in these areas your provider may recommend dorsal root ganglion stimulation (DRGS).

DRGS therapy involves placing a device that stimulates structures along the spinal column called the dorsal root ganglia that regulate pain signals. Each dorsal root ganglia along the spinal column are linked to different areas of the body. Stimulating a specific DRG offers the unique ability to target pain in specific areas of the body.

Why do nerves hurt more at night?

Peripheral neuropathy is when a nerve or group of nerves outside of the brain and spinal cord is injured or dysfunctions. It could be because of an injury to a single nerve, like carpal tunnel syndrome, or because a group of nerves have become defective, like with peripheral neuropathy of the feet.

“Across the board we know that neuropathy can cause pain depending on what type of nerves are involved,” says neurologist Benjamin Claytor, MD. “When people describe worsening symptoms at night they’re describing discomfort – pins and needles, tingling and burning pain.”

Here Dr. Claytor discusses what might be causing this nightly pain and how to find relief.

Distraction

Our attention level can influence how we perceive pain. So during the day when we’re at work or taking care of the kids – we’re distracted and busy. Although there hasn’t been much research around it, the idea is that we aren’t focusing on the pain during the day because we’re busy, we pay less attention to it and perceive less pain.

“Many patients will tell me that after they get home from work, have dinner and sit down to watch TV for the night that their pain flares up,” says Dr. Claytor. “This could be because the daytime distractions are now gone and you’re starting to unwind for the night.”

Temperature and sleep

Another thought behind nightly neuropathy has to do with temperature. At night our body temperature fluctuates and goes down a bit. Most people tend to sleep in a cooler room as well. The thought is that damaged nerves might interpret the temperature change as pain or tingling, which can heighten the sense of neuropathy.

Also consider poor sleep quality. If you’re not sleeping very well to begin with, either due to poor sleep habits or sleep related disorders, this could lead to increased pain perception.

Emotions and stress

Our emotional state can also influence how we perceive pain. Stress and anxiety can feed in to and amplify pain signaling. Living in a chronic state of stress wreaks havoc on your physical and mental health.

Medication

Sometimes medication dosing and timing might need to be adjusted, which could be particularly true for some short acting medications used for neuropathy pain.

How to stop neuropathy pain at night

“There are options we can explore if your neuropathy pain seems to be worsening at night,” explains Dr. Claytor. “There might be oral or topical medications we can prescribe, or maybe it’s getting your stress under control and being more mindful.”

Cognitive behavioral therapy, physical therapy and meditation may be complementary tools to reduce pain as well.

Dr. Claytor stresses the importance of talking to your doctor sooner rather than later. Often time’s people will wait so long to see their physician that there’s permanent nerve damage that might have been avoided.

“I think one of the most important things I can discuss with a patient who comes in with neuropathy pain at night is getting to the root cause of what is actually driving it,” says Dr. Claytor. “Depending on what the underlying cause is, treating that first and foremost can usually help reduce the pain overall – especially at night.”

Do pinched nerves go away on their own?

This common condition is caused by compression or constriction — in some cases, it can even be caused by stretching — and is characterized by numbness, tingling, a burning sensation, or pain that radiates outward from the affected area. Patients who suffer from pinched nerves often say that it feels as if their hands or feet have fallen asleep. If this sounds familiar, read on for advice on how to proceed.

 

Should you seek treatment for a pinched nerve?

According to Spine Universe, in most cases, the symptoms will resolve themselves on their own. However, seek medical treatment if any of the following occur:

Pain that is persistent

Pain that grows progressively worse

Numbness

Loss of sensation

Loss of bladder or bowel control

 

For any of these symptoms, medical treatment should be sought even if a pinched nerve is not suspected. It's important to rule out any threatening cause for sudden, unexplained pain or weakness.

 

What treatment options are available for a pinched nerve?

If the pain is persistent or worsening, consider seeking physical therapy. The chiropractic treatments offered at Spinal Dynamics can help chronic back pain sufferers on the path back to a normal, healthy lifestyle. While pinched nerves often heal themselves without treatment, there's no reason why you should suffer in the meantime. Hot and cold therapies are also beneficial, depending on whether the pain is accompanied by swelling — rare with this condition, but possible depending on what caused the injury.

What is better for pinched nerve ice or heat?

Signs and symptoms of a pinched nerve include:

Tingling

Burning

Numbness

Pain

Muscle weakness (especially in the arms/hands if you have a pinched nerve in your neck)

“Pins and needles”

The area may feel like it has “fallen asleep”

You may experience worsened symptoms when lying down or after just waking up. Pinched nerves can be caused by poor posture, staying in the same position for too long, or repetitive motions.

Consider These Home Remedies to Provide Relief:

Be conscious of posture

The Problem: Our bodies are designed for very specific movement patterns. If you’re continuously sitting or standing with poor posture for extended periods of time, you’re putting unnecessary stress on your body, which may damage your muscles or spine, eventually leading to a pinched nerve.

The Solution: watch your posture. Try using cushions, neck rests, or adjustable chairs to relieve pressure and give the nerve a chance to heal. If possible, try not to remain in the same position for too long and avoid crossing your legs.

Ice and heat packs

The Problem: Pinched nerves are a result of swelling and inflammation that compress the nerve. Imagine squeezing a straw and then trying to drink from it.

The Solution: try alternating between heat and ice packs to reduce swelling and inflammation. The combination of hot and cold increases the circulation of fresh blood to the area, which may help relieve pain. Hold an ice pack over the affected area for about 15 minutes at a time, three times a day to help reduce inflammation. Heat pads can be applied for a longer period, up to 1 hour, three times a day.

Lifestyle changes

The Problem: Being overweight or inactive can add increased stress to the body, leading to inflammation and pressure on the nerves.

The Solution: In the long-term, adding a low-impact exercise, such as walking, swimming, or bicycling, to a daily regimen may help reduce symptoms and keep the body in shape. Stretching before or after low-impact exercises can help keep the body flexible and reduce pressure and inflammation near the nerves. For some ideas for a low impact workout, you can check out our low impact routine by clicking the image below:

*As a reminder, always discuss any questions or concerns with your physician regarding your own health and dietary needs, as the information written should not replace any medical advice.

What is the difference between neuropathy and fibromyalgia?

Dr. Richard A. Lewis responds:

Dr. Richard A. Lewis

Peripheral neuropathy is a collection of disorders in which peripheral nerve fibers, which carry signals to and from the central nervous system (the brain and spinal cord), become damaged. Diabetes is the most common cause. Typically, nerve fibers in the hands and/or feet are affected. Symptoms include pins and needles, numbness, tingling, and weakness.

People with fibromyalgia may experience the same symptoms. However, these symptoms tend to come and go in fibromyalgia. In peripheral neuropathy, they are usually constant.

Fibromyalgia can cause other symptoms that people with peripheral neuropathy do not experience, including pain in soft tissue areas such as muscles and joints.

When a piece of the nerve (a biopsy) is taken from someone with peripheral neuropathy and tested, abnormalities in the nerve fibers can be seen. But in someone who has fibromyalgia—even if the person has numbness and tingling—no abnormalities are typically found.

Foot stepping on red tacks

The symptoms of peripheral neuropathy are usually constant, while those of fibromyalgia tend to come and go.

Fibromyalgia is believed to result primarily from pain-processing problems in the central nervous system. As far as we know, the peripheral nerves are not damaged in any way. People with fibromyalgia have many tender points on the body, often in the shoulders, neck, and low back. But when a piece of the nerve from these areas is tested, no abnormalities are typically found. People with fibromyalgia who have pain in their shoulders and backs often describe burning, tingling, and shooting pains in their arms and legs, which may sound like peripheral neuropathy. However, the results of nerve conduction tests—in which a series of electrical impulses are given to the nerve—are usually normal.

When someone comes to me with tingling, numbness, and burning, I need to determine whether these are symptoms of peripheral neuropathy or something else. If I don't find anything abnormal from a biopsy or a nerve conduction test and the person also has tender points, then fibromyalgia may be the cause.

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The treatments for fibromyalgia that have been approved by the U.S. Food and Drug Administration—including pregabalin (Lyrica), duloxetine (Cymbalta), and milnacipran (Savella)—can also be effective in treating the pain of peripheral neuropathy. The reason is that these medicines affect pain processing in the central nervous system, and while peripheral neuropathy is caused by damage to nerves outside of the brain and spinal cord, that pain still must be processed by the central nervous system.

What causes neuropathy to flare up?

Neuropathic pain is a pain condition that’s usually chronic. It’s usually caused by chronic, progressive nerve disease, and it can also occur as the result of injury or infection.

If you have chronic neuropathic pain, it can flare up at any time without an obvious pain-inducing event or factor. Acute neuropathic pain, while uncommon, can occur as well.

Typically, non-neuropathic pain (nociceptive pain) is due to an injury or illness. For example, if you drop a heavy book on your foot, your nervous system sends signals of pain immediately after the book hits.

With neuropathic pain, the pain isn’t typically triggered by an event or injury. Instead, the body just sends pain signals to your brain unprompted.

People with this pain condition may experience shooting, burning pain. The pain may be constant, or may occur intermittently. A feeling of numbness or a loss of sensation is common, too.

Neuropathic pain tends to get worse over time.

About 1 in 3 Americans experience chronic pain. Of those, 1 in 5 experience neuropathic pain.

A 2014 study estimated that as many as 10 percent of Americans experience some form of neuropathic pain.

Understanding the possible causes can help you find better treatments and ways to prevent the pain from getting worse over time.

What causes neuropathic pain?

The most common causes for neuropathic pain can be divided into four main categories: disease, injury, infection, and loss of limb.

Disease

Neuropathic pain can be a symptom or complication of several diseases and conditions. These include multiple sclerosis, multiple myeloma, and other types of cancer.

Not everyone with these conditions will experience neuropathic pain, but it can be an issue for some.

Diabetes is responsible for 30 percent of neuropathic cases, according to the Cleveland Clinic. Chronic diabetes can impact how your nerves work.

People with diabetes commonly experience loss of feeling and numbness, following by pain, burning, and stinging, in their limbs and digits.

Long-term excessive alcohol intake can cause many complications, including chronic neuropathic pain. Damage to nerves from chronic alcohol use can have long-lasting and painful effects.

Trigeminal neuralgia is a painful condition with severe neuropathic pain of one side of the face. It’s one of the more common types of neuropathic pain and it can occur without a known reason.

Lastly, cancer treatment may cause neuropathic pain. Chemotherapy and radiation can both impact the nervous system and cause unusual pain signals.

Injuries

Injuries to tissue, muscles, or joints are an uncommon cause of neuropathic pain. Likewise, back, leg, and hip problems or injuries can cause lasting damage to nerves.

While the injury may heal, the damage to the nervous system may not. As a result, you may experience persistent pain for many years after the accident.

Accidents or injuries that affect the spine can cause neuropathic pain, too. Herniated discs and spinal cord compression can damage the nerve fibers around your spine.

Infection

Infections rarely cause neuropathic pain.

Shingles, which is caused by reactivation of the chicken pox virus, can trigger several weeks of neuropathic pain along a nerve. Postherpetic neuralgia is a rare complication of shingles, involving persistent neuropathic pain.

A syphilis infection can also lead to the burning, stinging unexplained pain. People with HIV may experience this unexplained pain.

Limb loss

An uncommon form of neuropathic pain called phantom limb syndrome can occur when an arm or leg has been amputated. Despite the loss of that limb, your brain still thinks it’s receiving pain signals from the removed body part.

What’s actually happening, however, is that the nerves near the amputation are misfiring and sending faulty signals to your brain.

In addition to arms or legs, phantom pain may be felt in the fingers, toes, penis, ears, and other body parts.

Other causes

Other causes of neuropathic pain include:

vitamin B deficiency

carpal tunnel syndrome

thyroid problems

facial nerve problems

arthritis in the spine

What are the symptoms?

Each person’s symptoms of neuropathic pain may vary slightly, but these symptoms are common:

shooting, burning, or stabbing pain

tingling and numbness, or a “pins and needles” feeling

spontaneous pain, or pain that occurs without a trigger

evoked pain, or pain that’s caused by events that are typically not painful — such as rubbing against something, being in cold temperatures, or brushing your hair

a chronic sensation of feeling unpleasant or abnormal

difficulty sleeping or resting

emotional problems as a result of chronic pain, loss of sleep, and difficulty expressing how you’re feeling

How’s it treated?

A goal of neuropathic pain treatment is to identify the underlying disease or condition that’s responsible for the pain, and treat it, if possible.

An important goal is that your doctor will aim to provide pain relief, help you maintain typical capabilities despite the pain, and improve your quality of life.

The most common treatments for neuropathic pain include:

Over-the-counter pain medication

Nonsteroidal anti-inflammatory drugs (NSAIDs), such as Aleve and Motrin, are sometimes used to treat neuropathic pain.

However, many people find these medicines aren’t effective for neuropathic pain because they don’t target the source of the pain.

Prescription medication

Opioid pain medications don’t usually reduce neuropathic pain as well as they reduce other types of pain. Plus, doctors may hesitate to prescribe them for fear that a person may become dependent.

Topical pain relievers can be used, too. These include lidocaine patches, capsaicin patches, and prescription-strength ointments and creams.

Antidepressant drugs

Antidepressant medications have shown great promise in treating symptoms of neuropathic pain.

Two common types of antidepressant drugs are prescribed to people with this condition:

tricyclic antidepressants

serotonin-norepinephrine reuptake inhibitors

These may treat both the pain and symptoms of depression or anxiety caused by chronic pain.

Anticonvulsants

Anti-seizure medications and anticonvulsants are often used to treat neuropathic pain. Gabapentinoids are most commonly prescribed for neuropathic pain.

It’s not clear why anti-seizure drugs work for this condition, but researchers believe the medications interfere with pain signals and stop faulty transmissions.

Nerve blocks

Your doctor may inject steroids, local anesthetics, or other pain medications into the nerves that are thought to be responsible for the wayward pain signals. These blocks are temporary, so they must be repeated in order to keep working.

Implantable device

This invasive procedure requires a surgeon to implant a device in your body. Some devices are used in the brain and some are used in the spine.

Once a device is in place, it can send electrical impulses into the brain, spinal cord, or nerves. The impulses may stop the irregular nerve signals and control symptoms.

These devices are typically used only in individuals who haven’t responded well to other treatment options.

Lifestyle treatments

Physical, relaxation, and massage therapies are all used to relieve symptoms of neuropathic pain. These forms of treatment can help ease muscles.

Your healthcare provider can also teach you ways to cope with your pain.

For example, some people with neuropathic pain may experience increased symptoms after sitting for several hours. This might make desk jobs difficult to perform.

A physical therapist or occupational therapist can teach you techniques for sitting, stretching, standing, and moving to prevent pain.

WERBUNG

How can this pain be managed?

If your doctor is able to identify an underlying cause for the neuropathic pain, treating it may reduce and even eliminate the pain.

For example, diabetes is a common cause of neuropathic pain. Proper diabetes care — which includes a healthy diet and regular exercise — may eliminate or reduce neuropathic pain.

Taking care of blood sugar levels can also prevent worsening pain and numbness.

Multimodal therapy

A multipronged approach can be an effective way to manage the condition.

A combination of medications, physical therapy, psychological treatment, and even surgery or implants may be used to bring about the best results.

Outlook

Neuropathic pain can negatively impact your life if you don’t take steps to treat it and prevent worsening symptoms.

Over time, this can lead to serious disability and complications, including depression, problems sleeping, anxiety, and more.

Fortunately, researchers are learning more about why this condition develops and what can be done to effectively treat it. That’s leading to better treatment options.

Finding the correct treatment options for you can take time, but you and your doctor can work together to find relief from the symptoms of this painful condition.

Does Epsom salt help with neuropathy?

Foot Soak and Care Options for Peripheral Neuropathy

Peripheral neuropathy refers to nerve damage that can cause weakness, pain, and numbness most commonly in your hands and feet. Peripheral nerves communicate information from the brain to your arms and legs, so when they are damaged it can affect functioning in your arms, hands, legs, and feet. Some may experience symptoms from peripheral nerve damage because the nerve isn’t able to send normal, healthy communication through to your arms or legs, which can lead to numbing or weakness. Others experience symptoms when the nerve sends out the wrong signals to your arms or legs, leading to pain and discomfort. Peripheral neuropathy treatment is all about minimizing the symptoms and associated conditions of this disorder.

Peripheral Neuropathy in Your Feet

There are a few different causes of peripheral neuropathy. The most common cause of peripheral neuropathy is diabetes, which can lead to pain, numb or tingling feet. Other reasons for developing peripheral neuropathy include injuries where your nerves are damaged, certain cancers, smoking, alcoholism, and blood disorders. While there is no cure for peripheral neuropathy, there are ways to safely manage your symptoms and reduce their effects on your daily life.

Caring for Feet with Peripheral Neuropathy

When it comes to peripheral neuropathy treatment, many types of care involve reducing pain and uncomfortable symptoms in addition to addressing the root cause. Here are a few ways to help ease symptoms of peripheral neuropathy in your feet:

Foot Soak

Soaking your feet in warm water is a great way to relieve pain and stress while also encouraging healthy blood flow. If your feet are swollen, a foot soak on cool water can actually help bring down inflammation. You can enhance a warm foot soak by using Epsom salts, herbs, and essential oils, which can also encourage the muscles in your feet to relax. You can soak your feet at home in the bathtub or invest in an at-home foot spa so you can treat your feet to regular soaks. Some foot spas even come with massagers that can also encourage blood flow and relieve foot pain.

Gentle Exercise

Gentle exercises and stretches will get your heart pumping and allow for more oxygen to reach your affected muscles and tissues. While some exercises like running can be hard on the body, and especially your feet, there are more gentle options that can still get your heart rate up and help ease the pain in your feet. Some examples of gentle exercise options for peripheral neuropathy treatment include walking, yoga, and swimming. Scheduling a nice walk 3-4 times a week can keep your muscles and nerves fresh with oxygen and blood flow.  As a diabetic neuropathy treatment, walking has an added benefit of helping to maintain your blood sugar levels.

Healthy Diet

For people who do not have peripheral neuropathy caused by diabetes, there are ways to update your diet to incorporate healthier, vitamin-rich foods. Sometimes neuropathy can be caused by vitamin deficiencies and certain foods can help you meet your recommended vitamin doses for the day. Additionally, doctors generally recommend avoiding some food and alcoholic drinks when you suffer from peripheral neuropathy because alcohol can negatively affect your nerves and even restrict blood flow. Your doctor may also recommend supplemental vitamins or other natural oils to help improve your nerve function.

Foot Protection

It is important to keep an eye on your feet and make sure you aren’t getting any cuts or scrapes that can lead to infections. When numbness is a main symptom of peripheral neuropathy, you may not notice right away that you have injured your foot. Avoid walking barefoot, especially outside or anywhere you might accidentally harm your feet. There are also types of shoes that doctors and others who have peripheral neuropathy can recommend. Generally, slip-on shoes that are not too tight can help support your feet and also provide proper protection.

Pain Management

While pain medications are the most obvious way to manage your pain, there are other options as well. Your doctor may prescribe medications to help with peripheral neuropathic treatment that can treat pain, some of which are specifically for those who have a root cause of diabetes. Talk with your doctor if you have concerns about taking medications like opioids that come with side effects like drug dependence and increased tolerance. Alternatives to pain management can include acupuncture, massage, and warm compresses.

The best way to help reduce your pain and discomfort from peripheral neuropathy is to address the root cause. Meet with your doctor at least once a year to discuss your symptoms and treatment options for what is causing your peripheral neuropathy. Call now to schedule an appointment at Fox Integrated Healthcare. We offer healthy, non-invasive treatments like chiropractic adjustments, massage therapy, and physical therapy for peripheral neuropathy so you can experience reduced symptoms and feel like you are back to your old self again.

How long does nerve pain last?

When Will My Pinched Nerve Stop Hurting?

A pinched nerve is a common condition that may arise when excessive pressure is placed on a nerve by its bones, muscles, or other surrounding tissues. The pressure interferes with the way the nerve functions and leads to a variety of uncomfortable symptoms such as numbness, weakness, and tingling. Symptoms may affect your back, hips, legs, ankles, or feet.

There are a variety of reasons you may experience a pinched nerve. An injury, rheumatoid arthritis, thyroid disease, diabetes, spinal stenosis, repetitive work or hobbies, pregnancy, or obesity may all increase your risk for this condition.

To diagnose a pinched nerve, a doctor will test your reflexes as well as your ability to move your muscles. They may also order an imaging test such as an MRI, CT-scan, or x-ray to look at the structures in your back or neck or an electromyography (EMG) to check the function of your nerves.

Pinched Nerve Pain is Usually Short-Lived

So how long does a pinched nerve cause pain and discomfort? In most cases, symptoms improve and nerve function resumes to normal within 6 to 12 weeks of conservative treatment. Conservative treatment options include physical therapy, and non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen. Lifestyle modifications such as rest, ice and hot therapy, frequent exercise, and sleeping position changes may help as well.

There are a number of factors that will play a role in how long your pinched nerve lasts. The cause of the inflammation, degree of compression, and your immune system response can help determine when your symptoms will subside.

In the event your pinched nerve persists for more than a few months, surgery may be recommended to prevent permanent damage and chronic pain. It may involve getting rid of a portion of a herniated disc or bone spurs. This will alleviate nerve pressure and ensure greater comfort.

Since a surgical procedure may come with risks and a lengthy recovery period, you should always try conservative treatments at first.

How to Prevent a Pinched Nerve

While a pinched nerve isn't always avoidable, there are some things you can do to reduce your risk of developing one. Focus on good posture and don't stay in one position for a long period of time. Also, adhere to a nutritious, well-balanced diet and engage in a regular exercise program that focuses on strength, flexibility, and health weight maintenance. In addition, limit repetitive activities like cutting, sitting, standing, typing, and golfing.

All information provided on this website is for information purposes only. Please see a healthcare professional for medical advice. If you are seeking this information in an emergency situation, please call 911 and seek emergency help.

How do I know I have nerve pain?

Where does it hurt?

Your arms, hands, legs or feet? Is your entire body suffering from a stabbing, throbbing or numbness that even the simple act of walking becomes like an everyday chore?

If so, this pain you are feeling is known as neuropathy pain, which is nerve pain as the result of a lack of blood flow to the heart. This can cause certain parts of the body to feel discomfort and pressure making every day activities such as standing, balancing or picking up a spoon near impossible.

But don’t worry, you’re not alone.

Nerve pain is common in most diabetic and chemotherapy patients, as well as individuals suffering from a broken ankle or foot. Let’s take a moment to look at some of the more common signs to neuropathy pain.  Ask yourself do I have one or all of these pain symptoms?

Numbness or tingling in feet and hands

Loss of balance and falling

Throbbing and sharp pain

Extreme sensitivity to touch

Dropping things with your hands

Muscle weakness

Heavy feeling in arms and legs

Dramatic drop in blood pressure

Difficulty digesting

Excessive sweating

If you answered yes to one or all of these, you may be experiencing nerve pain. Recognizing this is the first step to getting the help you need.

So, how can you treat nerve pain?

For starters, a healthy diet and active lifestyle can contribute greatly to easing every day pain. Secondly, rest easy knowing there is a team ready and able to assist you at our new neurovascular clinic opening May 2017. It is here where our Intraneural Facilitation or INF™ treatment will be able to improve blood flow and reduce discomfort with three unique hold positions.

Is Apple Cider Vinegar Good for Arthritis? Does it Help with Arthritis Pain Relief?

Trust me when I say this will be a game changer in pain relief.

Imagine getting up each morning, standing on your own and walking outside without any pain. That’s what I like to call a success.

Are you ready to experience a pain-free life?

Does turmeric help nerve pain?

For thousands of years, turmeric maintained prominence in Ayurvedic medicine, one of the oldest practices in the world. The concept of using natural herbs and spices for their healing properties is not a new one. With so many options available, which medicinal herbs are the best?

Curcuma longa is a species of ginger originating in Southeast Asia, which contains the powerful turmeric rhizome within its roots. Turmeric powder contains curcumin, the antioxidant and anti-inflammatory agent responsible for most of its health benefits.

But, is turmeric good for back pain and nerve repair? Can it help relieve nerve pain from sciatica and herniated discs?

Turmeric for Back Pain

Research continues to emerge, demonstrating significant benefits in using turmeric for conditions characterized by inflammation like asthma and allergies, IBS, and IBD. Curcumin can even help relieve fibromyalgia and muscle pain and arthritis and joint pain.

Recent studies suggest that turmeric can also help with upper and lower back pain. Curcumin has the potential to reduce inflammation and discomfort associated with sciatic nerve pain, spinal cord injuries, and herniated discs. Thus, it may be an effective natural treatment option for back pain. (1)

What is Sciatica?

Sciatica refers to the radiating pain originating down the sciatic nerve, which travels from your lower back (lumbar) through the hips and buttocks, and finally down each leg. During painful flare-ups, sciatica often only impacts one side of the body.

Sciatica usually transpires when a bone spur, a herniated disc, or the narrowing of the spine (spinal stenosis) compresses some part of the nerve. When the nerve is compressed, or pinched, this causes a tremendous amount of pain, numbness, and inflammation in the affected leg.

Several risk factors may raise your chances of developing sciatic nerve pain. They are:

Age: Changes in the spine related to age, such as bone spurs or herniated discs, are a common cause of sciatica.

Obesity: Excess weight increases spinal stress and can trigger changes in the integrity of the spine. A weight loss regimen can help prevent this particular risk factor.

Occupation: Work that requires heavy lifting, twisting, turning, or extended periods of motor vehicle operation may increase the odds of developing sciatica.

Prolonged Sitting: People with sedentary lifestyles characterized by lengthy periods of sitting are more likely to develop sciatica compared to active individuals.

Diabetes: This condition affects the body’s ability to utilize sugar, which may increase your risk of nerve damage. Lowering blood sugar can help preserve nerve function.

Most individuals make a full recovery from sciatica, but it’s essential to seek medical attention if the condition worsens over time. Exercise regularly, maintain good posture, and use anti-inflammatories to help reduce back pain and discomfort. (2)

What is a Herniated Disc?

The term “herniated disc” describes extreme difficulty with one of the rubbery cushions, or discs, between the vertebrae that comprise the spine. A spinal disc contains a jelly-like center (nucleus) surrounded by a tough and rubbery exterior called an annulus.

Often called a ruptured disc or a slipped disc, these names refer to the same condition where the nucleus protrudes through a torn annulus and irritates a nearby nerve. A herniated disc may lead to uncomfortable symptoms such as arm or leg pain, numbness or tingling, and weakness.

Like sciatica, risk factors include excess body weight, sedentary jobs, and genetic predisposition. Smoking may also play a role as it lessens oxygen flow to discs, leading them to break down prematurely. (3)

Why Turmeric Curcumin?

Research has shown that using turmeric for inflammation may target flare-ups and painful bouts with upper and lower back pain. By reducing the body’s natural inflammatory response, it’s thought that curcumin may help relieve nerve pain.

Turmeric is also a powerful antioxidant capable of improving our immune system response. It’s important to note that curcumin will not repair herniated discs, sciatica, or physical problems with the spine. But, it may reduce inflammation, improve oxygen and nutrient flow, and promote the healing process.

In this post, we’ll cover the studies demonstrating the effect turmeric has on reducing back pain, sciatic nerve pain, and discomfort associated with herniated discs and spinal injuries.

Is Turmeric Good for Back Pain?

Despite considerable efforts, the current treatment methodology for spinal cord injury (SCI) is largely supportive. Spinal cord injury is a type of neurotrauma that brings delayed scarring along with acute and chronic inflammation and back pain, making regeneration and therapy extremely difficult.

One study compared curcumin’s anti-inflammatory properties against leading treatment options for SCI. The results showed that curcumin could increase the likelihood of functional improvements and back pain reduction using multiple mechanisms of action.

Turmeric performs this task by stimulating the proliferation of the spinal cord’s neural stem cells, and by reducing free radical-mediated damage to the spinal cord. Curcumin also directly targets the inflammation associated with SCI, which helps expedite the healing process. (4, 5)

Another study examined curcumin’s effects on the sciatic nerve pain threshold in a group of 120 male rats. Following 14 days of curcumin administration, the study showed substantial decreases in the presence of NF-κB, a significant mediator of inflammation.

This result suggests that turmeric may help improve neuropathic pain by inhibiting proinflammatory cytokines. In other words, it may reduce the lower back pain frequently associated with sciatica. (6)

Curcumin appears to be an excellent natural remedy to manage pain by reducing inflammation and enhancing antioxidant capacity with minimal side effects. This benefit makes it useful for day-to-day aches and pains, but also for post-surgical recovery.

Further research shows an additional, lesser-known mechanism of action that often contributes to lower levels of back pain. Turmeric may mitigate pain linked to depression by reversing negative changes in serotonin levels. (7)

There aren’t a significant amount of studies using turmeric exclusively for upper and lower back pain. However, it’s important to note how curcumin behaves within the body when deciding whether or not it may help treat your specific ailment.

Most back pain derives from the inflammatory response and free radical damage within the body. Research has shown that turmeric is one of the most powerful natural anti-inflammatory agents in existence. Its constituent, curcumin, is also a potent antioxidant with numerous molecular targets that may help with back pain relief. (8, 9)

Turmeric for Nerve Repair

Does turmeric help nerve damage? Besides being able to help nerve inflammation, it appears turmeric may also contribute to nerve repair. One study administered curcumin on a group of rats that sustained nerve crush injuries. The results found that curcumin successfully promoted functional recovery and nerve regeneration in the injured group. (10)

Although this was an animal study, the results were promising. More human studies should be completed in this area to see if the effects are replicable.

How to Use Turmeric for Back Pain

Consuming more turmeric in food or drinking a turmeric smoothie won’t provide the pain relief you’re looking for. Here’s why: curcumin, the primary source of turmeric’s anti-inflammatory properties, is only about 3.14% of turmeric powder. In other words, you’d need to add a ton of turmeric to your food to feel any benefit, which is hardly feasible.

You’ll need an encapsulated turmeric supplement with a higher ratio of curcumin to treat your back pain effectively. Make sure to get turmeric and black pepper together when purchasing your supplement. The addition of BioPerine (the patented form of black pepper extract) significantly increases the absorption of curcumin by 20 times.

Your supplement should also contain between 20-25 mg of AstraGin, a natural patented ingredient that supports a healthy gut environment while boosting turmeric uptake by another 92%. More absorption means greater pain relief.

Dosage Recommendations

How much turmeric should I take for back pain? The correct turmeric dosage for back pain depends on the severity of your condition. High-quality curcumin supplements are considered safe and well-tolerated, even at higher doses. We recommend you consume between 150-250 mg of curcumin per day for the best results.

If you find the back or nerve pain unbearable, we suggest you take a second dose 8 hours apart from the first. This way you can keep inflammation down throughout the day.

How long does it take for turmeric to work for pain?

Much like you’d see with other inflammatory conditions like arthritis, patience is going to be key here. While some people do see immediate results, it’s more common to feel a reduction in pain with 4-8 weeks of continuous use. Be consistent with your dosing regimen and give turmeric time to reduce systemic inflammation.

Potential Side Effects

What are the negative effects of turmeric? Turmeric side effects are quite rare, usually mild, and often only occur when ignoring the proper dosage protocol. Still, here are a few potential adverse reactions to remember when taking turmeric.

Turmeric possesses a glucose-lowering effect. Diabetics should use extra caution.

Curcumin is a natural anticoagulant and may cause issues if you’re taking blood thinners.

Excessive dosages can increase the odds of developing a headache, stomach discomfort, or nausea.

Who should not take turmeric? If you are pregnant or nursing, do not consume curcumin in a medicinal amount. If it is before a scheduled surgery, do not take turmeric as it may lead to blood clotting issues.

Final Thoughts on Turmeric for Nerve Pain

Is turmeric good for nerve pain, sciatica, and herniated discs? The answer appears to be yes. Studies show that curcumin is an excellent all-natural anti-inflammatory that may help modulate and manage pain and help nerve inflammation.

If you’re having difficulties with back pain, contact a doctor or certified medical professional to discuss the possibility of incorporating turmeric and curcumin into your daily regimen.

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Does sugar make nerve pain worse?

8 Foods That You Should Avoid if You Have Peripheral Neuropathy

Much like many other health conditions, peripheral neuropathy can be controlled using proper diet and nutrition as a tool. One of the best ways to manage peripheral neuropathy symptoms is to manage any medical conditions that put you at risk. This can include controlling your blood sugar if you have diabetes or controlling alcohol intake if that is linked to a health problem. Effective neuropathy treatment is often paired with dietary guidelines that can protect your health. In addition to this monitoring, general nutrition advice is often good for the body and helps to prevent illness from becoming a problem. Read on for a list of foods that may be problematic if you already suffer from peripheral neuropathy.

Gluten

It is becoming more common now to acknowledge gluten allergies, gluten sensitives, and celiac disease as problematic, and this is especially true for those with peripheral neuropathy. Common sources of gluten include any food with white, wheat, cake, or baking flour as an ingredient. Gluten is also found in some unexpected foods like traditional soy sauce, so it is important to read product labels and look for items marked gluten-free. Consuming gluten when your body cannot properly digest it can lead to inflammation, which worsens the nerve inflammation seen in peripheral neuropathy patients.

Alcohol

As a neurotoxin, alcohol has the potential to damage your nerves. Even a healthy person who drinks too much can begin experiencing symptoms such as numbness, pain, and tingling in their hands or feet, known as alcoholic neuropathy. When this occurs, a person’s peripheral nerves have become damaged by the exposure to alcohol, leaving them unable to transmit signals between the body, spinal cord, and brain properly. This can compound already existing nerve problems.

Added Sugars

While it is generally accepted that added sugar has negative health effects, this can especially be true where peripheral neuropathy is concerned. Eating food with a lot of added sugar will increase your blood sugar levels, which can lead to damage in the nerves and the blood vessels that feed nerves. There are safe alternatives like stevia and other artificial sugar, or you can satisfy your sweet tooth with the natural sugars in fruit!

Refined Grains

Processed grains have a high glycemic index, meaning they can also increase blood sugar. Controlling your blood sugar is actually the best thing you can do to prevent peripheral neuropathy associated with diabetes, so this can be important. Improving the glycemic impact of your diet is an important measure to take. You can achieve this by replacing refined grains with whole grains whenever possible.

Trans and Saturated Fats

Known as “unhealthy fats,” these can be found in most fatty meats and high-fat dairy products. When consumed in excess, these fats lead to inflammation and increase the risk for type 2 diabetes, both of which exacerbate peripheral neuropathy. Instead, you can replace fatty protein sources with more lean options or grass-fed proteins. Eating a moderate amount of heart-healthy, polyunsaturated omega-3 fatty acid, monounsaturated fats like avocados, and some medium-chain saturated fats like coconut oil can all be good alternatives.

Salty Snacks

Foods with a high sodium level can be particularly problematic as the amount of salt can restrict blood flow, contributing to numbness as a symptom of peripheral neuropathy. Potato chips, cold cuts, and fast food are all particularly high in sodium and should be avoided whenever possible. Anything processed or canned is also likely to contain a lot of sodium and can be considered risky.

Heavy Metals

Certain foods increase the risk for elevated levels of unsafe metal in the body, most commonly mercury. Mercury is found in many popular fish that are regularly eaten, due to the presence of mercury in the oceans. Eating a large amount of this fish will lead to an accumulation of the heavy metal in your body, so being cautious about the type and quantity of fish you eat is crucial. Focusing on healthy fish oils and fish with shorter lifespans can be beneficial to health, so it is important to balance your seafood consumption.

Produce with Pesticides

When buying fruits and vegetables, look for items marked as organic or otherwise indicating they have not been treated with pesticides. These are often made of dangerous chemicals, designed to keep the produce looking better for a longer period of time and increasing their shelf life. While this is helpful for a grocery store, you want to avoid eating produce that has absorbed these chemicals, as they can increase the toxic load on your body and worsen inflammation.

Is Magnesium good for nerve pain?

Clinical experience, as well as research in nerve pain conditions such as pancreatic cancer, has shown that magnesium can be an effective treatment for pain. Although it is clear why magnesium can decrease muscle pain (it makes muscles relax), why it would help nerve pain was less clear. A new study on rats to be printed in The Journal of Physiology confirms our clinical experience that magnesium decreases nerve pain — while also pointing to how it works.

A major mechanism of pain is the excessive stimulation of a brain chemical called "NMDA." The few medications that help decrease and balance this pain-carrying neurotransmitter have the downside of causing significant side effects. Magnesium seems to settle down NMDA without the toxicity. The upside of magnesium is that is very inexpensive (pennies a dose). The downside is that it hasn’t yet made it through the FDA approval process.

The good news is that you don't have to wait for the FDA. Magnesium is one of the over 50 nutrients in the Energy Revitalization System vitamin powder. For those who get diarrhea from magnesium, Jigsaw Magnesium w/SRT from Jigsaw Health provides sustained-release magnesium and is very effective without causing the diarrhea side effect. In addition, magnesium oxide, though not as well absorbed, can be found for about a nickel per 500 mg tablet in most health food stores.

For an especially powerful effect, the magnesium can be used intravenously, and is an important tool used by most holistic physicians. Magnesium delivered via IV is the single most effective treatment to eliminate an acute migraine headache and has even been shown to ease the incredibly severe nerve pain that can sometimes be seen in pancreatic cancer. It is also very helpful for settling down fibromyalgia pain, which has a muscle and nerve component.

The authors of the study suggest that magnesium deficiency can be a major amplifier of pain. Because of food processing, most people are magnesium deficient. If you have pain, a dose of 250 to 500 mg of magnesium a day can start to decrease these deficiencies as well as the pain, after just several weeks — while also leaving you feeling more energetic and decreasing your risk of heart disease! (If you have kidney problems, do not use without your physician's OK.)

Is nerve pain a disability?

Nerves can be damaged after being injured in an accident and due to certain medical conditions. Signs of nerve damage could include tingling in the hands and feet and muscle weakness in the arms or legs.

Depending on the extent of damage to the nerve, it can heal on its own or become permanent, even with treatment. If you suffer from a condition that causes nerve damage that is so severe that it impacts your ability to work for at least a year, you may be eligible to receive Social Security Disability benefits.

Dayes Law Firm is here to help you with your disability claim. We know what it takes to gather the medical documentation needed to increase your chances of approval. If your claim has been denied, we are also prepared to guide you through the appeals process. An initial consultation with a member of our legal team is free and confidential. We also charge no upfront fees if you decide to move forward.

Main Nerves of the Upper Limbs

When people suffer from nerve damage, it is often accompanied by extreme pain and an inability to perform basic everyday tasks. The arms are made up of a network of nerves that extend from the shoulder down to the fingers. These nerves control movement and sensations. An injury to any nerve can impact the ability to bend the elbow, raise your arm or use your hands and fingers to pick up items. 

The main nerves that supply the upper limbs of the body include:

Axillary nerve – Provides movement and sensation in the shoulder and helps raise the arm

Median nerve – Main nerve in the forearm responsible for sensation and feeling in the hands

Musculocutaneous nerve – Provides sensation in the forearm and helps bend the elbow

Radial nerve – Provides sensation to the back of the hand and thumb, and bending and flexibility of the elbow, fingers and wrist

Ulnar nerve – One of the arm’s major nerves responsible for movement and sensation in the hands and fingers, and flexibility of the wrist

Nerve Injuries in the Hands and Wrists

Injury to a nerve can happen due to an accident or trauma or as the result of strain or repetitive motion over time. Since the nerves are responsible for carrying signals to and from the brain, a damaged nerve can impair movement and sensation throughout the body, including in the hands and wrists.

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Two conditions that cause injury to the nerves in these areas include:

Carpal Tunnel Syndrome

Carpal tunnel syndrome is a condition that causes numbness, tingling or weakness in the hand. It happens when the median nerve becomes pressed or squeezed at the wrist. Repetitive movements, such as typing on a keyboard, can aggravate the median nerve in the wrist and cause it to become inflamed.

Other symptoms may include pain in the hand and wrist, a burning sensation in the middle and index fingers and numbness in the thumb and finger. Although this condition is not actually in the Social Security Administration’s (SSA) list of impairments, you may quality under listing 11.4 for peripheral neuropathy.

Cubital Tunnel Syndrome

Cubital tunnel syndrome is a condition involving pressure on the ulnar nerve, which controls muscle movements in the hands. It can cause numbness and loss of coordination in the fingers and hand weakness. Since this condition can sometimes be corrected and treated, getting approved for disability benefits will be difficult without other underlying conditions.

What is Peripheral Neuropathy?

Peripheral neuropathy is the result of damage to the nerves outside of the brain and spinal cord. The peripheral nerves help control movement and feeling throughout the body and also send sensory information to the central nervous system. When these nerves are damaged, it can cause weakness, numbness and pain, most often in the hands and feet.

Peripheral neuropathy can be caused by a number of different conditions. Diabetes is the most common, but it can also happen due to traumatic injuries, infections or exposure to toxins. In many cases, symptoms may improve if it is caused by a treatable condition.

To Receive Disability for Nerve Damage

If nerve damage has impacted your ability to work or carry out daily tasks, you may quality for disability. A Phoenix-based Social Security Disability lawyer from our firm is prepared to help you fulfill the criteria of a listing in the SSA’s blue book or gather enough evidence to show the severity of your nerve damage.

Medical Tests Must Reflect Diagnosis

All of your motor function or nerve tests must adequately reflect your current diagnosis to help show the SSA that you are in need of disability benefits. A nerve conduction velocity (NCV) test can help assess nerve damage while an electromyography (EMG) test can help check the health of your nerves.

An RFC Assessment from Treating Doctor

It is also important for the SSA to understand your ability to perform normal daily functions. A residual functional capacity (RFC) assessment completed by your treating doctor will be able to show how well you can complete common tasks, such as lifting, reaching, pulling and grasping items. The lower your scores on a RFC assessment, the more likely you may obtain disability payments for your nerve damage.

How can you tell the difference between muscle pain and nerve pain?

If you are in pain, the one thing that you want most is relief. Not surprisingly, it is usually beneficial to understand the root cause of your pain. Knowing whether you are experiencing either muscle pain or nerve pain can be the first step in finding relief.

Causes of Muscle vs. Nerve Pain

Causes of Muscle vs. Nerve Pain

According to the Cleveland Clinic, musculoskeletal pain is primarily caused by injuries, like car accidents, falls or direct blows to the muscle. It can also be caused by overuse of the muscles and improper alignment or posture.

Nerve pain, or neuralgia, can be caused by chronic diseases like diabetes, chronic kidney disease or infections like herpes zoster (shingles) or Lyme disease. Trauma can also cause neuralgia, as well as pressure from other parts of the body. These can all result in pain in the nerves.

Different Types of Pain

We all experience pain differently, but in general, people describe muscle pain as an aching or stiffness. The pain is typically localized in the muscle itself, and it usually hurts when you use the muscle. You feel fatigued and may have trouble sleeping.

Nerve pain is described as crushing, burning, tingling or numbness. It is sharp and you may feel pain on the skin above the nerves as well.

Alleviating Your Muscle Pain

Alleviating Your Muscle Pain

Always consult your personal physician if you are concerned about any pain that you may be having. They can best help you identify and properly treat your symptoms. However, the Cleveland Clinic offers some strategies that you may want to take to relieve your musculoskeletal pain. These include:

Applying heat or cold packs

Resting the muscle

Getting a therapeutic massage

Physical therapy

Acupuncture

Stretching exercises

Anti-inflammatory medications

Visiting a chiropractor

When managing back pain or other types of muscle pain, it's important to prevent more serious injury by changing the factors that caused your pain to begin with. Maintain proper posture by using a sit-to-stand desk, use proper lift techniques and safety gear, and continue to strengthen your muscles to provide additional support. Be sure to follow your treatment plan carefully and communicate with your physician if you need more help.

Relieving Nerve Pain

Relieving Nerve Pain

After consulting with your doctor, they may prescribe any of the following medical treatments according to the National Institutes of Health:

Oral medications

Skin patches

Injections

Physical therapy

Surgery to reduce the pressure on the nerve that is causing the pain

Ablation therapy to destroy the nerve causing the pain

A spinal cord stimulator type device

Acupuncture or biofeedback

Your treatment will depend on your condition, how much the pain affects your life and your other health factors. Of course, maintaining your best state of health can help you in managing your back pain or other nerve pain successfully.

Whether you have muscle pain or nerve pain, you don't need to suffer needlessly. Speak with your physician about different ways to successfully control your pain so you can get back to living your best life.

Does an MRI show nerve damage?

Neck or low back pain that radiates into your arms or legs is often a sign of impingement or pinching of a nerve as it emerges from your spinal cord. An MRI may be able help identify structural lesions that may be pressing against the nerve so the problem can be corrected before permanent nerve damage occurs.

Nerve damage can usually be diagnosed based on a neurological examination and can be correlated by MRI scan findings. The MRI scan images are obtained with a magnetic field and radio waves. No harmful ionizing radiation is used.

The MRI can show you a picture of the spine from the side as if it was sliced from top to bottom (sagittal view). This view allows your doctor to see the vertebrae and discs present between them and identify any abnormality in these structures.

The MRI can also provide cross-sectional images of the spine (axial view). Your doctor will be able to see the spinal cord as a grey area in the middle surrounded by a white area which is the spinal fluid. There are little white channels on either side of the spinal cord where the nerve roots come out from the spinal cord.

The conditions that may be causing nerve damage that can be identified by MRI include spinal cord compression or fracture, arthritic changes, tumors pressing on a nerve, or herniated vertebral discs.

Nerve damage often progressively gets worse and cannot be completely cured, but symptoms can be reduced with prompt treatment. So it's important to be evaluated and diagnosed as soon as possible for suspected signs and symptoms of nerve injury.

For high-quality, advanced imaging studies at reduced costs visit Houston MRI® & Diagnostic Imaging or call 713-425-8190 to book your appointment.

Our mission at Houston MRI® & Diagnostic Imaging is to provide the patients and physicians with affordable medical diagnostic imaging in a warm and patient friendly environment. It is our goal to make the medical imaging procedure as pleasant as possible. Our promise to our communities is "hospital quality imaging without the hospital costs" with efficient service to both our patients and physicians.

Is gabapentin good for nerve pain?

Gabapentin and its use in pain

management

Why do I need gabapentin?

Gabapentin is a drug used to treat nerve pain. This type of pain is often not relieved

by normal painkillers. It can be used in combination with other painkillers to improve

your pain relief.

How does gabapentin work?

Gabapentin works by changing the way in which nerves send messages to your

brain. When something presses on a nerve, or a nerve doesn’t work properly in some

way, the nerve can send false messages to your brain. The brain thinks that a part of

your body is being hurt when it is not. This makes you actually feel pain. By altering

the way nerves work, gabapentin may reduce your pain.

Isn’t gabapentin for treating Epilepsy?

Yes, gabapentin is used for treating epilepsy by ‘calming down nerves’. Research

has shown that gabapentin by a ‘similar process’ is also effective in helping to relieve

certain types of pain.

How long will gabapentin take to work?

You should notice that your pain starts to improve over one to two weeks after

starting gabapentin, but it may take longer in some people. However, some feel

benefit straight away. Your treatment will be reviewed when you next see the doctor

or nurse.

How long will I have to take gabapentin for?

If the gabapentin is helpful, you can continue and your treatment will be reviewed

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regularly. It is also important that you continue to take your regular painkiller, unless

you have been advised to stop taking these by your doctor.

How should I take gabapentin?

You should take gabapentin in addition to your current tablets unless told otherwise.

Gabapentin is started at a low dose and increased gradually to minimise any side

effects.

You should take gabapentin as shown in the table. If your pain completely

disappears with a lower dose, you can stay on that dose rather than increasing to the

next dose.

Are there any side effects?

All drugs have side effects, but they do not happen in all the people who take them.

The most common side effects of gabapentin are dizziness, tiredness, drowsiness

and weakness. Other possible side effects are detailed in the drug information sheet

supplied with the tablets.

If you have troublesome side effects from gabapentin, speak to your doctors, nurse or

pharmacist straight away. Side effects from gabapentin usually reduce or disappear

after taking the same dose for a few days.

Do I need any tests whilst I’m taking gabapentin?

No, you will not need any special checks whilst you are taking gabapentin.

Can I drink alcohol whilst taking gabapentin?

If the gabapentin makes you feel tired or gives you other side effects, then drinking

alcohol may increase these side effects. Because of this, we advise that you should

avoid drinking alcohol if these side effects are troublesome.

Is it safe for me to drive or operate machinery whilst I’m taking

gabapentin?

Gabapentin may cause drowsiness. If you feel affected by this, we advise that you

should not drive or operate complex machinery until the effects have worn off.

Is it safe for me to take other medicines whilst I’m receiving treatment

with gabapentin?

Before you take or buy any new medicines – including herbal remedies – tell your

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doctor or pharmacist that you are taking gabapentin and ask their advice. If you are

taking any antacids, avoid taking them TWO HOURS BEFORE and UP TO TWO

HOURS AFTER your gabapentin dose.

What should I do if I forget to take a dose?

You should take a missed dose as soon as you remember. However, if it is almost

time for your next dose, skip the missed dose and take your medication as normal.

DO NOT ‘double up’ to make up for your missed dose.

Stopping gabapentin

Do not stop taking gabapentin unless your doctor tells you to. If gabapentin is

discontinued then this is normally done gradually over a number of weeks. If it is

stopped suddenly you may experience adverse effects, ie nausea, pain and sweating,

anxiety and insomnia.

Remember:

This medicine has been prescribed for you. It should not be taken by anyone else.

Additional information

The information in this leaflet is not intended to replace your doctor’s advice. If you

require more information, or have any questions, please speak to your doctor, or

contact the Clinical Nurse Specialists on 01284 712528.

Keep all medicines out of the reach of children

How do you calm down neuropathy?

What predicts depression and anxiety among people with PN? Not necessarily the severity of the PN symptoms! The predictors are the psychological variables (i.e.: How do you feel? Hopeless, optimistic, anxious, etc.); social variables (i.e.: Are you active? Do you have support?) All of these variables can be changed!

Dwelling on what might have been if you were not diagnosed, self-pitying, ruminating about better times, and think of yourself primarily as a “PN patient” does not provide the escape from stress of the illness. These coping strategies are ineffective and can make your neuropathy symptoms worse.

Below are effective Self-Care and Coping Skills:

Managing Peripheral Neuropathy

The following suggestions can help you manage peripheral neuropathy:

Take care of your feet, especially if you have diabetes. Check your feet daily for signs of blisters, cuts or calluses. Tight shoes and socks can worsen pain and tingling and may lead to sores that won’t heal. Wear soft, loose cotton socks and padded shoes. You can use a semicircular hoop, which is available in medical supply stores, to keep bed covers off hot or sensitive feet.

Quit smoking. Cigarette smoking can affect circulation, increasing the risk of foot problems and possibly amputation.

Eat healthy meals. If you’re at high risk of neuropathy or have a chronic medical condition, healthy eating is especially important. Emphasize low-fat meats and dairy products and include lots of fruits, vegetables and whole grains in your diet. Drink alcohol in moderation.

Massage. Massage your hands and feet, or have someone massage them for you. Massage helps improve circulation, stimulates nerves and may temporarily relieve pain.

Avoid prolonged pressure. Don’t keep your knees crossed or lean on your elbows for long periods of time. Doing so may cause new nerve damage.

Skills for Coping With Peripheral Neuropathy

Living with chronic pain or disability presents daily challenges. Some of these suggestions may make it easier for you to cope:

Set priorities. Decide which tasks you need to do on a given day, such as paying bills or shopping for groceries, and which can wait until another time. Stay active, but don’t overdo.

Acceptance & Acknowledgement. Accept and acknowledge the negative aspects of the illness, but then move forward to become more positive to find what works best for you.

Find the positive aspects of the disorder. Of course you are thinking there is nothing positive about PN. Perhaps your outlook can help increase empathy, encourage you to maintain a balanced schedule or maintaining a healthier lifestyle.

Get out of the house. When you have severe pain, it’s natural to want to be alone. But this only makes it easier to focus on your pain. Instead, visit a friend, go to a movie or take a walk.

Get moving. Develop an exercise program that works for you to maintain your optimum fitness. It gives you something you can control, and provides so many benefits to your physical and emotional well-being.

Seek and accept support. It isn’t a sign of weakness to ask for or accept help when you need it. In addition to support from family and friends, consider joining a chronic pain support group. Although support groups aren’t for everyone, they can be good places to hear about coping techniques or treatments that have worked for others. You’ll also meet people who understand what you’re going through. To find a support group in your community, check with your doctor, a nurse or the county health department.

Prepare for challenging situations. If something especially stressful is coming up in your life, such as a move or a new job, knowing what you have to do ahead of time can help you cope.

Talk to a counselor or therapist. Insomnia, depression and impotence are possible complications of peripheral neuropathy. If you experience any of these, you may find it helpful to talk to a counselor or therapist in addition to your primary care doctor. There are treatments that can help.

How to Sleep With Neuropathy

Sleep is an essential part of living—sleep helps us avoid major health problems and it is essential to our mental and physical performance. It affects our mood and stress and anxiety levels. Unfortunately, sleep disturbance or insomnia is often a side effect of neuropathy pain. It is a common complaint among people with living with chronic pain.

It’s no surprise that about 70 percent of pain patients, including those suffering from PN, back pain, headaches, arthritis and fibromyalgia, report they have trouble sleeping according to the Journal of Pain Medicine.

Pain can interfere with sleep due to a combination of issues. The list includes discomfort, reduced activity levels, anxiety, worry, depression and use of medications such as codeine that relieve pain but disturb sleep.

Most experts recommend a range of seven to nine hours of sleep per night for adults, regardless of age or gender. This may seem impossible to people with chronic pain, but there are steps you can take to improve your sleep, which may lead to less pain and lower levels of depression and anxiety. First, talk with your doctor to see if there are medications that may lessen your sleep disturbance. You should also check with your doctor to make sure your current medications aren’t causing some of your sleep disturbance.

Beyond medication, there are several things you can do yourself to improve your sleep. Here are some methods to try and help you fall asleep more quickly, help you sleep more deeply, help you stay asleep, and ultimately help keep you healthy.

Following are tips for improving your sleep:

Reduce your caffeine intake, especially in the afternoons

Quit smoking

Limit and/or omit alcohol consumption

Limit naps to less than one hour, preferably less

Don’t stay in bed too long—spending time in bed without sleeping leads to more shallow sleep

Adhere to a regular daily schedule including going to bed and getting up at the same time

Maintain a regular exercise program. Be sure to complete exercise several hours before bedtime

Make sure your bed is comfortable. You should have enough room to stretch and turn comfortably. Experiment with different levels of mattress firmness, foam or egg crate toppers, and pillows that provide more support

Keep your room cool. The temperature of your bedroom also affects sleep. Most people sleep best in a slightly cool room (around 65° F or 18° C) with adequate ventilation. A bedroom that is too hot or too cold can interfere with quality sleep.

Turn off your TV and Computer, many people use the television to fall asleep or relax at the end of the day. Not only does the light suppress melatonin production, but television can actually stimulate the mind, rather than relaxing it.

Don’t watch the clock – turn your alarm clock around so that it is not facing you

Keep a note pad and pencil by your bed to write down any thoughts that may wake you up at night so you can put them to rest

Refrain from taking a hot bath or shower right before bed; the body needs to cool a degree before getting into deep sleep

Try listening to relaxing soft music or audio books instead, or practicing relaxation exercises.

Visualizing a peaceful, restful place. Close your eyes and imagine a place or activity that is calming and peaceful for you. Concentrate on how relaxed this place or activity makes you feel.

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Some patients find comfort from a pillow between their legs that keeps their knees from touching. And there’s an added benefit: A pillow between your legs at night will prevent your upper leg from pulling your spine out of alignment and reduces stress on your hips and lower back.

It may take three to four weeks of trying these techniques before you begin to see an improvement in your sleep. During the first two weeks, your sleep may actually worsen before it improves, but improved sleep may lead to less pain intensity and improved mood.

What foods aggravate nerve pain?

Doctors tell us the benefits of a healthy diet range from disease prevention, longevity and overall making you feel good. For those of us living with chronic neuropathy, smart nutrition choices are essential to minimizing nerve pain. March is National Nutrition Awareness month, and we’re taking this opportunity to shed light on metabolic neuropathy and how what you eat affects your pain. 

What is metabolic neuropathy?

Metabolic neuropathy is a secondary neuropathy to a disease process that is already occurring in the body. Often metabolic neuropathy appears in those with diabetic neuropathy and idiopathic neuropathy, but can it be intrinsic of most others. Causes can include diabetes, food allergies, high cholesterol and glucose/blood sugar levels.

In our experience, metabolic neuropathy can be latent with no clear symptoms until the patient starts notices common signs of neuropathic pain. If you suspect food allergies can be causing your pain, it’s important to discuss it with your physician. He or she may run tests to find the source and create a treatment plan that is best for you.  

Why does metabolic neuropathy — or food allergens — cause me pain?

While this is an area that we feel more research is needed, nerve pain is caused by a lack of blood flow to heart, essentially creating little to no circulation in targeted areas such as our hands and feet. Certain foods can cause inflammation or escalated blood sugar levels, which then disrupt the circulation of blood flow to the nerves, creating nerve toxicity and more pain. 

What foods will cause me the most pain?

Healthy foods are not a one-size-fits-all. Some foods such as fruits can be beneficial to some while for others, such as those with diabetic neuropathy, too much sugar can still cause inflammation and pain. The key is to know your body and have open communication with your physician. With that in mind, these are the typical foods we see that cause the most pain sensitivities.

Artificial sweeteners

Dairy

Dishes with gluten (cereals, crackers, grains, pasta, salad dressings, etc.)

High-sugar products (canned fruit, granola, juice, ketchup, soda, protein bars, etc.)

Trans & saturated fats (commercially baked items, coconut oil, fried foods, margarine, etc.)

Which foods should I eat more of to reduce my pain?

There are several dietary steps you can take to reduce your pain. In the Neuropathic Therapy Center, we recommend considering a plant-based diet. Studies on plant-based diets have shown improved blood sugar levels, higher energy, lower cholesterol, reduced risk for cardiovascular disease, less inflammation — and most important — fewer pain symptoms.

I know cutting out those favorite cheeses, ice-creams and meats seems not only daunting but difficult in practice. However, it can be done! You can find plant-based recipes to try on Loma Linda University Health’s online cooking show “Live It: In the Kitchen.”

Another step you can take is making sure you drink water throughout the day. I know, it’s easy on a busy day to neglect your water intake and miss the needed eight 8-ounce glass recommendation, but water reduces inflammation, prevents low blood flow and ultimately reduces pain. 

Maintaining a healthy and well-balanced diet is essential to leading a pain-free life. Before making any changes or beginning a new diet, talk to your doctor to see what is best for you.

Which juice is good for nerves?

Much can go wrong when your body fails in major functions like sending messages from your brain via your nervous system or like contracting and relaxing muscles. This is one of many reasons you shouldn't skimp on nutrients — make sure you're getting foods that are good for nerves and muscles.

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There's no single vitamin or mineral that takes care of nerves and muscles by itself. If you want everything to work properly, you need to make sure you're consuming a wide variety of foods, especially fruits and vegetables, which are full of the micronutrients you need.

In some cases, however, you'll find that animal products encompass many foods that are good for nerves and muscles, so if you're looking exclusively for plant-based food (for example, if you're vegan), you need to do a little extra planning.

The Importance of Vitamin B12

Peripheral neuropathy, a general term for disorders caused by damage to the system of nerves that run from the brain and spinal cord to the rest of the body, can be caused by malnutrition, specifically a lack of vitamin B12, according to the Foundation for Peripheral Neuropathy.

Unfortunately, fruits and vegetables are lacking in vitamin B12, which is found primarily in animal-based foods such as red meat, dairy products, fish, poultry and eggs.

If you're vegetarian or vegan, you need to get your vitamin B12 from either fortified grains or a supplement. This is especially important because, as the Foundation for Peripheral Neuropathy explains, a B12 deficiency can damage the myelin sheath that protects your nerves.

Without the myelin sheath, your nerves won't function properly. A vitamin B12 deficiency might start out mild but its symptoms could still include problems with the nervous system and brain function. If unaddressed, however, this damage could progress to the point of being debilitating.

Read more: 12 Tips to Getting a Vegetarian Diet Right

Other Best Food for Nerves

The best foods for nerves include those that are high in other B vitamins, and like B12, they are mostly found in animal products. For example, vitamin B1, also known as thiamine, which plays a role in muscle contraction and nerve signal conduction, can be found in beef steak and pork, fish and eggs, but Medline Plus lists legumes, peas, nuts and seeds as good plant sources.

Another important nutrient is niacin, also known as vitamin B3. Plant-based sources of B3 include peanuts and enriched breads and cereal.

If you're looking to drink your nutrients, there might be a best juice for nerves: beetroot juice.

A July 2017 study published in the American Journal of Physiology, which looked at a small group of 14 participants, found that supplementation using beetroot juice could reduce muscle sympathetic nerve activity. This best juice for nerves is made from beets, which are a source of calcium, magnesium and potassium.

These same minerals aren't just found in the best juice for nerves — you can also turn to leaf vegetables for nervous system function. Leafy greens have magnesium, which is needed for nerve transmission, explains the University of Michigan.

Mustard greens are rich in calcium, which also plays a role in nerve function. And vegetables such as spinach have potassium for nerve transmission. These leaf vegetables for your nervous system will ensure those signals get sent from your brain efficiently.

Best Food for Muscles

Leaf vegetables are not for nerve repair alone — they're also great for muscles, as the University of Michigan points out. Those same greens that are full of magnesium are good for muscle contraction as well, and the mustard greens, which are a good source of calcium, can help muscles relax and contract. Vegetables with potassium are also good for muscle contraction.

And it's not just greens. Other vegetables are rich in these nutrients. Potassium can be found in fruits and vegetables like bananas, sweet potato, raisins, dates, peas and pumpkin. Calcium can be found in broccoli and legumes. Good sources of magnesium are artichokes and legumes.

Read more: Health Benefits of Muscular Strength & Endurance

Even though animal sources are an easy go-to for B vitamins and other foods that are good for nerves and muscles, these nutrients can be found in plenty of plant sources too. It just takes a little bit of extra planning to incorporate the right fruits, vegetables, beans and nuts into your diet.

How can I stop neuropathy pain at night?

The pain, tingling, and burning sensations from diabetic peripheral neuropathy can be debilitating any time of day. But, for some people, these uncomfortable sensations get particularly worse at night, especially when they’re trying to sleep.

If you’re in this category, you might have been told you’re imagining it. But, recent research from the Comprehensive Pain Center at Oregon Health & Sciences University indicates more acute pain at night isn’t in your head. In a study of nearly 650 participants, investigators found patients with diabetic peripheral neuropathy — regardless of age, gender, or other health conditions — reported feeling the most significant pain between 11pm and 8am.

Next time you feel your peripheral neuropathy pain intensifying at night, consider these possible causes. In some cases, you can try to get the discomfort under control.

Fewer distractions: At night, there’s less to take your mind off your pain — no chores, no errands, and no talking as you try to drift off to sleep. That’s when your mind and body become more aware of your surroundings. You notice your pain more, making sleep elusive.

To combat that heightened awareness, try to focus on something you enjoy to take your mind off what you’re feeling.

Cooler temperatures: With peripheral neuropathy, according to Loma Linda University Health, your feet will be far more sensitive to cooler air. As temperatures drop at night, your peripheral nerves can begin to tingle more, and you’ll feel more burning or sharp pains. Your heart rate also slows when you’re colder, slowing your blood and increasing painful sensations.

If you can handle the touch on your feet, wrap up in blankets to warm up.

Stress/Fatigue: Sometimes, physical stress and exertion can increase your nerve pain as your body begins to relax at the end of the day. Vigorous exercise and the soreness that accompanies it can contribute to more night-time nerve pain.

Be sure you alternate your exercise routines so you’re not over-taxing your body, and pay attention to when you need to take a break from exercise and let your body rest.

Medication: Even though your medication might work well during the day, keeping you mostly free from pain, it eventually wears off. This typically happens at night, according to the Innovations Stem Cell Center. When you’ve been comfortable all day, you’ll notice the pain much more when it starts to creep back in.

 

TRY THESE STRATEGIES TO STAY COMFORTABLE AT NIGHT IF YOUR HAVE PERIPHERAL NEUROPATHY PAIN:

Control your blood sugar. Work to keep your levels between 80-130 mg/dL before eating and under 180 mg/dL after meals.

Soak your feet in a warm bath to relax your nerves at night. Be sure to check the water temperature to avoid burning your feet.

Exercise regularly. It increases blood flow and oxygen to your feet, reducing pain. Listen to your body, though, and take breaks when needed.

How do you sleep with nerve pain?

If you suffer from nerve pain caused by diabetic neuropathy, physical trauma, sciatica, lupus, arthritis, or other causes, you may find that your pain gets worse at night. While not everyone experiences this, it is quite common for people with nerve pain to report greater pain later at night or whenever they get in bed.

The pain may make it harder for you to get quality sleep, and that may in turn make your pain and overall health and wellbeing even worse. It’s a vicious cycle.

Let’s look first at why your nerve pain may be worse at night, then we’ll look at some ways you may be able to get better rest.

Why Nerve Pain is Worse at Night

Just as chronic pain can have many causes, so too can increased pain at night. Not all causes are fully understood, but here are some possible reasons you may be hurting more at night.

Body Position

When you lay down, the weight of your body may put pressure on your nerves in ways that it doesn’t when you’re upright. This is particularly common with sciatica and other chronic pain caused by pinched or compressed nerves.

Temperature

Cooler temperatures help many people sleep better. However, cold can also make arthritis pain worse. Neuropathy may make you more sensitive to cold and more likely to experience it as pain.

Attention and Distraction

You may simply be more aware of your pain at night when there is less to distract you from it. This doesn’t mean the pain isn’t real — it is — only that you may be noticing it more at night than you do when you have other things to occupy your mind.

Hormone Levels

As your body prepares itself for sleep, your hormone levels, metabolism, and many other biochemical processes adjust. Some of these changes may heighten your pain. Cortisol, for example, has anti-inflammatory effects. However, your cortisol levels drop through the first half of your sleep cycle to let you rest, potentially making pain from rheumatoid arthritis worse.

Medication Timing and Dosage

The medications that control your pain well during the day may be wearing off too soon at night. Or your nighttime biochemistry and symptoms may require a different dosage or medicine.

How to Sleep Better with Chronic Pain

You and your pain management specialist may have to take an experimental approach to sleeping better. What works well for one kind of chronic pain may not work well for another, and your body will respond in its own unique way. Here are some strategies that may help you reduce your nighttime pain and get better sleep.

Try Sleeping in Different Positions

If your chronic pain is caused by pinched or compressed nerves, adjusting your sleep position may relieve some of the pressure. For example, people with sciatica who prefer to sleep on their side often find it helpful to sleep with their affected leg on top. People with hip or knee pain may find relief by sleeping with a pillow between their legs.

Adjust the Temperature

Experiment with different room temperatures when you sleep. It may take some time to find the best temperature for you: cool enough to help you sleep, not cold enough to make your pain worse. Consider keeping a journal of each night’s room temperature, sleep quality, and pain, then see what patterns you notice over time.

Get Appropriate Exercise During the Day

Exercise during the day can help reduce some kinds of chronic pain, and it may help you rest better too. Talk with your pain management doctor about what kinds of exercise are appropriate and safe for you.

Practice Good Sleep Habits

While the day’s stimulations may distract you from your pain, they won’t help you sleep. Develop a sleep routine that helps prepare your body for rest. This might include turning off the TV and other screens 1-2 hours before bedtime, reading a book, or taking a warm bath. Anything that helps you relax and unwind before you head to sleep.

Prepare Your Mind for Rest

The stress of chronic pain can make it even harder to rest. Try meditation or deep breathing exercises to lower your stress and help reduce your perception of pain. They also give you something else to focus on instead of your pain.

Talk With Your Doctor About Your Medications

If the medications you’re taking to manage your pain are wearing off or not working as well at night, tell your doctor and discuss your options. For example, if you have rheumatoid arthritis, your doctor may recommend modified-release corticosteroids to prevent nighttime inflammation.

Good Sleep for Better Health

Whatever you do, don’t suffer sleeplessly in silence. Chronic poor sleep will only make your chronic pain worse, and it robs you of a better quality of life. Less nighttime pain and better sleep will help you feel better all day long.

If you’d like some help managing your pain for better rest and health, you can make an appointment with any United Physician Group Pain Management practice. We offer effective treatments that bring lasting relief. We’ll help you rest well and get your life back.

Tags: health information, health tips, sleep

Is heat good for nerve pain?

Every pain is different. Each type can be a symptom of an underlying issue, an unpleasant sidekick to a condition, or an overall nuisance on everyday life. Treating pain can vary as well. While going straight to the doctor or trying an over-the-counter medication are options, another can be applying hot or cold compresses to the area where the pain is happening.

Hot vs Cold for Pain: What’s the Difference?

While both temperatures can soothe pain, they do so in different ways. Heat increases blood flow, nutrients, and oxygen to the affected area and, therefore, works to relax tight muscles. Cold lessens pain by reducing inflammation, muscle spasms, and circulation. While reducing circulation sounds bad, it’s actually a good thing because less circulation means your blood vessels shrink, which then lessens swelling and bleeding.

Let’s explore the different kinds of pain and how each respond when heat or cold is introduced:

Joint Pain/Inflammatory Pain

Typically caused by conditions such as arthritis and some autoimmune diseases like rheumatoid arthritis, joint pain/inflammatory pain can feel like stiffness in the joints or an “on fire” feeling throughout the bodyor similar to how you feel when you have the flu (fatigue, exhaustion, chills, etc.). Triggers for this type of pain can include intense physical activity, stress, and even weather. When to use heat or cold to treat joint pain depends on the cause of the pain and what works best for you. For example, gout responds well to heat because it eases stiffness and relaxes the muscles in the surrounding area. Osteoarthritis, on the other hand, does well with cold because it numbs pain. Once you know the underlying cause of your joint pain, such as an arthritis condition, you can talk to your doctor about adding heat or ice to your treatment plan and/or to manage flare-ups.

wysiwyg_imageupload:5839

Heat may be better for pain caused by inflammatory conditions such as arthritis to ease stiffness and relax the muscles. (Source: 123RF)

Muscle Pain

Muscle pain can affect one or more sections of the body at a time and can be caused by injury or overuse. For instance, with back pain, you could be hurting because you overworked your back muscles at the gym or because you strained (or “pulled”) a muscle by tearing the fibers of skeletal muscle. For the most part, if muscle pain is temporary (or acute) it can be treated with cold compresses for no more than 15 minutes a few times a day and rest to allow tissues to heal. At the same time, if the pain is chronic (lasts longer than 6 months) heat is the best bet; it can even be alternated with cold if desired.

wysiwyg_imageupload:5838

Icepacks or cold compresses may help alleviate nerve or muscle pain. (Source: 123RF)

Nerve Pain

Nerve pain can be caused by many different types of conditions and varies in how it feels. For example, a patient with sciatica (a condition where pain is caused by spinal nerve compression in the lower back) can be described as a “radiating” pain; other times, nerve pain can feel like numbness or tingling. Pain caused by conditions such as sciatica respond well to ice or cold treatments because that temperature tends to calm inflammation and numb any soreness in the tissue. It’s best to use cold when the pain is still sharp and move on to heat once that sharpness has subsided. The heat will increase blood flow and help tissues heal faster.

Say goodbye to Sciatic Nerve Pain Within Days With this Natural Home Remedy

Home remedies like heating pads, microwavable gel packs, a ziplock filled with ice, or a store-bought freezer pack and other compresses can be helpful in alleviating frequent chronic pain. Apply for no more than 15 minutes at a time, two to four times a day. At the same time, it’s important to know your body’s limits. Regardless of the type of pain you are experiencing, if you get to a point where the pain is intolerable or if it turns into numbness or weakness, see your doctor right away.

Does Vicks Vapor Rub help neuropathy?

Most peripheral neuropathy (PN) treatments are centered on pain reduction and improvement in

function. Effective treatment for injured nerves often requires a combination of medicines,

exercise and other therapies. It can take some time to find the combination that is right for you.

Mild pain may respond to a simple over-the-counter (OTC) drug, like ibuprofen or

acetaminophen. Or your provider may prescribe one or more medications for you. More

commonly used medicines include neuropathic pain agents, most often anti-seizure medications

or certain anti-depressants. Consult your provider to learn what is right for you.

Should you suffer from Diabetic Peripheral Neuropathy (DPN) the most important thing you can

do is to manage your blood glucose level which can prevent further nerve damage. Managing

your diabetes plays a critical role in treating DPN, so keep your blood sugar levels in normal

range with frequent testing, proper diet, exercise, medications and/or insulin therapy.

In addition to working with your providers, the Neuropathy Action Foundation (NAF) has found

that some patients find relief by exploring the treatments listed below. Many patients find that

an integrative approach – one that uses both conventional methods and Complementary and

Alternative Medicine (CAM) therapies – is the best way to manage their pain and discomfort.

Therefore, this brochure was created by the NAF based on what we have heard from patients

since the NAF was created in 2006. Since some CAM therapies, particularly nutritional

supplements, interact with certain prescription drugs or may not be appropriate for use by some

patients, it is very important to consult with your medical provider before starting a new CAM

treatment.

NOTE: This brochure is for educational purposes and not for the purpose of rendering medical advice.

Information in this brochure is not intended to replace the counsel of your provider. It is important to

consult your provider before altering your treatment plan. Information provided does not imply medical

recommendation or endorsement. The NAF does not endorse any medications, products, equipment or

treatments.

Absorbine Jr.® – This product is applied directly on the pain area typically at bedtime. It is a

formulation of menthol combined with natural herb extracts. It is available in most drug stores.

Acupuncture/Acupressure – Acupuncture is a method of encouraging the body to function.

This is done by inserting needles and applying heat or electrical stimulation at very precise

acupuncture points.

Alpha Lipoic Acid (ALA) – ALA, found in all cells of the body, is a vitamin-like chemical called

an antioxidant. Yeast, liver, kidney, spinach, broccoli, and potatoes contain small amounts of

ALA. It is also made in the laboratory and has been used since the 1950’s as a dietary

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supplement. ALA is approved in Germany for the treatment of DPN. ALA seems to help

prevent certain kinds of cell damage in the body. There is evidence that ALA can improve the

function and conduction of neurons in diabetes, may help with regrowth of damaged nerves and

may help limit and treat neuropathy caused by chemotherapy. It is sold in drug stores.

Analgesic Creams, Rubs, and Sprays - Topical pain killers, or analgesics, are sprayed on or

rubbed into the skin over painful muscles or joints. Although are all designed to relieve pain,

different products use different ingredients. Here are the most common ingredients found in

products available without a prescription.

 Counterirritants. Ingredients such as menthol, methylsalicylate (oil or wintergreen), and

camphor are called counterirritants because they create a burning or cooling sensation

that distracts your mind from the pain.

 Salicylates. These same ingredients that give aspirin its pain-relieving quality are found

in some creams. When absorbed into the skin, they may help with pain, particularly in

joints close to the skin, such as the fingers, knees, and elbows.

 Capsaicin Cream. The main ingredient of hot chili peppers, capsaicin is also one of the

most effective ingredients for topical pain relief. When first applied, capsaicin creams

cause a warm tingling or burning sensation. This gets better over time. You may need to

apply these creams for a few days up to a couple of weeks before you notice relief.

Aquatic Aerobic Exercise - Water supports your body so your muscles are developed without

jarring. Exercise programs can be found in gyms with pools or in therapy pools supervised by

physical therapists.

B Vitamins - Patients with peripheral neuropathy may be deficient in B-complex vitamins.

Many patients have told us over the years that taking B12 daily has helped them. Also,

benfotiamine, a fat-soluble, highly absorbable form of thiamine (vitamin B1) might reduce

diabetic pain and improve nerve conduction velocity. It is important not to take more than the

recommended amount of vitamin B6 daily, as this can actually cause neuropathy.

Bed Cradle – Supportive treatments like a bed cradle that can keep sheets and blankets from

touching sensitive feet and legs have been shown to help many patients over the years.

Biofeedback - Biofeedback is a technique that trains people to improve their health by

controlling certain bodily processes that normally happen involuntarily, such as heart rate, blood

pressure, muscle tension, and skin temperature. Patches, called electrodes, are placed on

different parts of your body to measure your heart rate, blood pressure, or other function. A

monitor is used to display the results. With help from a biofeedback therapist, they will describe

a situation and guide you through relaxation techniques. The monitor lets you see how your

heart rate and blood pressure change in response to being stressed or remaining relaxed.

Initially, you will use the monitor to see your progress, but eventually you will be able to achieve

success without a monitor or electrodes. Biofeedback is primarily used to treat high blood

pressure, tension headache, migraine headache, chronic pain, and urinary incontinence.

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CoQ10 – Also known as ubiquinone or ubiquinol. CoQ10 is an antioxidant that is essential for

nerve health. Taken as a nutritional supplement, it has been shown to decrease signs of

neuropathy caused by diabetes and chemotherapy, and in some cases, to help with regrowth of

damaged nerves. CoQ10 is available without a prescription at drug stores.

Compounded Pharmacy Medications – Many traditionally prescribed oral medications for

neuropathy have side effects and OTC products may not be helpful enough. Therefore, some

patients are taking advantage of specially created medications that combine the active

analgesic benefits of various products with nerve health supplement ingredients into creams,

gels, patches, etc. Traditional pharmacists are not in a position to create such products, but

Compounding Pharmacists can work with your doctors to create medication alternatives for you.

Diet – Making the right choices in your diet will make a huge difference in your overall health!

Limit your refined carbs and sugary drinks; choose water over soda, and drink skim milk instead

of whole milk. Choose baked or broiled foods over fried, and limit your sodium intake. You are

what you eat, but when you eat is just as important when managing diabetes. Keep regular

meal and snack times to keep your blood sugar levels constant. Also watch your size portions.

Ergonomics and Splints – Can be helpful for people suffering from muscle weakness as the

result of PN. Also, making ergonomic changes to one's workplace may reduce the symptoms of

carpal tunnel and help alleviate the pain from peripheral neuropathy.

Evening Primrose Oil – Evening primrose oil is the oil from the seed of the evening primrose

plant, and is one of the main sources of the essential fatty acid “gamma-linolenic acid” (GLA).

Some people use evening primrose oil for nerve damage related to diabetes. Studies have

found that GLA may help reduce symptoms of diabetic neuropathy.

Exercise Classes – Low impact exercise classes can be helpful in strengthening weakened

muscles, helping restore better balance, relieving pain and depression through the release of

endorphins. It is important that those who suffer from PN keep moving to maximize potentials

for wellness and minimize our propensity for weakness.

Feldenkrais® – A form of physical therapy that uses gentle movement and directed attention to

improve movement and enhance human functioning. Some say this technique helped them

increase their ease and range of motion, flexibility and coordination. Feldenkrais teaches that

increasing a person's kinesthetic self-awareness of functional movement could lead to

increased function, reduced pain, and greater ease and pleasure of movement.

Ice Pack – May relieve pain, swelling and inflammation from injuries and conditions such as PN.

Icy Hot® – For some people, this over-the-counter topical ointment cools down the hot feet

and/or warms up cold feet. It may also help with muscle and joint pain.

Infrared Light Therapy – Available from a variety of providers, this therapy uses infrared light.

It is purported to increase circulation and reduce pain. It is available through podiatrists,

chiropractors, and other medical practitioners, as well as machines available for home use.

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Ivory® Soap – While some dismiss this product for PN as an urban myth or quackery

nonsense, some people are finding that placing a bar of Ivory between the sheets at the foot of

the bed actually reduces their night time PN feet distress. (Some have used other soaps.)

Lidocaine Patches – These are commonly used for severe pain using very high powered pain

medications and are available only by prescription. There are also a number of over-the-counter

pain patches for lesser levels of pain and containing non-narcotic ingredients.

Massage - Massage or massage therapy is a system of structured palpations or movements of

the soft tissues of the body. The massage system may include, but is not limited to, such

techniques as, stroking, kneading, gliding, percussion, friction, vibration, compression, passive

or active stretching within the normal anatomical range of movement. It is increasingly being

offered along with standard treatment for a wide range of medical conditions and situations.

Meditation - Meditation is one of the most widely used forms of complementary therapy,

particularly as a palliative for chronic illness. Available meditation research is generally of lowto-modest quality, but tends to support this intervention for the reduction of stress and pain, and

improving quality of life in a variety of medical conditions.

Neuragen® – Neuragen is a topical product that works directly at the site of the pain. Neuragen

claims to reduce the spontaneous firing of damaged peripheral nerves. By calming these firings

at the source, Neuragen has been reported to reduce shooting and burning pains quickly and

without the side effects of oral medications. Some patients who have used Neuragen have

reported sleeping better and being able to walk without pain. Neuragen is a homeopathic pain

reliever and may be used alone or in with other medications. It is available over the counter in

most local pharmacies either in the diabetic section or the analgesic (pain) section.

Nikken® – Magnetic, infrared, and other therapeutic products including creams and vitamin

supplements. The magnetic insoles have been helpful for some who find walking difficult.

Peppermint Lotion – Cooling and soothing for neuropathic distress. The often used Dr.

Scholl’s Peppermint Foot & Leg Lotion version is available at most pharmacies.

Physical Therapy – A variety of physical therapies can be helpful for some neuropathy

conditions, particularly in relation to restoring balance, increasing lost muscle strength, and

relieving neuro-muscular disorder pain and distress.

Reflexology – Reflexology is an alternative medicine (therapy) involving application of pressure

to the feet and hands with specific thumb, finger, and hand techniques without the use of oil or

lotion. It is based on a system of zones and reflex areas that reflect an image of the body on the

feet and hands, with the premise that such work effects a physical change to the body.

Reikii – Reiki is a Japanese technique for stress reduction and relaxation that also promotes

healing. It is administered by "laying on hands" and is based on the idea that an unseen "life

force energy" flows through us and is what causes us to be alive.

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Shoes – Orthopedic inserts and specially designed shoes have been reported to help many

who suffer from PN. Find a good shoe store that will consult with you and fit you well. If you are

wearing an orthotic, be sure to take it with you to be sure it fits well in your shoe choice.

Properly fitting shoes are essential for those with neuropathic distress in their feet and/or with

leg and back pain problems. Wear shoes/slippers to protect your feet, even when you are at

home. Many insurance programs, including Medicare, can help cover the costs.

Sore No More® - A pain-relieving gel that begins to work immediately once massaged onto

affected area. Claims to have unique heating and cooling ingredients made from a special

blend of natural plant extracts in combination with menthol, capsaicin and witch hazel.

Tai Chi – Tai Chi is a Chinese martial art practiced for both its defense training and its health

benefits. Many believe that Tai Chi helps with fall prevention, general healthcare in older

people, improving balance and enhancing psychological health. This simple movement exercise

is favored by many with PN as it helps to develop and maintain proper balance.

Transcutaneous Electronic Nerve Stimulation (TENS) - TENS is a method of therapy that

may be used to treat nerve pain. It works by inhibiting pain signals from reaching the brain. It is

a drug-free therapy that works by placing very small electrical impulses on specific nerve paths.

The electrical impulses are delivered to the nerves through electrodes that are placed on the

skin. Although it doesn't work for everyone or all types of pain, TENS may be prescribed in

combination with other treatments, primarily to provide relief from acute forms of nerve pain.

Tonic Water – Through the concentration of the active ingredient, quinine, some say this helps

with leg cramps/muscle spasms. If you are prone to cramping, you might consider trying a ¼ or

½ cup of tonic water each evening. For refractory muscle cramps, prescription quinine sulfate

may be an option.

Vicks Vapor Rub® – Massaging one’s feet with Vicks, particularly at night, soothes neuropathic

pain and distress in one’s feet and legs. It is also excellent for softening your toe nails and

diminishing common toe nail problems.

Warm/Cool Baths and Showers - Excellent de-stressors and can help with reducing pain.

Water – Drinking plenty of water is essential to maintain good health. Drink 6-8 ounce glasses

of water per day; if that is hard, incorporate foods with high water contents, like soup or fruits

(fresh, frozen or canned in light syrup) into your meals.

Weight Loss – Achieving and maintaining a healthy weight can help relieve numerous chronic

health problems. Blood sugar levels are better controlled after weight loss which is important for

managing DPN. Additionally, one will have more energy for exercise, and depressive states will

be more easily overcome.

Yoga – There are many types and styles of yoga from very mild movements, stretches and

poses to very active, demanding exertion. Deep breathing and contemplative relaxation stillness

are integral components of yoga practice. Gentle and chair yoga are most recommended.

What does nerve pain feel like?

What is nerve pain?

Nerve pain, also called neuralgia or neuropathic pain, occurs when a health condition affects the nerves that carry sensation to the brain. It is a particular type of pain that feels different from other kinds of pain.

Sciatic Nerve Pain | Ikonsultang Medikal (April 18, 2017)

There are different types of nerve pain, including:

post-herpetic — this can happen after you've had shingles (herpes zoster) and affects the same area as the shingles rash

trigeminal— causing pain in the jaw or cheek

occipital — causing pain at the base of your skull that can spread to the back of your head

pudendal — causing pain in the ‘saddle area’ between the legs

What are the symptoms of nerve pain?

Nerve pain often feels like a shooting, stabbing or burning sensation. Sometimes it can be as sharp and sudden as an electric shock. People with neuropathic pain are often very sensitive to touch or cold and can experience pain as a result of stimuli that would not normally be painful, such as brushing the skin.

It’s often worse at night. It might be mild or it might be severe.

People who have nerve pain often find that it interferes with important parts of life such as sleep, sex, work and exercise.

Some people with nerve pain become angry and frustrated, and may have anxiety and depression.

CHECK YOUR SYMPTOMS — Use the Symptom Checker and find out if you need to seek medical help.

What causes nerve pain?

Nerve pain can be due to problems in the central nervous system (brain and spinal cord), or in the nerves that run from there to the muscles and organs. It is usually caused by disease or injury.

Common causes include:

an injury to the brain, spine or nerves

poor blood supply to the nerves

heavy drinking

phantom pain after an amputation

vitamin B12 or thiamine (vitamin B1) deficiency

certain medicines

Conditions that can cause nerve pain include:

infections such as shingles and HIV/AIDS

multiple sclerosis

diabetes

stroke

cancer and its treatment with radiation, surgery or chemotherapy

trapped nerves, such as in carpal tunnel syndrome

There are other conditions associated with nerve pain.

Sciatica is pressure on the nerves of the lower back that causes pain down the leg. The pain can be accompanied by pins and needles, numbness or weakness in the leg.

Fibromyalgia is a chronic pain syndrome associated with burning or aching pain in different parts of the body. The cause is not well understood, but it can be triggered by emotional distress and poor sleep. There may be genetic factors, too.

Peripheral neuropathy occurs when the peripheral nerves that connect the brain and spinal cord to the rest of the body are damaged. It’s caused by diabetes, autoimmune diseases and other conditions.

How is nerve pain diagnosed?

The main way your doctor will diagnose nerve pain is by listening to you and examining you.

In the examination, they will probably test your nerves by testing the strength of your muscles, checking your reflexes, and by seeing how sensitive it is to touch.

You may be asked to have tests like:

blood tests to check your general health and look for underlying conditions

nerve conduction studies which measure how quickly your nerves carry electrical signals

a CT scan or an MRI scan to look for anything that could be pressing on a nerve

How is nerve pain treated?

There are many ways to treat nerve pain. Treating the underlying cause, if there is one, is the first step.

Painkillers and a range of different medicines can help, as can non-drug treatments like exercise, acupuncture and relaxation techniques.

Nerve pain can be difficult to treat. Any underlying conditions such as diabetes and vitamin B12 deficiency can be managed. Otherwise, treatments aim to directly ease the pain. Options include medicines and non-medicine strategies.

Medicines

Some nerve pain will be controlled with simple painkillers like aspirin, paracetamol or a non-steroidal anti-inflammatory drugs (NSAIDs). Stronger painkillers such as opioids are sometimes used, but these have significant side effects that can be harmful especially in the long term, and can be addictive.

Many other medicines can be effective against nerve pain. They include medicines originally used to treat depression (such as amitriptyline and duloxetine) and seizures (gabapentin, pregabalin and carbamazepine).

Non-medicine treatments

Non-medicine treatments can help people to understand and cope with the pain. They include:

education and counselling

exercise

acupuncture

relaxation techniques

psychological treatments to help you feel in control of your pain and reduce distress

transcutaneous electrical nerve stimulation (TENS) to block the transmission of pain sensations to your brain

People with chronic pain may find it helpful to attend a multidisciplinary pain clinic where health professionals can work out a personalised pain management plan. You will need a referral from your doctor to attend a pain clinic. You can find a list of pain services on the Pain Australia website.

Resources and support

There are support groups and helplines for different types of nerve pain throughout Australia. Visit the Pain Australia website for more information.

Pain Australia also has a list of resources.

Call the Australian Pain Management Association’s Pain Link helpline on 1300 340 357.

Learn more here about the development and quality assurance of healthdirect content.

Last reviewed: July 2020

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Can B12 repair nerve damage?

Vitamin B12 Enhances Nerve Repair and Improves Functional Recovery After Traumatic Brain Injury by Inhibiting ER Stress-Induced Neuron Injury

Fangfang Wu,1,2,† Ke Xu,3,† Lei Liu,1,† Kairui Zhang,1 Leilei Xia,4 Man Zhang,1 Chenhuai Teng,1 Heyan Tong,2 Yifang He,2 Yujie Xue,2 Hongyu Zhang,2 Daqing Chen,1,* and Aiping Hu1,2,*

Author information Article notes Copyright and License information Disclaimer

This article has been corrected. See Front Pharmacol. 2021 April 12; 12: 598335.

This article has been cited by other articles in PMC.

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Abstract

Traumatic brain injury (TBI) is one of the most common causes of neurological damage in young human populations. Vitamin B12 has been reported to promote axon growth of neuronal cells after peripheral nerve injury, which is currently used for the treatment of peripheral nerve damage in the clinical trial. Thus, we hypothesized that TBI can be attenuated by vitaminB12 treatment through its beneficial role on axon regeneration after nerve injury. To confirm it, the biological function of vitaminB12 was characterized using hematoxylin and eosin (H&E) staining, Luxol fast blue (LFB) staining, western blot analysis, and immunohistochemistry staining. The results showed that the neurological functional recovery was improved in the VitaminB12-treated group after TBI, which may be due to downregulation of the endoplasmic reticulum stress-related apoptosis signaling pathway. Moreover, the microtubule stabilization, remyelination and myelin reparation were rescued by vitamin B12, which was consistent with the treatment of 4-phenylbutyric acid (4-PBA), an endoplasmic reticulum stress inhibitor. The study suggests that vitamin B12 may be useful as a novel neuroprotective drug for TBI.

Keywords: vitamin B12, traumatic brain injury, endoplasmic reticulum stress, microtubule, myelin

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Introductions

Traumatic brain injury (TBI) is commonly found following traffic accidents in adults or perinatal asphyxia in newborns, which causes brain swelling with an increase in intracranial pressure and a subsequent decrease in cerebral perfusion leading to ischaemia (Fink et al., 2012). Previous therapeutic approaches have focused on protecting the blood-brain-barrier at the early stage of injury to mitigate damages such as ionic homeostasis disturbances, secondary cerebral oedema, inflammation and the generation of free radicals (Mayer et al., 2013; Katz et al., 2015; Ma et al., 2017). The repair processes following TBI are severely limited due to a failure to entirely replenish the neuronal population (Sun, 2014). Moreover, the degeneration and necrosis of axons are also the pivotal pathological event of acute TBI (Zhang et al., 2015). Therefore, inhibiting neuronal apoptosis and promoting axon regeneration are of great significance in promoting the functional recovery from TBI (Sun, 2014; Zhang et al., 2016).

Microtubules stability is a major determinant of axonal growth and neuronal polarization during axon formation (Murillo and Sousa, 2018). A previous study had demonstrated that the administration of fibroblast growth factor 13 (FGF13) maintained microtubule stability, and promoted axon formation and neuronal polarization after spinal cord injury (Li et al., 2018). Microtubule-stabilizing proteins (MSPs), as cytoskeletal proteins, cross cells and transport nutrients to ensure the integrity of cell function (Nogales, 2000). Members of the MSP family, such as microtubule-associated proteins (MAPs), Tau and doublecortin (DCX) can promote microtubule assembly, stabilize the microtubule, and play key roles in directing neuronal migration into the cerebral cortex and axon regeneration at the early stage of neuronal migration (Takei et al., 2000; Kapitein and Hoogenraad, 2015; Brunden et al., 2017). Thus, a drug that reduces neuronal apoptosis and promotes microtubule stability may represent a promising approach for the clinical treatment of TBI (Brunden et al., 2017; Gao et al., 2018).

Vitamin B12 (Mecobalamin, MeCbl) is an important micronutrient that is required in numerous biological processes (Rathod et al., 2016). It is considered a coenzyme in folate metabolism and nucleotide biosynthesis, which makes it crucial in the metabolism of fatty acids and some amino acids and normal nervous system function (Field et al., 2018). Furthermore, vitamin B12 deficiency results in methionine deficiency, leading to the dyes-synthesis of both phospholipids and myelin (Gröber et al., 2013). Currently, combination therapy with vitamin B12 is widely combined and used in clinical patients with nerve diseases. It has been reported that systemic administration of vitamin B12 promoted the recovery process from peripheral nerve damage in experimental rats (Hobbenaghi et al., 2013). Additionally, vitamin B12 was recently shown to be a superoxide scavenger contributing to neuronal cells axonal growth (Chan et al., 2018). Thus, we hypothesized that vitamin B12 could enhance axon formation after TBI via stabling microtubule and reducing neuronal apoptosis.

The accumulation of misfolded protein in the endoplasmic reticulum (ER) leads to ER dysfunction, which is known as ER stress (Hughes and Mallucci, 2018). Recent studies have demonstrated that ER stress is involved in a range of neurological diseases, including cerebral ischaemia, neuro-degenerative disorders and Alzheimer’s disease (Roussel et al., 2013; Hood et al., 2018). Our previous study indicated that ER stress inhibition significantly protected against neuronal apoptosis after spinal cord injury (He et al., 2017), but the role of ER stress in TBI is still unclear. An increasing number of studies suggested that vitamin B12 regulated ER homeostasis (Sukocheva et al., 2001; Ghemrawi et al., 2013). Furthermore, it was reported that vitamin B12 deficiency activated ER stress pathways by increasing the phosphorylation of PERK and IRE1α and the expression of ATF6 (Ghemrawi et al., 2013). Given our previous work on ER stress and its participation in nerve disease, we hypothesized that vitamin B12 could promote nerve regeneration after TBI by regulating ER stress.

In this study, we explored the effect of vitamin B12 on nerve regeneration after TBI both in vivo and in vitro. Meanwhile, we investigated the role of ER stress during the vitamin B12 treatment for TBI by inspecting changes in neuronal apoptosis, microtubule, myelin regeneration, and axonal growth.

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Materials and Methods

Animals

Adult C57BL/6 male mice aged 6–8 weeks and weighing 20–26 g were purchased from the Animal Center of the Chinese Academy of Sciences (Shanghai, China). Animals were housed under a 12-h light/dark cycle at 21–23°C and provided access to food and water ad libitum. The care and use of all animals were approved by the Ethics Committee of Wenzhou Medical University and conformed to the guidelines set forth by the Chinese National Institutes of Health. Mice were allocated to the following four groups using a random number table: the sham animal group, which received only anesthesia and a craniotomy: the TBI group; and two vitamin B12 treatment groups (doses of 0.5 mg/kg/day and 1.5 mg/kg/day) that received vitamin B12 intraperitoneally following surgery.

Cell Culture and OGD/Re-oxygenation Model

PC12 cells were purchased from the Cell Bank of the Type Culture Collection of the Chinese Academy of Sciences, Shanghai Institute of Cell Biology, Chinese Academy of Sciences. The PC12 cells were highly differentiated and adhered. Cells were cultured with RPMI 1640 supplemented with 10% FBS, 100 U/mL penicillin and 100 μg/mL streptomycin, and then incubated in a humidified atmosphere containing 5% CO2 at 37°C. For oxygen-glucose deprivation (OGD), cells were incubated in an anaerobic chamber for 6 h at an oxygen level that remained below 0.5% with normal growth medium or FBS-free medium, and then cells were incubated for another 12 h under normal culture conditions. Vitamin B12 (200 μM) pretreatment was administered for 2 h before OGD. To further estimate the effect of ER stress activation during OGD, cells were pretreated with 4-phenylbutyric acid (4-PBA) (1 mM) for 1 h. All experiments were performed at least three times.

Surgical Procedures

TBI procedures were performed in male mice by controlled cortical impact (CCI). Briefly, all male mice were anesthetized with isoflurane via brain stereotaxis, and an incision was made in the middle of the scalp to expose the skull. After removing the bone flap, CCI was performed with a controlled impactor device at a speed of 4 m/s, a depth of 1 mm and a 150-ms impact duration (Impact OneTM Stereotaxic Impactor, Leica, Milan, Italy). Postoperatively, the incision was sutured and treated with a local antibiotic application (cefazolin sodium salt). The mice were placed on a heating pad at 37°C to recover from anesthesia. All experiments were conducted with all efforts to reduce the number of animals used and their suffering as much as possible.

Drug Administration

Vitamin B12 (V2876, Sigma) and 4-PBA (P21005, Sigma) were used as drugs in this study. The vitaminB12 was dissolved in normal saline as 150 mg/ml stock. The mice were treated with vitamin B12 in 0.5 mg/kg or 1.5 mg/kg by intraperitoneal injection from 1 day after injury for 2 consecutive weeks. The 4-PBA (100 mg/kg) was administered before vitamin B12 treatment via intraperitoneal injection. Every drug was filtered by 0.2 μm microfiltration membrane before injection.

Brain Water Content

Mice were decapitated under deep anesthesia and perfusion at 24 h after TBI induction. The olfactory bulbs and brain stems were removed from their brains. Then brains were divided into two segments: right hemispheres and left hemispheres. Each part of the brain was weighed immediately to determine the wet weight. The samples were dried at 72°C for 72 h to obtain dry weights. Brain water contents were calculated as follows: [(wet weight - dry weight)/wet weight] × 100%.

Garcia Neurobehavioral Score

According to Garcia neurobehavioral score, the mice in each group were scored on day 1, day 7, and day 14 after TBI. The recovery of nerve function after TBI was observed by double-blind method. Briefly, (1) spontaneous activity (0 ≤ 3 points). (2) symmetrical movement of limbs (0 ≤ 3 points). (3) forelimb extension (0 ≤ 3 points). (4) climbing (0–3 points). (5) body trunk reaction (0 ≤ 3 points). (6) tentacles reaction (0 ≤ 3 points). (7) lateral rotation reaction (0 ≤ 3 points).

Tissue Preparation

Animals were anesthetized with isoflurane at specific time points following TBI. For immunofluorescence staining, brain tissues were dissected out, post-fixed by 4% paraformaldehyde (PFA) for 12 h, embedded in paraffin, cut into 5 mm sections and mounted on slides for subsequent staining. For western blot, a brain segment was dissected and stored at -80°C immediately. Animal tissues were lysed with RIPA lysis buffer (50 mM Tris, 150 mM NaCl, 1% Triton X-100,1% sodium deoxycholate, 0.1% SDS, 5 mM sodium orthovanadate, 5 mM sodium fluoride, 1 mM and EDTA, pH 7.4) supplemented with 10 μl/ml protease inhibitor cocktail (GE Healthcare Biosciences, Pittsburgh, PA, United States). The samples were homogenized using mechanical disruption and ultrasound cell breaker (30 s/times in three times). The tissue lysates were incubating at 4°C for 15 min. The supernatants were collected after centrifuging at 12,000 rpm at 4°C for 15 min.

Animal Experiment

Luxol fast blue (LFB) staining: The sections were deparaffinized, rinsed in dimethylbenzene I, dimethylbenzene II, absolute ethyl alcohol I, absolute ethyl alcohol II, 95% ethanol, 90% ethanol, 80% ethanol, 70% ethanol, and distilled water and then incubated in an LFB solution (0.01% in 95% ethanol) overnight at 60°C. Gray and white matter tissues were differentiated by immersing the slides in 0.05% lithium carbonate solution for 5 – 10 s, followed by 2 changes of 70% ethanol for 1 min each, and then rinsed in distilled water. The sections were observed under a microscope to confirm proper differentiation. Differentiation steps were repeated until a sharp contrast was achieved between blue-stained white matter and colorless gray matter.

Nissl staining: We dewaxed the paraffin sections and stained them with 5% toluidine blue at room temperature for 10 min. Sections were soaked in 95% ethanol for 2 min, dimethylbenzene for 3 min and sealed with neutral balsam. The Nissl-stained slides were observed using a Nikon microscope.

H&E staining: An H&E staining kit was purchased from Beyotime Company (Jiangsu, China), and the experimental procedure was performed according to the kit instructions.

Immunohistochemistry: Paraffin sections were deparaffinized by dimethylbenzene and then rehydrated in an alcohol gradient. After incubated in 3% oxydol for 15 min, antigen retrieval was performed in citric acid by a pressure cooker, and then the slides were cooled for 2 h. BSA at 5% was used for pre-incubation at 37°C for 30 min, and the sides were incubated with the primary antibodies at 4°C for 24 h. The following primary antibody was used: MBP (1:1000, Cell Signaling Technologies, America). In the next step, glass slides were incubated with goat anti-rabbit IgG (H+L) HRP secondary polyclonal antibody (1:1000, Yeason) at 37°C for 1 h and then with DAB for approximately 5 min. Stained sections were photographed with a fluorescence microscope (Nikon, Tokyo, Japan).

Western Blot

Proteins from tissues and cells were quantified with BCA reagents. 40 μg proteins were separated on a 12% gel and transferred onto a polyvinylidene fluoride (PVDF) membrane (Bio-Rad, Hercules, CA, United States). The membranes were blocked for 120 min with 5% (w/v) milk dissolved in 0.1% Tween-20 in TBS at room temperature, and then were incubated overnight at 4°C with the following primary antibodies: Caspase12 (1:1000, Abcam, United States), IRE1α (1:1000, Abcam, United States), GRP78 (1:1000, Abcam, United States), XBP-1 (1:1000, Abcam, United States), CHOP (1:1000, Cell Signaling Technologies, United States), Ace-tubulin (1:2000, Cell Signaling Technologies, United States), Tau (1:1000, Abcam, United States), MAP2 (1:2000, Cell Signaling Technologies, United States), myelin basic protein (MBP) (1:1000,Cell Signaling Technologies, United States), and GAPDH (1:10000, Bio-world, United States). Subsequently, the membranes were washed thrice with TBST and the membranes were incubated with horseradish-peroxidase conjugated secondary antibodies rabbit/mouse polyclonal antibody (1:1000, Yeason) for 60 min. A ChemiDocTM XRS imaging system (Bio-Rad, United States) was used to visualize the signals. Quantity One was used to analyze the relative band densities, and the band densities of target proteins were normalized to that of GAPDH. All experiments were repeated at least in triplicate.

Immunofluorescence Staining

Cells were fixed with 4% PFA for 30 min at 37°C. The prepared tissue sections and cells were blocked with 5% BSA for 30 min and then incubated at 4°C overnight with the following primary antibodies: MAP-2 (1:500, Abcam, United States), Ace-tubulin (1:500, Cell Signaling Technologies, United States), Tyr-tubulin (1:500, Sigma Aldrich, United States), GRP78 (1:1000, Abcam, United States), and MBP (1:500, Cell Signaling Technologies, United States). Next, the sections and cells were incubated with an Alexa Fluor 594/647 donkey anti-mouse/rabbit secondary antibody (1:1000, Abcam, United States) for 1 h at 37°C. Nucleis were stained with DAPI. The samples were imaged under a Nikon ECLIPSE Ti microscope (Nikon, A1 PLUS, Tokyo, Japan). 10 images were captured from each sample in the cortex randomly. The quantitative of immunofluorescence was performed by Image J. All experiments were repeated at least in triplicate.

TUNEL Staining

The TUNEL analysis kit (40307ES20, Yeason) was used for detecting the level of DNA damage. The brain sections were deparaffinized and rehydrated by difference concentrated-ethanol. After washing with PBS, the sections were treated with 10.2 mM sodium citrate buffer. The sections were stained with Alexa Fluor 488-12-dUTP Labeling Mix. The sections were counter staining with DAPI after washing with PBS. The images were captured by the fluorescence microscope (Olympus Inc., Tokyo, Japan). The TUNEL positive cells in six random fields of each section were counted for analysis.

Statistical Analysis

Statistically analyzed data were presented as the mean ± standard error of the mean (SEM). Student’s t-test was used to determine statistical significance between two groups. For comparison of three or more groups, one-way analysis of variance (ANOVA) followed by Tukey’s post hoc test was used to analyze the results. The difference was considered statistically significant when the P-value was <0.05.

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Results

Vitamin B12 Decreased En-Cephaledema and Motor Neuron Loss After TBI

To evaluate the therapeutic role of vitamin B12 in the treatment of TBI, vitamin B12 was administered intraperitoneally immediately following TBI. Brain water content was detected at 24 h after TBI. The brain water content of the TBI group was obviously increased relative to the sham group (91.91 ± 1.488 vs. 83.53 ± 0.7815, Figure 1A, Mean ± SEM, n = 6), and the brain water contents of the vitamin B12-treated TBI groups were reduced to differing degrees relative to the TBI group (86.11 ± 1.070 in 0.5 mg/kg vitamin B12 dose group and 85.31 ± 0.7846 in 1.5 mg/kg vitamin B12 dose group vs. 91.91 ± 1.488 in TBI group, Mean ± SEM, n = 6). These results indicated that vitamin B12 significantly alleviated ipsilateral brain oedema after TBI injury.

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FIGURE 1

Vitamin B12 treatment reserves tissue structure damage and protects functional recovery after TBI. (A) Quantification of brain water content in the ipsilateral brain cortex at 1 day after TBI. ##P < 0.01 vs. the sham group. ∗P < 0.05 and &P < 0.05 vs. the TBI group values represent the mean ± SEM, n = 6. (B) Garcia test evaluation at 7 days, 14 days after TBI. #P < 0.05 vs. the sham group. ∗P < 0.05 vs. the TBI group values represent the mean ± SEM, n = 5. (C–D) Representative images of H&E and Nissl staining in the cortex at 14 days post-TBI.

Motor function recovery was estimated for 14 days after injury using the 21-point Garcia test. As shown in Figure 1B, the sham-operated group had an average score of 21, representing a normal motor function. The TBI+vitamin B12 group showed better functional recovery after 7 days. Additionally, H&E and Nissl staining were performed to assess the histological morphology in each group. As shown in Figure 1C, there was obvious severe cerebral cortex tissue loss in the TBI group relative to the sham group. Consistent with the Garcia scores, the vitamin B12-treated groups showed less tissue damage and neuronal apoptosis (Figure 1D), indicating that vitamin B12 reduced tissue damage, protected neurons in the cortex and ameliorated the pathological morphology of the lesion area after TBI in mice.

Vitamin B12 Alleviated Caspase12-Dependent Neuronal Apoptosis

To determine whether vitamin B12 treatment could decrease apoptosis in brain tissues, immunofluorescence staining was performed after TBI. As shown in Figure 2A, vitamin B12 treatment obviously reduced the amount of cleaved-caspase12 positive neurons relative to the TBI group. Meanwhile, western blot results indicated that the vitamin B12-treated groups showed reduced levels of cleaved-caspase12 expression relative to their untreated counterparts in Figure 2B,C. Moreover, TUNEL staining was performed on 7 days after injury to further verify the anti-apoptotic effect of vitamin B12. As shown in Figure 2D,E, significantly increased number of apoptotic cells was found in the TBI group relative to the sham group. In comparison, vitamin B12 treatment greatly reversed TBI-induced apoptosis. Therefore, these findings demonstrated that vitamin B12 attenuated TBI-induced neuronal cell apoptosis.

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FIGURE 2

Vitamin B12 protects neurons from apoptosis. (A) Immunofluorescence staining of cleaved caspase-12 (green) in the cortex at 7 days post-injury. Scale bar = 50 μm. (B,C) The expression and quantification of cleaved caspase-12 proteins in the cortex in the 7 days post-injury. ##P < 0.01 vs. the sham group. ∗P < 0.05 and &P < 0.05 vs. the TBI group values represent the mean ± SEM, n = 5. (D,E) Representation and quantification of immunofluorescence staining of TUNEL (green) in the cortex at 7 days post-injury. ##P < 0.01 vs. the sham group. ∗P < 0.05 and &P < 0.05 vs. the TBI group values represent the mean ± SEM, n = 5. Scale bar = 100 μm.

1 Vitamin Like Chemical to Heal Neuropathy & Nerve Damage | Dr Alan Mandell, DC

Vitamin B12 Inhibited ER Stress Signaling Pathway

Under chronic ER stress, the associated apoptosis may contribute to pathophysiological processes involved in a number of prevalent diseases, including neurodegenerative diseases, diabetes, atherosclerosis and renal disease (Tabas and Ron, 2011). Hu et al. (Wu et al., 2018) reported that the ER-localized E3 ligase RNF183 triggered apoptosis in response to prolonged ER stress. Meanwhile, our previous study indicated that ER stress signaling induced neuronal apoptosis in spinal cord injury (He et al., 2017). To clarify the relationship between vitamin B12 and the regulation of ER stress, we detected ER stress signaling pathway proteins and the downstream apoptosis-related proteins by western blot and immunofluorescence staining. As shown in Figure 3A–F, the levels of ER stress-related proteins (GRP78, IRE1α, XBP-1, and CHOP) were significantly increased at 3 days and decreased after vitamin B12 treatment. Meanwhile, immunofluorescence staining revealed that the number of GRP78 positive cells was significantly increased in the TBI group, and vitamin B12 reversed this trend to a differing degree (Figure 3B). These findings suggested that vitamin B12 alleviated the level of ER stress.

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FIGURE 3

Vitamin B12 reduces the level of ER stress. (A) Representative western blots of the expression of IRE1α, GRP78, XBP-1, Chop. (B) Immunofluorescence staining of GRP78 (green) in the cortex at 7 days post-injury. Scale bar = 100 μm. (C–F) Quantification from (A) ##P < 0.01 vs. the sham group. ∗P < 0.05, &P < 0.05, and &&P < 0.01 vs. the TBI group. ∗P < 0.05 vs. the indicated group. Values represent the mean ± SEM, n = 5.

Vitamin B12 Inhibited Microtubule Damage Through ER Stress After TBI

Numerous studies have indicated that vitamin B12 has neuroprotective effects on TBI (Sun et al., 2012; Chen et al., 2015). We hypothesized that vitamin B12 may play a neuroprotective role by maintaining microtubule stability. We detected the expressions of MAP-2 and Tau, promote axon microtubulin bundling and dynamics and stabilize microtubule. As shown in Figure 4A–C, the expressions of MAP-2 and Tau decreased after injury, and the Tau expression was significantly higher in the vitamin B12-treated group relative to the TBI group after 7 days. Interestingly, only the 1.5 mg/kg dose of vitamin B12 reversed the loss of MAP-2. Then we examined MAP-2 expression by immunofluorescence. The results revealed that the MAP-2-positive neurons in the TBI group were significantly disorganized 7 days after injury. However, the vitamin B12-treated groups showed good neurological morphology, which was similar to the morphology observed in the sham group relative to the TBI group (Figure 4D). In addition, this result was further confirmed by immunofluorescence in PC12 cells with OGD, as shown in Figure 4E. The Ace-tubulin and Tyr-tubulin proteins were detected to examine stable microtubules and dynamic microtubules, respectively. The results showed that the Ace-tubulin/Tyr-tubulin ratio after vitamin B12 treatment was increased relative to the OGD treatment group. Taken together, vitamin B12 exerted microtubule stabilizing effect.

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FIGURE 4

Vitamin B12 inhibits microtubule damage through ER stress after TBI. (A) Representative western blots of the expression of MAP-2, Tau. (B,C) Quantification from (A) ##P < 0.01, #P < 0.05 vs. the sham group. ∗P < 0.05, &&P < 0.01 vs. the TBI group. ∗∗P < 0.01 vs. the indicated group. Values represent the mean ± SEM, n = 5. (D) Representative fluorescent images depicting MAP-2 (green) with NeuN (red) in the cortex after TBI. Scale bar = 50 μm, scale bar = 10 μm. (E) Representative fluorescent images depicting Ace-tubulin (green) with Tyr-tubulin (red) in the PC 12 cells. Scale bar = 20 μm. (F) Representative western blots of the expression of IRE1α, GRP78, XBP-1, Chop, Cleaved-cas12. (G–K) Quantification from (F) ∗P < 0.05, ∗∗P < 0.01, and ∗∗∗P < 0.001 vs. the indicated group. Values represent the mean ± SEM, n = 4. (L) Representative western blots of the expression of MAP – 2, Ace-tubulin. (M,N) Quantification from (L). ∗P < 0.05 vs. the indicated group. Values represent the mean ± SEM, n = 4. (O) Representative fluorescent images depicting Ace-tubulin (green) with Tyr-tubulin (red) in the PC 12 cells. Scale bar = 20 μm. (P). Representative fluorescent images depicting MAP-2 (green) in vivo. Scale bar = 50 μm.

We next explored the relationship between vitamin B12 protection and ER stress by using 4-PBA, which is the most commonly used ER stress inhibitor. As shown in Figure 4F–K, ER stress-induced apoptosis signaling pathway levels were substantially down-regulated in the vitamin B12 and 4-PBA co-treatment group relative to the vitamin B12 group. Meanwhile, microtubule stabilization protein expressions (MAP-2 and Ace-tubulin) were significantly increased in the co-treatment group relative to the vitamin B12 group, which indicated that vitamin B12-mediated protection was most likely achieved by inhibiting ER stress (Figure 4L–N). Next, we used immunofluorescence to detect Ace-tubulin and Tyr-tubulin in PC12 cells in vitro and MAP-2 in vivo. The results showed that the Ace-tubulin/Try-tubulin ratio in the vitamin B12+4-PBA group was increased relative to the vitamin B12 group, which was consistent with MAP-2 in mice (Figure 4O,P). Taken together, these results suggested that vitamin B12 was able to stabilize microtubules by reducing ER stress level.

Vitamin B12 Promoted Myelin Regeneration by ER Stress After TBI

Myelin regeneration is a key factor in sensory and motor function recovery after brain injury (Cantuti-Castelvetri et al., 2018). We explored the effect of vitamin B12 on re-myelination by LFB staining. Histopathology with LFB staining revealed that the TBI group showed white matter lesions in the corpus callosum relative to the sham group (Figure 5A). Vacuolar changes and microtubule loss from the myelin sheath were also observed in the TBI group. The vitamin B12 treatments reduced the degree of myelin sheath destruction, and 1.5 mg/kg dose of vitamin B12 showed slightly better effects than the 0.5 mg/kg dose. Next, MBP, which is constituents of the myelin sheath was detected by western blot and immunohistochemistry. As shown in Figure 5B–D, MBP protein expression was significantly decreased after TBI, but increased by vitamin B12; there was no statistical significance between the two groups receiving different vitamin B12 concentrations. Taken together, these results revealed that vitamin B12 promoted myelin regeneration after TBI. We next explored whether ER stress was involved in the protective effect of vitamin B12 on remyelination. LFB staining revealed that the myelin sheath in the corpus callosum was clear, and the microtubules in the axons were tightly arranged in the vitamin B12+4-PBA group relative to vitamin B12 treatment group (Figure 5E). Moreover, the expression of MBP was consistent with the LFB staining. As shown in Figure 5F,G, the expression of MBP was significantly increased in the co-treatment group relative to the vitamin B12 treatment groups. Meanwhile, immunohistochemistry results showed that the vitamin B12+4-PBA group presented tighter and more continuous MBP positive myelin relative to that in the vitamin B12 groups (Figure 5H). All these results indicated that the vitamin B12 enhanced re-myelination by inhibiting ER Stress.

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FIGURE 5

Vitamin B12 protects against myelin damage after TBI through ER Stress. (A) Representative images of white matter with LFB staining images of the myelin sheath at 14 days. Scale bar = 1000 μm, Scale bar = 250 μm. (B,C) Protein expressions and quantification data of MBP in each group. ##P < 0.01 vs. the sham group, ∗∗P < 0.01 and &&P < 0.01 vs. the TBI group. Values represent the mean ± SEM, n = 4. (D) Immuno-histochemisty staining of MBP in each group. (E) Representative images of white matter with LFB staining images of the myelin sheath at 14 days. Scale bar = 1000 μm, Scale bar = 250 μm. (F,G) Protein expressions and quantification data of MBP in each group. ∗P < 0.05 vs. the indicated group values represent the mean ± SEM, n = 4. (H) Immuno-histochemisty staining of MBP in each group.

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Discussion

Increased understanding of neuroprotection in TBI has helped to establish the concept of promoting nerve cell function recovery to potentially improve functional recovery (Wieloch and Nikolich, 2006; Loane and Faden, 2010). Numerous studies have reported that microtubule stabilization and remyelination play pivotal roles in several CNS diseases (Sengottuvel and Fischer, 2011; Abu-Rub and Miller, 2018; Li et al., 2018). There is a consistent evidence that vitamin B12 promotes the synthesis of neurotrophic factors, which in turn support neurite outgrowth and survival (Okada et al., 2010). However, whether vitamin B12 can alleviate the damage caused by brain trauma is still unclear. To assess this possibility, vitamin B12 was administered intraperitoneally immediately following TBI. And the results showed that vitamin B12 was able to promote nerve repair after TBI.

The ER is the main organelle responsible for protein folding, lipid biosynthesis and Ca2+ storage (Tsai and Weissman, 2010). Increased ER stress may be a self-protective signal transcription pathway after mild injury (Xie et al., 2016), In contrast, excessive ER stress triggers extensive neuronal death via CHOP activation. CHOP is the downstream of ER stress-induced apoptosis. The cytoplasmic calcium-activated calpain cleaves and activates caspase-12 in response to ER-released calcium (Hood et al., 2018; Tan et al., 2018). It has been confirmed that, ER stress is also involved in TBI (Hood et al., 2018). Vitamin B12 has been currently used to treat peripheral nerve damage in the clinic (Hobbenaghi et al., 2013). In this study, we found that the ER stress was involved in the process of vitamin B12 treating TBI (Figure 3). As showed in Figure 3A, IRE1α, GRP78, XBP-1 and CHOP were increased significantly after TBI injury, and reversed following the 3-day treatment of vitamin B12. Meanwhile, vitamin B12 alleviated ER stress-induced apoptosis. Taken together, ER stress plays an important role in neuronal apoptosis induction after TBI, and vitamin B12 inhibits neuronal death by down-regulating ER stress.

A growing number of studies has reported that microtubule stabilization might play a pivotal role in axon regeneration in several CNS diseases (O’Donovan, 2016; Abu-Rub and Miller, 2018; Chuckowree et al., 2018). In an injured brain, microtubules are vulnerable to misalignment and dissolution in neurons. And microtubules also implicate in the injury-induced glial responses and adaptive neuroplasticity in the aftermath of injury (Chuckowree et al., 2018). Tau protein is involved in regulating axonal microtubule assembly and disassembly. It has been reported that the plasma phospho-tau levels and phospho tau/total tau ratio during the acute phase and chronic TBI were superior to total/tau levels as discriminating indices for the severity and status of neurotrauma patients from healthy controls (Rubenstein et al., 2017). This study also demonstrated that the vitamin B12 could maintain the stability of the microtubule after TBI. As shown in Figure 4, vitamin B12 exerted microtubule-stabilizing effect in vitro and in vivo. Meanwhile, the high dose (1.5 mg/kg) of vitamin B12 treatment showed better effectiveness than the 0.5 mg/kg dose in TBI mice. In addition, the combination therapy with the ER stress inhibitor 4-PBA partially strengthened the neuro-protective effect of vitamin B12. However, whether vitamin B12 directly inhibits the ER stress signaling pathway requires further investigation.

CNS injury-induced growth cone collapse and retraction of the axonal cytoskeleton are closely related to growth inhibitory molecules associated with myelin (Stassart et al., 2018). The myelinating cells surrounding axons not only accelerate the propagation of electrical impulses, but also provide metabolic support for axons and refine neural circuits (Figlia et al., 2017). Myelin has a significant role in the progression of white matter pathology after TBI and in the potential for plasticity and subsequent recovery (Armstrong et al., 2016). Besides, myelin is an active form of vitamin B12, and the MeCbl plays an essential role in the synthesis and maintenance of myelin (Gröber et al., 2013). Vitamin B12 accelerates Schwann cells differentiation by suppressing Erk1/2 activities (Nishimoto et al., 2015). In addition, vitamin B12 has been reported to promote the remyelination in focal demyelination rat (Nishimoto et al., 2015). Thus, we evaluated the effect of vitamin B12 on remyelination after TBI. These data suggested that vitamin B12 increased the level of MBP, which plays vital roles in the myelination process and the appropriate formation of myelin thickness and compactness. Meanwhile, LFB staining showed that vitamin B12 restored myelin by reducing the vacuolar changes in the myelin sheath after TBI. We also used the ER stress inhibitor 4-PBA to assess the role of ER stress in remyelination. The results showed that ER stress was involved in the treatment of TBI induced myelin damage by vitamin B12. Therefore, we can conclude that the vitamin B12 enhance the survival of the nerve cell in the TBI mouse by inhibiting ER stress. In our further study, we will investigate the effects of vitamin B12 on glial cells and the relationship between membrane-associated proteins and autophagy signals, ultimately meeting the goal of deeper understand of the treatment mechanism of vitamin B12 in TBI.

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Ethics Statement

The care and use of all animals were approved by the Ethics Committee of Wenzhou Medical University and conformed to the guidelines set forth by the Chinese National Institutes of Health.

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Author Contributions

AH and DC conceived and designed the experiments. FW, KX, LL, MZ, and CT performed the experiments, analyzed data and wrote or revised the manuscript. KZ, LX, HT, YH, and YX provided assistance with experiments. HZ was responsible for experiment supplementation and manuscript modification. All the above authors discussed the results and approved the manuscript submission.

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Conflict of Interest Statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

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Footnotes

Funding. This work was supported by research grants from the National Natural Science Foundation of China (81802251, 80217111), and Zhejiang Provincial Natural Science Foundation of China under grant nos. LQ18H150003 and LY19H150001.

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Can damaged nerves heal?

Your doctor will review your medical history, ask about any accidents or previous surgeries, and discuss your symptoms with you. Your doctor will also conduct a physical and neurological examination. If your neurological examination shows signs of a nerve injury, your doctor may recommend diagnostic tests, which may include:

How to Get Rid of a Pinched Nerve

Electromyography (EMG). In an EMG, a thin-needle electrode inserted into your muscle records your muscle's electrical activity at rest and in motion. Reduced muscle activity can indicate nerve injury.

Nerve conduction study. Electrodes placed at two different points in your body measure how well electrical signals pass through the nerves.

Magnetic resonance imaging (MRI). MRI uses a magnetic field and radio waves to produce detailed images of the area affected by nerve damage.

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Our caring team of Mayo Clinic experts can help you with your peripheral nerve injuries-related health concerns

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Treatment

If a nerve is injured but not cut, your injury is more likely to heal. Injuries in which the nerve has been completely severed are very difficult to treat and recovery may not be possible.

Your doctor will determine your treatment based on the extent and cause of your injury and how well the nerve is healing.

If your nerve is healing properly, you may not need surgery. You may need to rest the affected area until it's healed. Nerves recover slowly and maximal recovery may take many months or several years.

You'll need regular checkups to make sure your recovery stays on track.

If your injury is caused by a medical condition, your doctor will treat the underlying condition.

Depending on the type and severity of your nerve injury, you may need medications such as aspirin or ibuprofen (Advil, Motrin IB, others) to relieve your pain. Medications used to treat depression, seizures or insomnia may be used to relieve nerve pain. In some cases, you may need corticosteroid injections for pain relief.

Your doctor may recommend physical therapy to prevent stiffness and restore function.

Surgery

A nerve graft from the lower leg

Peripheral nerve graftOpen pop-up dialog boxNerve transfer

Nerve transferOpen pop-up dialog box

If your injury does not seem to be healing properly, your surgeon can use EMG testing in the operating room to assess whether scarred nerves are recovering. Doing an EMG test directly on the nerve is more accurate and reliable than doing the test over the skin.

Sometimes a nerve sits inside a tight space (similar to a tunnel) or is squeezed by scarring. In these cases, your surgeon may enlarge the tight space or free the nerve from the scar.

Sometimes a section of a nerve is cut completely or damaged beyond repair. Your surgeon can remove the damaged section and reconnect healthy nerve ends (nerve repair) or implant a piece of nerve from another part of your body (nerve graft). These procedures can help your nerves to regrow.

If you have a particularly severe nerve injury, your doctor may suggest surgery to restore function to critical muscles by transferring tendons from one muscle to another.

Restoring function

A number of treatments can help restore function to the affected muscles.

Braces or splints. These devices keep the affected limb, fingers, hand or foot in the proper position to improve muscle function.

Electrical stimulator. Stimulators can activate muscle served by an injured nerve while the nerve regrows. However, this treatment may not be effective for everyone. Your doctor will discuss electrical stimulation with you if it's an option.

Physical therapy. Therapy involves specific movements or exercises to keep your affected muscles and joints active. Physical therapy can prevent stiffness and help restore function and feeling.

Exercise. Exercise can help improve your muscle strength, maintain your range of motion and reduce muscle cramps.

Clinical trials

Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this condition.

Preparing for your appointment

A number of tests may be used to help diagnose the type and severity of peripheral nerve injuries. When you make your appointment, be sure to ask whether you need to prepare for these tests. For instance, you may need to stop taking certain medications for a few days or avoid using lotions the day of the test.

If possible, take along a family member or friend. Sometimes it can be difficult to absorb all the information you're given during an appointment. Someone who accompanies you may remember something that you forgot or missed.

Other suggestions for getting the most from your appointment include:

Write down all your symptoms, including how you were injured, how long you've had your symptoms and whether they've gotten worse over time.

Make a list of all medications, vitamins and supplements that you're taking.

Don't hesitate to ask questions. Children and adults with peripheral nerve injuries have several options for restoring lost function. Be sure to ask your doctor about all the possibilities available to you or your child. If you run out of time, ask to speak with a nurse or have your doctor call you later.

How long do damaged nerves take to heal?

Nerves and Nerve injury

Your nerves transmit sensory (feelings of touch, pressure or temperature) and motor (movement of muscles) impulses to and from your brain. Damage to nerves may result in reduction or a complete loss of sensation, weakness and dry skin.

When one of your nerves is cut or damaged, it will try to repair itself. The nerve fibres (axons) shrink back and ‘rest’ for about a month; then they begin to grow again. Axons will regenerate about 1mm per day. The extent to which your nerve will recover is variable, and it will always be incomplete. Recovery is improved if the cut nerve ends are brought together and repaired surgically.

If your nerve ends are not brought together, the nerve fibres still attempt to grow and find the other end. However, often the result is a lump of nerve ends (a neuroma) that is tender to knocks or pressure and in some cases can be uncomfortable all the time.

 

How long does my nerve take to regenerate?

Regeneration time depends on how seriously your nerve was injured and the type of injury that you sustained. If your nerve is bruised or traumatized but is not cut, it should recover over 6-12 weeks. A nerve that is cut will grow at 1mm per day, after about a 4 week period of ‘rest’ following your injury. Some people notice continued improvement over many months.

Sensory nerves are more resilient than motor nerves and can recover sensation months or years after injury.

Motor nerves have a time limit for healing. The reason for this is a structure called the ‘motor endplate’, where the nerve joins into the muscle. If the motor endplate receives no nerve impulse for more than 18-24 months, it dies away and there is no longer any way that the muscle can be activated by the nerve. The muscle then whithers away. Thus surgical repair of motor nerves needs to happen within 12-18 months of the injury.

Before sensation returns to the injured area, your limb is at risk of damage as it has no protective sensation. Please be careful of your hands or feet, especially around hot or sharp objects. Similarly, before the motor nerves recover your hand or limb may not be able to move normally or may develop abnormal postures. Hand therapy or physiotherapy will allow movement to be maintained while the nerve cells regenerate.

 

How do I know the nerve is recovering?

As your nerve recovers, the area the nerve supplies may feel quite unpleasant and tingly. This may be accompanied by an electric shock sensation at the level of the growing nerve fibres; the location of this sensation should move as the nerve heals and grows. Over time, these feelings subside and the area should begin to feel more normal.

 

Will my nerve recover completely following surgery?

Unfortunately, nerves never recover completely after they have been cut. The degree of your nerve’s recovery depends on a number of factors:

Age: As with many other things in life, your body becomes less efficient at healing itself as it grows older.

Mechanism of injury: Nerve damage from a cut has better chances of healing than damage from a crush.

The time since the injury: The quicker your nerve heals, the better it will recover.

The mechanism of repair: direct repair is best. Refer to surgical nerve repair options below.

The type of nerve: Sensory nerves heal better than motor nerves.

Associated injuries and whether there is tension across the repair. Sometimes the recovering nerve may be trapped within scar tissue. Recovery is significantly reduced if this happens.

 

Options for nerve repair and nerve surgery

Immediate nerve repair

Direct nerve repair

I use a microscope or magnifying glasses (loupes) to repair your cut nerve with sutures finer than a human hair. This type of nerve repair surgery has the best recovery rates. Whether or not I can perform direct nerve repair on your injured limb depends on the injury your nerve has suffered.

Nerve grafting

Sometimes I cannot directly repair your nerve ends, for example, if there is a piece of nerve missing or a delay in repair.

With nerve grafting, I take a length of nerve from somewhere else in your body and place it as a graft. I perform this repair using a microscope, too. You will have a scar from the surgery and often a numb patch in the area I took the nerve graft from.

Possible donor nerves include sensory nerves of skin of the forearm and leg. Having a numb patch on the side of your arm or foot is usually less bother than having a numb area on your hand.

As with all procedures I perform, we will have an in-depth consultation about all aspects of the surgery and recovery, including possible donor nerves, risks etc.

 

Later nerve surgery

Nerve Freeing (Neurolysis)

The nerve may have been repaired, and some recovery of function may have occurred, however scar tissue around the nerve causes tethering and discomfort when you move your hand. The scar tissue can also limit nerve cell regeneration. I can surgically release the scar tissue from around the nerve.

Nerve grafting

Your nerve may fail to recover due to a neuroma (link to the top of the page), or there is a persistent gap in the nerve. During the procedure, I cut back your nerve ends until I can see healthy ends, and I place a piece of nerve graft to facilitate normal re-growth of your nerve. The function (sensation and power) of your nerve is initially worse and then should gradually improve – it will be like beginning recovery all over again. Unfortunately, your hand’s function will never return to normal but should be improved with nerve grafting. The pain and discomfort you feel at the site of injury improves as recovery progresses.

Nerve wrapping

Sometimes a nerve is persistently tender. This is usually due to a neuroma. Wrapping a vein, fat or another substance around your nerve provides padding around the nerve and will make the area less sensitive.

Nerve burying

After a nerve is injured, sometimes painful neuromas develop in smaller nerves of your hand. They are usually in locations that are not suitable for nerve repair such as amputated fingers. I can cut away the neuroma and bury the nerve end deep in a muscle or bone. This prevents the nerve end from being knocked and should reduce the electric shock like pain. The area that the nerve supplied will be completely numb, and this is permanent.

 

Possible complications after nerve repair and nerve surgery

Minimal or no improvement

Improvements of your symptoms may be minimal, or there may be no improvement at all.

Bleeding

This occasionally requires a return to theatre.

Infection

You will be given antibiotics at the beginning of your procedure and occasionally after your operation. Antibiotic use is carefully monitored to reduce antibiotic resistance. The signs of infection to look out for include increasing redness, swelling, pain and purulent discharge. Most wound infections will respond quickly to antibiotics. Very occasionally further surgery may be required to clean out a deeper infection. Infection can lead to delayed recovery and increased stiffness.

Delayed wound healing

This may require dressings from the district nurses.

Scarring

Can be improved with massage and moisturizing cream.

Stiffness

I may ask you see an expert hand therapist to provide you with a splint and complete a personalised regime of exercises to reduce stiffness. Please read more about the hand therapists that I work with.

Complex regional pain syndrome

Some people have hands that are very sensitive to surgery or trauma and become very painful, stiff and swollen following surgery. This is treated with special kinds of pain relief and physiotherapy. Read more about Complex Regional Pain Syndrome.

Complications specific to nerve grafting

You will be left with a scar and a numb area on your arm or leg where the donor nerve was taken from. In rare cases, a painful lump at the site of the donor nerve may develop requires further surgery. Please read more about Complications following Hand Surgery.

What medicine is good for nerve pain?

Treatment

-Peripheral neuropathy

Contents

Overview

Symptoms

Causes

Diagnosis

Treatment

Complications

Treatment for peripheral neuropathy may include treating any underlying cause or symptoms.

Treatment may be more successful for certain underlying causes. For example, ensuring diabetes is well controlled may help improve neuropathy, or at least stop it getting worse.

Treating the underlying cause

There are many different causes of peripheral neuropathy, some of which can be treated in different ways.

For example:

diabetes can sometimes be controlled by lifestyle changes, such as stopping smoking, cutting down on alcohol, maintaining a healthy weight and exercising regularly

vitamin B12 deficiency can be treated with B12 injections or tablets

peripheral neuropathy caused by a medicine you're taking may improve if the medicine is stopped

Some less common types of peripheral neuropathy may be treated with medicines, such as:

steroids – powerful anti-inflammatory medicines

immunosuppressants – medicines that reduce the activity of the immune system

injections of immunoglobulin – a mixture of blood proteins called antibodies made by the immune system

But the underlying cause may not always be treatable.

Four Favorite Exercises for Pinched Nerve and Lower Back Pain

Relieving nerve pain

You may also require medicine to treat any nerve pain (neuropathic pain) you're experiencing.

Unlike most other types of pain, neuropathic pain does not usually get better with common painkillers, such as paracetamol and ibuprofen, and other medicines are often used.

These should usually be started at the minimum dose, with the dose gradually increased until you notice an effect.

Higher doses may be better at managing the pain, but are also more likely to cause side effects.

The most common side effects are tiredness, dizziness or feeling "drunk". If you get these, it may be necessary to reduce your dose.

Do not drive or operate machinery if you experience drowsiness or blurred vision. You also may become more sensitive to the effects of alcohol.

The side effects should improve after a week or two as your body gets used to the medicine.

But if your side effects continue, tell your GP as it may be possible to change to a different medicine that suits you better.

Even if the first medicine tried does not help, others may.

Many of these medicines may also be used for treating other health conditions, such as depression, epilepsy, anxiety or headaches.

If you're given an antidepressant, this may treat pain even if you're not depressed. This does not mean your doctor suspects you're depressed.

The main medicines recommended for neuropathic pain include:

amitriptyline – also used for treatment of headaches and depression

duloxetine – also used for treatment of bladder problems and depression

pregabalin and gabapentin – also used to treat epilepsy, headaches or anxiety

There are also some additional medicines that you can take to relieve pain in a specific area of your body or to relieve particularly severe pain for short periods.

Capsaicin cream

If your pain is confined to a particular area of your body, you may benefit from using capsaicin cream.

Capsaicin is the substance that makes chilli peppers hot and is thought to work in neuropathic pain by stopping the nerves sending pain messages to the brain.

Rub a pea-sized amount of capsaicin cream on the painful area of skin 3 or 4 times a day.

Side effects of capsaicin cream can include skin irritation and a burning sensation in the treated area at the start of treatment.

Do not use capsaicin cream on broken or inflamed skin, and always wash your hands after applying it.

Tramadol

Tramadol is a powerful painkiller related to morphine that can be used to treat neuropathic pain that does not respond to other treatments your GP can prescribe.

Like all opioids, tramadol can be addictive if it's taken for a long time. It'll usually only be prescribed for a short time.

Tramadol can be useful to take at times when your pain is worse.

Common side effects of tramadol include:

feeling sick or vomiting

dizziness

constipation

Treating other symptoms

In addition to treating pain, you may also require treatment to help you manage other symptoms.

For example, if you have muscle weakness, you may need physiotherapy to learn exercises to improve your muscle strength.

You may also need to wear splints to support weak ankles or use walking aids to help you get around.

Other problems associated with peripheral neuropathy may be treatable with medicines.

For example:

erectile dysfunction

constipation

the slow movement of food through your stomach (gastroparesis)

In some cases, you may need more invasive treatment, such as:

botulinum toxin injections for hyperhidrosis 

a urinary catheter if you have problems emptying your bladder

Alternative and complementary therapies

As peripheral neuropathy can be a very painful and troublesome problem that may only partly be relieved by standard treatments, you may be tempted to try other therapies.

These may include:

acupuncture

herbal medicine

benfotiamine (a form of vitamin B1) supplements

alpha-lipoic acid (an antioxidant) supplements

But while some people may find these helpful, the evidence for them is not always clear.

Speak to your doctor before trying these treatments in case they could interfere with your ongoing treatment.

What promotes nerve healing?

Peripheral nerve injury is a common complication in trauma, and regeneration and function recovery are clinical challenges. It is indispensable to find a suitable material to promote peripheral nerve regeneration due to the limited capacity of peripheral nerve regeneration, which is not an easy task to design a material with good biocompatibility, appropriate degradability. Magnesium has captured increasing attention during the past years as suitable materials. However, there are little types of research on magnesium promoting peripheral nerve regeneration. In this review, we conclude the possible mechanism of magnesium ion promoting peripheral nerve regeneration and the properties and application of different kinds of magnesium-based biomaterials, such as magnesium filaments, magnesium alloys, and others, in which we found some shortcomings and challenges. So, magnesium can promote peripheral nerve regeneration with both challenge and potential.

Magnesium and Peripheral Nerve Injury

Magnesium is the fourth abundant mineral ion in the human body. Magnesium is involved in more than 300 kinds of enzymatic reactions (Alawi et al., 2018) and various metabolic cycles, playing a significant role in cellular energy metabolism, synthesis of nucleic acid, protein, and cytokine, regulation of various transporters and ion channels, and plasma membrane integrity (Romani, 2011; de Baaij et al., 2015). Therefore, it is necessary to take magnesium regularly for preventing magnesium deficiency. Studies have shown that magnesium deficiency can induce inflammatory syndrome, which is characterised by macrophage activation and release of inflammatory cytokines and acute-phase proteins (Pan et al., 2011), closely related to a variety of chronic and inflammatory diseases such as asthma, attention deficit hyperactivity disorder, diabetes mellitus, cardiovascular disease, migraine headaches, and osteoporosis (Song et al., 2005; Gröber et al., 2015; Dominguez et al., 2020). What is more, magnesium is also essential for the survival and function of neurons: magnesium is involved in the formation of membrane phospholipids, signal transduction (Stangherlin and O’Neill, 2018), the formation of the myelin sheath (Seyama et al., 2018) and synapse (Sun et al., 2016), and regulating the transmission of neurotransmitters such as dopamine and serotonin (5-HT). Many studies have shown that magnesium can promote axons growth and neural stem cells proliferation (Vennemeyer et al., 2014; Sun et al., 2016), regulate the inflammatory response, and then inhibit apoptosis. Magnesium deficiency is closely related to diabetic peripheral neuropathy (DPN) (Dong et al., 2011; Hyassat et al., 2014; Chu et al., 2016; Zhang et al., 2018) and various neurodegenerative diseases such as Parkinson’s disease and Alzheimer’s disease (Oyanagi et al., 2006; Yamanaka et al., 2019). Therefore, magnesium plays an essential role in maintaining the health of the nervous system (Botturi et al., 2020).

Peripheral nerve injuries are usually caused by inflammation, tumours, and traumatic injuries, accounting for 3–10% systemic trauma (Lee et al., 2010). There are more than 300,000 cases of peripheral nerve injury worldwide every year (Siemionow and Brzezicki, 2009). Severe peripheral nerve injury can lead to lifelong dysfunction mediated by the injured nerve, high disability rate and cost, which greatly impact individuals and society. After peripheral nerve injury, the injured neurons undergo secondary oxidative stress response and degeneration, leading to the production of inflammatory cytokines such as IL-1, IL-6, TNF-α, and IFN-β, which promote the Wallerian degeneration and apoptosis of Schwann cells (SCs) (Pan et al., 2011). After that, degeneration occurs in the axons and myelin sheath at the distal stump of the injured nerve, causing secondary nerve damage, thus inhibiting the regeneration of the injured nerve and suppressing the recovery of nerve function (Pan et al., 2011; Allodi et al., 2012). After peripheral nerve injury, macrophages and SCs clear the remaining axons and myelin fragments. The proliferated SCs arrange into bundles surrounded by the basement membrane and secret a series of neurotrophic factors and cell adhesion molecules (Belanger et al., 2016). Thus, the axons of the proximal end grow to the distal end of the injury. Unfortunately, in most peripheral nerve injuries, the broken ends are far apart, and the long recovery time can easily lead to irreversible degenerative lesions in the innervated muscles. Therefore, it is almost impossible to achieve complete recovery after peripheral nerve injury without external intervention to guide and accelerate axonal regeneration (Pfister et al., 2011).

At present, many strategies have been adopted for peripheral nerve injury repair, and autografts are considered to be the “gold standard” clinically. At the same time, there are some insurmountable limitations of autologous nerve graft, such as the risk of donor site lesion, the limited supply and limited therapeutic effect, the risk of pathological changes in the donor site, the limited source of donor nerve and the limited therapeutic effect (Vennemeyer et al., 2015). To replace autografts, nerve conduits made of biomaterials have become a new choice. An ideal nerve conduit should provide mechanical guidance and a suitable microenvironment for nerve axon regeneration and also protect the regenerated nerve. The materials used for nerve conduits mainly include extracellular matrix, natural polysaccharides/proteins, and synthetic polymers (Fei et al., 2017). Studies have shown that they have the same effect as autografts on peripheral nerve repair (Jang et al., 2016). However, due to the lack of mechanical, their ability to repair long gap injuries beyond 20 mm is limited. Therefore, there is an urgent need for advanced materials to reach an ideal nerve repair. Based on the protective effect of magnesium on the nervous system, magnesium begins to be used in the treatment of peripheral nerve injury in recent years, and related research has developed rapidly. In this review, we are aiming at providing an overview of magnesium in promoting peripheral nerve regeneration.

The Effect and Mechanism of Magnesium ion on Peripheral Nerve Regeneration

Magnesium ion is one of the necessary ions for cell metabolism. It is abundant in cells and participates in hundreds of enzyme reactions in the body. In the local microenvironment, magnesium ion has been proved to regulate mitochondrial calcium buffering as the second messenger, also with the effects of anti-apoptosis, anti-oxidation and anti-inflammatory, which is also of great significance for nerve impulse conduction. At present, most of the studies on the nervous system of magnesium ion focus on craniocerebral injury and spinal cord injury (Vennemeyer et al., 2014; Li W. et al., 2015; Jia et al., 2016), while only a few studies focused on peripheral nerve injury. According to the existing studies, the potential mechanism of magnesium ion in peripheral nerve injury repair can be summarised as the following aspects:

Nerve Protection

The protective effect of magnesium ions on the central nervous system has been studied. Clinically, magnesium sulfate has been used to prevent cerebral palsy in preterm infants. Wolf et al. (2020) has revealed that in the case of imminent preterm birth, prenatal treatment with magnesium sulfate during 24–32 weeks of gestation reduced the risk of moderate to severe cerebral palsy and had a neuroprotective effect. In addition, magnesium has been suggested to improve functional neurological outcomes in patients with global cerebral ischemia associated with cardiac surgery and cardiac arrest (Pearce et al., 2017). Identically magnesium also exerts neuroprotective effects on peripheral nerves.

It is generally believed that magnesium ions can play a neuroprotective role by inhibiting the secondary injury after nerve injury through regulating cell function, antagonizing of N-methyl-D-aspartic acid receptor (NMDA receptor) and calcium ions (Koltka et al., 2011). In addition to the degeneration of the damaged nerve stump, the uninjured nerve might also suffer from degeneration. Under the stress state, the magnesium ion level decreases. Then the calcium ion channel opens massively, and the calcium ion flows inside, leading to cell swelling and apoptosis. Thus, a supplementary magnesium ion can block the ion channel of NMDA receptor through the action of electric charge, thereby inhibiting the entry of calcium ion into cells and antagonizing the changes in cell permeability caused by injury and the neurotoxic effect of calcium ion (Jia et al., 2016).

Lambuk et al. (2017) found that the excitatory toxicity of glutamate plays a crucial role in the loss of retinal ganglion cells (RGCs) in glaucoma. The toxic effect of glutamate on RGCs was mediated by overstimulation of NMDA receptors. At the same time, intravitreal injection of magnesium Acetyltaurate (MgAT) could prevent NMDA-induced retinal and optic nerve damage (Lambuk et al., 2017).

Inhibition of Inflammatory Response

Inhibition of the inflammatory response promotes nerve regeneration by preventing SCs from apoptosis (Pan et al., 2009a,b,c), and magnesium supplements have also been reported to prevent motor neuron death in neonatal sciatic nerve injury (Nikolaos et al., 2004). Magnesium ion can promote peripheral nerve repair by inhibiting inflammation.

Pan et al. (2011) found that a high magnesium diet significantly increased magnesium concentrations in plasma and nerve tissue, which improved neurobehavioural and electrophysiological functions and reduced the deposition of inflammatory cells (such as macrophages) and inflammatory cytokines expression. High magnesium supplementation inhibits the expression of MCP-1 and RANES, thereby inhibiting macrophage deposition and myelin clearance (Pan et al., 2009c). Meanwhile, macrophages are a principal source of many inflammatory factors. However, it should be noted that the low magnesium environment might exert an opposite effect of enhancing inflammation in the damaged nerves compared with high concentration. Meanwhile, Pan et al. (2011) also found that high magnesium supplementation could reduce the apoptosis of SCs by promoting the expression of bcl-2 and bcl-XL and then down-regulating active caspase-3 and cytochrome expression.

Plenty of evidence demonstrates that magnesium ion is closely related to inflammation. Magnesium has been shown to inhibit activated macrophage-induced inflammation and thus promote the differentiation of mesenchymal stem cells (Hu et al., 2018). In addition, magnesium deficiency leads to significant increases in pro-inflammatory cytokines such as tumour necrosis factor-α, IL-1, and IL-6 (Nielsen, 2018). Arfuzir et al. (2020) observed that pre-treatment with MgAT prevented endothelin-1-induced IL-1β, IL-6, and tumour necrosis factor-α(TNF alpha) expression increasing, and also protected rats from endothelin-1-induced activation of nuclear factor κB (NF-κB) and c-Jun.

However, the underlying mechanisms of magnesium deficiency causing inflammatory response are not fully understood. Possible mechanisms include: (1) Cell entry of calcium and initiation of phagocytes; (2) Calcium channel opening and NMDA receptor activation; (3) Release of neurotransmitters such as substance P; (4) Membrane oxidation and activation of NF-κB.

Promote Schwann Cell Proliferation and Axon Regeneration

Schwann cells are neuro-gliocytes that constitute the peripheral nervous system. It not only participates in the formation of the myelin sheath but also maintains the growth environment of the axons through its rapid proliferation, division and secretion of various protein molecules after peripheral nerve injury and also promotes the self-repair and regeneration of nerves.

After peripheral nerve injury, SCs secrete large amounts of endogenous neurotrophic factor (NTF), including nerve growth factor (Guo et al., 2018). NGF plays a promoting role in the repair and regeneration of injured peripheral nerves (Shen et al., 2020), which can induce the growth of neuronal processes, prevent neuron degeneration and apoptosis, and then promote the regeneration and repair of injured nerves. It has been reported that NGF acts on the growth of axon fibres rather than neurons themselves (Kumamoto et al., 2015), which proves that it is feasible to apply topical drugs to promote the regeneration of the nerve.

Appropriate concentrations of magnesium ions in the tissue microenvironment can promote SCs proliferation (Monfared et al., 2018a), as well as SCs synthesis and NGF secretion. Therefore, magnesium filaments play a role in promoting the regeneration of neuronal axons, which is manifested by an increase in the number of regenerated axons and the cross-section of regenerated myelinated nerve fibres (Li B. H. et al., 2016). However, the effect of magnesium ions on the promotion of SCs proliferation is not positively correlated with its concentration. Excessive magnesium ion concentration had been reported to inhibit SCs proliferation (Monfared et al., 2018a).

The Corrosion of Magnesium

The ideal degradation rate of magnesium should match the growth rate of nerve tissue, but in reality, the degradation rate of magnesium is faster than the growth rate of tissue, which fails to provide long-term physical support and play the biological function of promoting nerve regeneration (Kiani et al., 2020). In vivo, magnesium mainly undergoes electrochemical reaction, which is affected by the properties of the material itself and the local microenvironment such as pH and protein. Magnesium mainly undergoes pitting corrosion in vivo, which is more likely to lead to material fracture and is not conducive to nerve regeneration (Raman and Harandi, 2017).

The corrosion process of magnesium can be divided into the following two steps: (1) In electrolyte solution, magnesium acts as anode to occur galvanic cell reaction, losing electrons and generating Mg2+, while water gets electrons and generates H2 and OH–. Then Mg2+ reacts with OH– and forms Mg(OH)2, which is deposited on the surface of the material and has a certain protective effect on magnesium; (2) As time goes on, Mg(OH)2 reacts with Cl– in body fluid to form MgCl2 which is more soluble in water, resulting in Mg(OH)2 falling off and magnesium corrosion. In order to have a better application in magnesium promoting peripheral nerve regeneration, the improvement of material properties can provide enough support to maintain sufficient strength and be gradually degraded and absorbed by the human body (Table 1; Williams et al., 2015; Charyeva et al., 2016).

TABLE 1

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Table 1. The corrosion resistance improvement of Magnesium.

Magnesium in Promoting Peripheral Nerve Regeneration

Magnesium Metal

The structural and functional damage of the peripheral nerve could be caused by various factors. The current “gold standard” of clinical treatment of peripheral nerve repair replaces the injury gap with an autograft. However, given the limitations of autografts, including the risk of donor site lesion, the limited supply and therapeutic effect, nerve guide conduit has gradually become a more potential alternative (Vijayavenkataraman, 2020). However, due to the lack of mechanical support provided by the empty conduits for nerve regeneration, the empty conduits fail to induce satisfying axon regeneration when injury gaps are more than 1 cm in length (Kuffler and Foy, 2020). Therefore, magnesium metal with excellent biocompatibility and degradability can be used as scaffold material in nerve conduit to provide mechanical support and promote nerve regeneration.

Li B. H. et al. (2016) bridged the two ends of the injured nerve for acute sciatic nerve compression injury model with magnesium wire. The results demonstrated that sciatic functional index (SFI), NGF, p75 neurotrophin receptor and tyrosine receptor kinase A expression increased in the magnesium group after 4 weeks, which suggested that magnesium wire could provide linear support for nerve regeneration thus improving peripheral nerve regeneration across the injury gap. However, the repair effect varies with the different lengths of the injury gap. Hopkins et al. (2017) compared the effect of magnesium filaments used in short and long gaps. The results suggested that regenerating nerve cells and axons could be seen at the end of the nerve stumps in the short gap repair; While in the long gap repair, although functional improvement in the isografts group was not observed in empty conduits plus magnesium wire group, it still found that regenerating tissue associated with the nerve stumps, which proved that magnesium wire could improve histological indexes of regenerated tissues.

Besides, the degradation rate of magnesium filament will also be affected by the filler in the conduit. Vennemeyer et al. (2015) repaired a 6 mm gap of the adult rat sciatic nerve with magnesium filaments placed in poly(caprolactone) nerve conduits for 6 weeks. The results showed that magnesium filaments absorbed actively were surrounded by regenerating nerve tissue, and inflammation caused by magnesium implants was mild. However, there is no synergistic effect between magnesium wire and keratin, which probably was related to the accelerated corrosion of magnesium filaments caused by keratin hydrogel.

3 Key Nutrients to Repair Damaged Nerve Tissue (Pinched Nerve & Neuropathy) - Dr Alan Mandell, DC

In conclusion, magnesium metal is widely used for peripheral nerve repair due to the following advantages: (i) Magnesium metal is featured by rapid and complete degradation; (ii) Magnesium metal has good histocompatibility. While other biomaterials may lead to severe inflammation during absorption, magnesium metal has less tissue stimulation and does less damage to the regenerating nerve tissue; (iii) During degradation, soluble magnesium ions and hydrogen are released, which have neuroprotective and antioxidant effects; (iv) Compared with other metal materials, magnesium metal has better flexibility and smoother surface, which are conducive to the adhesion of SCs; (v) The electrical conductivity of magnesium metal may provide electrical stimulation path for the injured nerve and its dominated muscle, thus contributing to nerve regeneration (Gordon, 2016).

However, magnesium metal still faces many challenges in clinical application: (i) Magnesium metal is not strong enough or degrades too fast to provide enough mechanical support for nerve regeneration during the whole healing process; (ii) The rapid degradation of magnesium metal results in the accumulation of degradation products and then does harms to tissues. Soluble magnesium ions and hydrogen released will increase pH, thus interfering with nerve generation; (iii) Compressive stress can also affect the degradation rate of magnesium metal and even lead to the fracture of magnesium metal. Therefore, faced with these problems, the magnesium metal to be used in clinical treatment should be improved further to slow degradation rate, which can be achieved by alloying with other metals, altering the surface by anodization or physical treatment and coating with water-resistance substances like polymers (Bordbar-Khiabani et al., 2019).

Magnesium Alloy

As a new biodegradable bimetallic material, magnesium alloy has been widely studied and has a certain potential in applying nerve guidance conduit (NGC). Compared with pure magnesium, magnesium alloy has the following characteristics: (1) In addition to magnesium ion, other metal ions such as Li, Zn, and Ca can be released to facilitate nerve repair (Fei et al., 2017); (2) The degradation rate is more likely to adjust than pure magnesium; (3) Zinc, aluminium, manganese, calcium, lithium, zirconium, rare earth, and other elements are commonly used in magnesium alloys. The corrosion properties, mechanical properties and biocompatibility of magnesium alloys may can be adjusted by changing the composition of elements (Li X. et al., 2016). At the same time, degradation rate, mechanical properties and cytotoxicity may vary with the changing composition of the alloy.

Fei et al. (2017) chose three magnesium alloys with good mechanical alloys with good mechanical properties, namely NZ20 (Mg-Sn-Zn), ZN20 (Mg-2Zn-Nd), and Mg-10Li, to explore their performance. The degradation was found to be: ZN20 < NZ20 < Mg-10Li, and researchers found the potential and feasibility of Mg-10Li and ZN20 in nerve repair, and NZ20 has potential cytotoxicity. However, the experiment has several limitations. Instead of using SCs, which are involved in peripheral nerve regeneration, the researchers selected endothelial cells. At the same time, the experiment was limited to the short term, and the long-term effects of magnesium alloy on neurons are still unclear. Given the limited existing results, more experiments are still needed to explore the impact of composition of magnesium alloy. At the same time, the degradation rate of magnesium alloy and the release rate of magnesium ions still cannot meet the needs of long gap nerve repair. On the basis of this experiment, magnesium alloy shows noticeable potential, and may be promising in promoting regeneration of peripheral nerve. Potential improvement directions include (1) Surface modification, such as surface coating, ion implantation, laser surface melting, and surface nano-crystallization. (2) Structure design: phase structure, particle structure, and amorphous structure (Li X. et al., 2016).

Mg-Based Metallic Glasses

Metallic glasses, also known as an amorphous alloy or liquid metal, have attracted significant attention. The amorphous structure imparts higher strength, higher wear resistance and corrosion resistance, and good fatigue performance. Magnesium, calcium, zinc, and strontium-based glasses represent a class of biodegradable amorphous alloys. As for magnesium-based glass, many metallic glass systems have been successfully developed, among which the Mg-Zn-Ca metallic glass system possesses a high glass-forming ability and contains the necessary elements of Ca and Zn for the human body (Sun et al., 2012; Dambatta et al., 2015). At the same time, rapid degradation of magnesium is a challenge in long nerve repair. Long nerve distances are difficult to be fully regenerated. It is vital to reduce the corrosion rate and maintain integrity during regeneration. Metallic glass can be a potential substitute for crystalline alloys in neural tissue applications.

Monfared et al. (2018b) used a Mg-Zn-Ca metallic glass system prepared by melt spinning method to prepare relaxed alloys (magnesium-based glass) and crystallised alloys (ordinary alloys), with the main composition of Mg70Zn26Ca4. By impregnation method and potential polarisation method, the result indicates that the relaxed ribbon had higher corrosion resistance. Biocompatibility was studied by MTT assay. The survival rates of the relaxed ribbons and crystallised ribbons were above 75% after 1, 3, and 7 days, indicating their good biocompatibility with the potential for nerve regeneration. However, the cell viability of the relaxed ribbons was higher than that of the crystallised ribbons at all time points, which could be attributed to the fact that the crystallised ribbons had more degradation rate than the relaxed bands. Because the concentration of ions released by the glass system exceeds the optimal concentration, the crystal ribbon released more ions into the medium and exerted toxic effects on cells. The results showed that the corrosion resistance of the relaxed band was better than that of the crystalline band, and it had good cell compatibility with SCs.

Many experiments have demonstrated that the promoting effect of magnesium ion on peripheral nerve regeneration is not positively correlated with the concentration, but there is an optimal concentration. The release rate of magnesium ions in the magnesium-based glass system prepared in this experiment is still beyond the optimal concentration, suggesting that further improving the preparation process and optimising the performance will be the direction of future research.

Surface Modification of Magnesium and Its Alloys

Although magnesium alloy and Mg-based metallic glass can significantly improve the corrosion resistance of magnesium and slow down the degradation rate, the long-term neurotoxicity of zinc, calcium, and other ions released from magnesium alloys in vivo still needs to be considered, and its corrosion resistance also needs to be further improved. Therefore, the surface modification of magnesium and its alloys become the focus of research and application of peripheral nerve regeneration now.

Surface modification methods of magnesium and its alloys mainly includes conversion coating, anodization, micro-arc oxidation and others. In contrast, in terms of biomedical and neural application, the frequently used way of surface modification of magnesium and its alloys is polymer coating by electrospinning, electrochemical deposition, dip-coating, spray-coating, spin-coating, and other ways. Moreover, it will lead to differences in the coating performance if different coating ways are applied (Tian and Liu, 2015).

Poly (3,4-ethylenedioxythiophene) (PEDOT) is an ideal coating material with excellent conductivity and biocompatibility, which has been used in nerve implantation (Richardson-Burns et al., 2007; Krukiewicz et al., 2019). Many types of research have been performed on how the coating improves the properties. Sebaa et al. (2013) modified the Mg surface with PEDOT coating and explored its properties. The adhesion strength of the PEDOT coating was good, in the range of 3–4B measured by ASTM-D 3359 standard tape test. Moreover, the corrosion resistance enhanced with the PEDOT coating. Catt et al. (2017) found that a composite coating composed of PEDOT and graphene oxide (GO) (PEDOT/GO) could significantly enhance the corrosion resistance of Mg. PEDOT/GO coated Mg exhibited lower toxicity and higher biocompatibility. However, Sebaa et al. (2013) lacked the test on the biocompatibility of the PEDOT coated Mg, and they only inferred the role in promoting the peripheral nerve regeneration from the properties of PEDOT instead of measuring the role of the PEDOT coated Mg. Moreover, when Catt et al. (2017) carried out the cytotoxicity experiments, the neurons were cultured only lasted for one day, and the long-term toxicity of the coated Mg has not been clarified.

There are some other coatings to be studied. Monfared et al. (2018a) coated Mg70Zn26Ca4 ribbons (a Mg-based metallic glass) with tannic acid (TA)/poly(N-vinylpyrrolidone) (PVPON). They investigated the corrosion resistance, and biocompatibility was higher than the uncoated and significantly higher than pure Mg. What is more, SCs had an excellent initial attachment with typical morphology on the surface of coated ribbons in vitro.

Those studies did not evaluate its promotion effect in vivo. Hydroxyapatite (HA) coated magnesium alloy (WE43) in vitro improved the adhesion and proliferation of adrenal pheochromocytoma cells (PC12). However, those of SCs were not significantly improved, while in vivo, it showed controlled degradation and reduced gas production, but only a little regeneration of sciatic nerve tissue (Almansoori et al., 2018). This research is more convincing to evaluate the properties of HA-WE43 because of the experiments in vivo. However, the role in promoting peripheral nerve regeneration is still not good enough, which need to be further improved.

Through most of the above experiments, there was a lack of tests on whether the coated magnesium and its alloys could promote peripheral nerve regeneration, which indicates that it is not rigorous to infer the role of samples after coating based solely on the effect of the coating itself on the peripheral nerve regeneration. Moreover, most of the experiments have only been performed in vitro and lacked in vivo experiments. What is more, in those studies, the methods to study the properties of the coatings are relatively fragmentary and different, so it is also necessary to establish a more systematic and scientific evaluation system for the properties of the coating. Except for the homogeneity of the coating, more universal properties such as thickness, adhesion, electrical conductivity, degradability, and hydrophobicity should also be included. Strong and homogeneous adhesion is the basis for constructing metals with a stable coating and predicting their properties in vivo (Sebaa et al., 2013). Good electrical conductivity and suitable degradation rate are the basis for promoting peripheral nerve regeneration. Hydrophobicity plays a role in isolating Cl– in solution from metals for corrosion resistance (Conceicao et al., 2010). These universal properties are extremely crucial for the application of coated samples, while characteristic properties such as self-healing, negatively charged, and mediating the attachment of another kind of coating are also excellent ways to improve coatings. Self-healing means it can repair its surface coatings and extend the life of the coatings (Fan et al., 2015). Negatively charged itself hinders Cl– in solution from entering the metal surface for corrosion resistance (Prabakar et al., 2013). At the same time, whether the properties of the metals will change after coating also required to be investigated, such as the change of conductivity and the ability to promote peripheral nerve regeneration. Although many challenges remain to be solved, it is undeniable that the coatings of magnesium and its alloy have great potential in promoting peripheral nerve regeneration, such as the combination of coatings with anti-inflammatory drugs to moderate the host response (Zhang et al., 2015), the modification of functional sites of coatings to improve histocompatibility, the combined use of different coatings to improve coating properties (Catt et al., 2017).

Mg2+-Improved Biomaterials

In addition to magnesium wire, magnesium alloy and magnesium and its alloys after surface coating, magnesium ion also possess good neuroprotective and nerve regeneration promoting effect. Thus, the performance of biomaterials improved by incorporation of Mg2+ to play its role in promoting peripheral nerve regeneration has attracted many researches.

Sun et al. (2019) hybridised Mg2+ and poly(glycerol-sebacate-maleate) (PGSM) into PGSM-Mg and investigated the properties improvement. PGSM-Mg showed suitable biodegradability and sustained release of Mg2+. It could promote SCs adhesion and proliferation better and expressed more neural-specific genes than several kinds of scaffolds, showing great potential to promote peripheral nerve regeneration.

Ramburrun et al. (2019) added magnesium-oleate (MgOl) and N-acetyl-L-cysteine (NAC) at different ratios in poly (3-hyroxybutyric acid-co-3-hydroxyva-leric acid) (PHBV) as a different experimental group. The morphology of PC12 was observed as linearly oriented fibre deposition, and cell proliferation was improved. Improved-PHBV had good physical properties, which is favourable for processing and fabricated as a nerve conduit. So, this Mg2+-improved biomaterial will hold great promise for applications in promoting peripheral nerve regeneration. If the study explored which concentration of MgOl can better promote SCs growth and proliferation, the study would be more valuable for peripheral nerve regeneration. Moreover, it lacked biodegradability tests, which is also essential for clinical application.

The variousness of peripheral nerve injury makes difficulties regenerating peripheral nerves, so exploring different biomaterials depending on the injury situation and combining with Mg2+ will enrich the pathways and fields of promoting peripheral nerve regeneration. Additionally, in order to make Mg2+ released at an appropriate rate at the site of the peripheral nerve injury and reduce the toxicity of magnesium, it will be an effective measure to explore how to control the binding and release of Mg2+ through biomaterials for the applications of magnesium to promote peripheral nerve regeneration. At the same time, it is necessary to detect and improve the degradability and plasticity of Mg2+-improved biomaterials.

Challenges and Prospects

Based on the existing literature, our review not only expounds the importance of magnesium ion to the nervous system and the mechanism of magnesium ion promoting peripheral nerve regeneration but also summarises the application of magnesium-based biomaterials to promote peripheral nerve regeneration by improving the corrosion resistance and biocompatibility (Figure 1 and Table 2). Above all, we can conclude that magnesium can promote peripheral nerve regeneration with both challenge and potential.

FIGURE 1

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Figure 1. Magnesium promotes the regeneration of the peripheral nerve.

TABLE 2

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Table 2. Magnesium promotes the regeneration of the peripheral nerve.

(1) The research on the effect and mechanism of magnesium on the peripheral nervous system has not been fully clarified, such as the toxic effect of magnesium. However, its effect and mechanism still play a crucial role in providing effective theoretical guidance for promoting peripheral nerve regeneration.

(2) The research on the properties of modified magnesium needs to be improved. At present, the research mainly focuses on its corrosion resistance and biocompatibility in vitro. However, it is still necessary to investigate its role in promoting peripheral nerve regeneration in vivo and further confirm the improvement of corrosion resistance and biocompatibility.

(3) The methods to study the properties of magnesium and its alloys are similar and systematic in research, while the methods to study the properties of coatings are relatively fragmentary and immethodical. However, various experimental methods have accumulated rich and valuable experience, which lays a good foundation for improving the coating performance testing system in the future.

(4) Magnesium alloy, its surface coating and other biomaterials modified by magnesium are the main forms to promote peripheral nerve regeneration. So, on the one hand, it is necessary to develop new alloys, coatings or biomaterials, and explore their properties and peripheral nerve promoting effects. On the other hand, in addition to further optimisation on the properties of the alloys, coatings or biomaterials, it is also necessary to consider the cost, efficiency, stability, and other issues, which is expected to play an important role in clinic widely.

(5) The ability of magnesium to promote bone regeneration and vascular regeneration has been widely recognised and has been used in the clinic (Witte, 2010; Chen et al., 2019). Combined with nerve regeneration ability, we can foresee the great potential of magnesium in clinical application, such as dental implants. However, there are still many difficulties to be overcome from the basic to the clinical.

The research on magnesium to promote peripheral nerve regeneration is rising in recent years, but research is relatively deficient. There is still great potential in this field where opportunities and challenges coexist, which needs the joint investment and efforts of many researchers, promoting the development of the research and putting it into clinical use in the future for the benefit of patients!

Author Contributions

JXZ, BZ, and JLZ summarized the related literature and wrote the manuscript. WL checked and polished the language. SZ contributed to conception, design, and critically revised the manuscript. All authors contributed to the article and approved the submitted version.

Funding

This work was supported by the National Natural Science Foundation of China (document no. 81970913); and China Postdoctoral Science Foundation, Grant/Award Number: 2019M653443; and Postdoctoral Foundation of Sichuan University, Grant/Award Number: 20826041C4100.

Conflict of Interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Publisher’s Note

All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.

Neuralgia refers to severe, shooting pain that occurs due to a damaged or irritated nerve. Neuralgia can affect any part of the body, causing mild to severe pain. Certain medications and surgical procedures can effectively treat neuralgia.

Severe neuralgia can interfere with a person’s ability to perform everyday tasks and may impact their quality of life.

Neuralgia has many possible causes, including:

infections, such as shingles, Lyme disease, or HIV

pressure on nerves from bones, blood vessels, or tumors

other medical conditions, such as kidney disease or diabetes

aging

This article covers the different types of neuralgia, their symptoms, and the treatment options available.

Symptoms

In general, neuralgia causes intense and distinct symptoms, including:

sudden episodes of extreme shooting or stabbing pain that follows the path of a damaged or irritated nerve

persistent aching or burning pain

tingling or numbness

involuntary muscle twitching or cramping

Where these pains originate in the body depends on the type of neuralgia a person is dealing with.

Types of neuralgia

Healthcare professionals divide neuralgia into categories depending on the areas of the body it affects. The following are some common types of neuralgia:

Trigeminal neuralgia

Trigeminal neuralgia (TN) involves the trigeminal nerve in the head. This nerve has three branches that send signals from the brain to the face, mouth, teeth, and nose.

TN falls into two subtypesTrusted Source: type 1 and type 2.

Type 1 TN, the more common type, causes a painful burning or electric shock-like sensation in parts of the face. People with type 1 TN experience irregular episodes that come on suddenly.

The duration of these episodes varies among people but can last up to 2 minutesTrusted Source, according to the National Institute of Neurological Disorders and Stroke.

Type 2 TN produces a constant, dull aching sensation in the face.

Causes

The exact cause of TN remains unclear. However, pressure from an enlarged blood vessel can irritate or even damage the trigeminal nerve.

Multiple sclerosis (MS) can give rise to TN. MS is a neurological disorder that causes inflammation that damages the myelin sheath surrounding nerve fibers in the central nervous system.

Postherpetic neuralgia

Postherpetic neuralgia (PHN) is a painful condition that affects the nerves in the skin.

Causes

According to the Centers for Disease Control and Prevention (CDC), PHN is the most common complication of shingles, affecting about 10–18%Trusted Source of people who develop it.

Shingles is a viral infection that causes blisters and a painful skin rash. The varicella-zoster virus, which causes chickenpox, remains dormant in the nervous system and reactivates later in life, causing shingles.

When the virus reactivates, it can cause inflammation in the nerve fibers. This inflammation can lead to permanent nerve damage that causes pain, even after the infection subsides.

Occipital neuralgia

This form of neuralgia affects the occipital nerves, which originate in the neck and send signals to the back of the head.

Occipital neuralgia causes a throbbing or shooting pain that starts near the base of the skull and radiates along the scalp. Occipital neuralgia pain can flow to the back of the eyes.

Causes

Occipital neuralgia has numerous potential causes, includingTrusted Source:

keeping the head in a downward, forward position for longer periods of time

tense neck muscles

lesions or tumors in the neck

inflamed blood vessels

infections

gout

diabetes

neck or head injuries

However, there are cases of occipital neuralgia that have no known cause.

Peripheral neuralgia

Peripheral neuralgia, or peripheral neuropathy, refers to pain that occurs due to nerve damage in the peripheral nervous system. This includes all nerve fibers outside of the brain and spinal cord.

Peripheral neuralgia can affect a single nerve or entire nerve groups.

Peripheral neuralgia can cause pain or numbnessTrusted Source in the hands, feet, arms, and legs. Other symptoms may include:

involuntary muscle twitching or cramping

loss of coordination

difficulty performing complex motor tasks, such as buttoning a shirt or tying shoelaces

hypersensitivity to touch or temperature

excess sweating

gastrointestinal problems

difficulty eating or swallowing

difficulty speaking

Causes

Sustaining damage to the peripheral nervous system can affect nerves that control muscle movements, transmit sensory information, and regulate internal organs.

Intercostal neuralgia

Intercostal neuralgia affects the nerves that sit just below the ribs. Doctors call the muscles in this area the intercostal muscles.

Intercostal neuralgia causesTrusted Source a sharp, burning pain that affects the chest wall, upper abdomen, and upper back. Certain physical movements, such as breathing, coughing, or laughing, can worsen the pain.

Additional symptoms may include:

tightness or pressure that wraps around the chest

tingling or numbness in the upper chest or upper back

muscle twitching

Causes

Several potential factors may contribute to intercostal neuralgia, such as:

injuries or surgical procedures that involve the chest

pressure on the nerves

shingles or other viral infections

Diagnosis

Because it can be caused by a variety of issues, there is no one test to diagnose neuralgia.

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If a person believes they may be dealing with some of the symptoms of a specific type of neuralgia, a doctor may suggest:

blood tests to check for infections

X-rays, CT scans, or MRI scans to see if there are any nerves being compressed

a neurological exam, which usually involves testing reflexes with small, painless tools to try to determine which areas are affected

Keeping notes around symptoms, such as when they began, how often they occur, and where the pain radiates, can all help a doctor with a diagnosis.

Treatments

Treatment options for neuralgia vary depending on the type and severity of the condition.

Topical ointments, local nerve block, and steroid injections may offer temporary pain relief for mild neuralgia.

Treating severe neuralgia pain may require prescription medications, surgical procedures, or both.

Medications

Pain relievers tend not to be very effective at managing neuralgia pain. Medications that can treat the underlying causes of neuralgia include:

anticonvulsants, such as carbamazepine, topiramate, and lamotrigine

antidepressants, such as amitriptyline

muscle relaxants, such as baclofen

membrane-stabilizing medications, such as gabapentin

Surgery

Some surgical procedures can help relieve neuralgia pain when the condition does not respond to medication.

Examples of surgical proceduresTrusted Source that can help treat neuralgia include:

Microvascular decompression: This helps remove an enlarged blood vessel pressing on a nerve. The procedure involves placing a soft pad between the blood vessel and the affected nerve.

Stereotactic surgery: This is a noninvasive procedure that delivers highly concentrated radiation beams to the root of a damaged nerve. The radiation disrupts the transmission of pain signals to the brain.

Balloon compression: This involves inserting a small balloon into the affected nerve. The balloon inflates, resulting in controlled, intentional nerve damage. This procedure prevents the affected nerve from sending pain signals to the brain. However, the effects of the procedure usually wear off after 1–2 years.

Outlook

Neuralgia causes painful symptoms that vary in duration and severity. As well as pain, neuralgia can cause numbness, muscle weakness, and hypersensitivity.

If a person does not receive treatment, neuralgia can interfere with their ability to perform daily tasks.

People can work with a healthcare professional to establish the best course of treatment for their specific symptoms. If the condition does not respond to initial treatments, a healthcare professional may refer the person to a pain management specialist.

A pinched nerve occurs when pressure or force is put on an area of a nerve, causing it to send warning signals to the brain. Pinched nerves are usually caused by a damaged nerve, and symptoms can include pain, numbness, and weakness.

In this article, learn about how to reduce the symptoms of a pinched nerve and how to prevent them in the future.

Ten home remedies for a pinched nerve

A pinched nerve may cause weakness, pain, tingling, or numbness.

There are a variety of ways a person can relieve the pain of a pinched nerve at home.

1. Extra sleep and rest

Sleep is essential for a healing nerve. The body repairs itself during sleep, so giving it more time to do so may help reduce symptoms quicker.

In many cases, resting the affected area and getting extra sleep is enough to allow the pinched nerve to heal on its own.

While treating a pinched nerve, it is also important not to overuse the nerve. Nerve damage can be made worse by overuse. A person with a pinched nerve should avoid any movements that irritate the nerve. They should also try to sleep in a position that relieves the pressure on the nerve.

2. Change of posture

A pinched nerve may be caused by or made worse by poor posture. Sitting or standing with an incorrect posture for extended periods puts unnecessary stress on the body, which may damage the spine and muscles, leading to a pinched nerve.

Using cushions, adjustable chairs, and neck rests when sitting may help relieve pressure and allow the nerve to heal.

3. Ergonomic workstation

People dealing with pinched nerves could try making changes in their workstation.

Using an ergonomic mouse and keyboard may help reduce pressure in the hands and wrists. Raising a computer monitor to eye level may help reduce neck pain and symptoms of text neck.

Using a standing workstation can help keep the spine moving and flexible, which could reduce back pain.

Ergonomic workstations have a range of positional options, suitable for many types of pinched nerve. Standing desks are available for purchase online.

The best way to find the right position is for an individual to experiment with the settings to see which position relieves pressure.

4. Pain relieving medications

Over-the-counter pain medications may also help with a pinched nerve. Non-steroidal anti-inflammatory drugs (NSAIDs) can help reduce swelling and relieve pain in cases of minor pinched nerves.

NSAIDs, such as ibuprofen, are available for purchase over-the-counter or online.

As with any drug, it is important to consult a doctor for dosage recommendations and any potential interactions before using NSAIDs.

5. Stretching and yoga

Gentle stretching and yoga may help relieve tension and pressure in the area. It is important not to stretch too deeply, as this may make symptoms worse.

If a person experiences any pain or discomfort while exercising, they should stop immediately to avoid damaging the nerve any further.

6. Massage or physical therapy

Having a massage may also help reduce physical pain and stress. Applying gentle pressure around the affected area may help relieve tension, and a full body massage can help the muscles relax.

Deep tissue massages may not be a good idea because the extra pressure may make the symptoms worse.

Physical therapy, using a combination of exercise, massage, and gentle stretches, can help relieve symptoms.

7. Splint

If it is possible, wearing a splint on the affected area can help prevent further damage and help the nerve heal. This is a standard treatment for pinched nerves in the hands and wrists.

Many people also sleep with the splint on to prevent any irritation in the night and help them sleep. The splint will help take pressure off the nerve.

8. Elevate the legs

People with pinched nerves in the back may find relief by elevating their legs to remove any pressure from the spine.

A person can achieve this by putting a few pillows under their knees, so their legs are at a 45° degree angle to the body.

9. Ice and heat packs

Alternating between heat and ice packs can help reduce swelling and inflammation in many cases. The combination of hot and cold increases the circulation of fresh blood to the area, which may help relieve pain.

Hold an ice pack over the affected area for about 15 minutes at a time, three times a day to help reduce inflammation. Heat pads can be applied for a longer period, up to 1 hour, three times a day.

Ice packs and heat packs for injuries are available for purchase online.

10. Lifestyle changes

In the long-term, adding a low-impact exercise, such as walking, swimming, or bicycling, to a daily regimen may help reduce symptoms and keep the body in shape. Losing extra weight can help reduce pressure on the nerves, and the added mobility from a regular workout may reduce inflammation.

Stretching before or after low-impact exercises can help keep the body flexible and reduce pressure and inflammation near the nerves.

Symptoms

The warning signals sent by a pinched nerve may cause a few different symptoms in the body, especially in the area around the nerve.

Signs and symptoms of a pinched nerve include:

tingling

burning

numbness

pain

muscle weakness

stinging pain, such as pins and needles

the area may feel it has “fallen asleep”

Symptoms may also be worse while lying down or just after waking up.

A pinched nerve also puts a person more at risk for other problems. Symptoms of sciatica, tennis elbow, and carpal tunnel syndrome may appear in people with a pinched nerve.

Pinched nerves can occur anywhere in the body but happen most often in the neck, back, elbows, and wrists.

Causes of pinched nerves

A pinched nerve typically happens when a nerve is damaged and cannot send regular signals to the brain, which may cause feelings of numbness and tingling.

A pinched nerve can happen for a range of reasons. A herniated disc or bone spurs that are compressing the nerve may cause it. It may also be caused by arthritis in the area.

Also, certain activities and habits can cause a pinched nerve. Sitting, standing, or walking with poor posture may contribute to a pinched nerve.

Injuries from sports or repetitive actions may compress a nerve. Extra pressure and weight caused by obesity may also lead to pinched nerves.

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When to see a doctor

A pinched nerve is sending warning signs to the brain, so it is important that people listen to them. Anyone feeling pain from a pinched nerve that continues after regular treatments or lasts for more than a few days should report it to a doctor.

There are a few symptoms that require medical attention as soon as possible, including:

a pinched nerve affecting the bladder

an inability to grip objects or a tendency to drop things

nerve damage that causes a limb or area of the body to give out or collapse

Doctors may request imaging tests, such as a magnetic resonance imaging (MRI) or a computerized axial tomography (CAT) scan, to get a better picture of the nerves and how they are affected. This will help narrow down treatment options, which include painkillers or corticosteroids, physical therapy, or, in severe cases, surgery.

Surgical treatment comes with its risks and complications, so anyone considering surgery should work directly with their doctor to find a treatment plan that is right for their personal needs.

Outlook

Most pinched nerves are temporary and easily treated at home. Persistent symptoms may be a sign of more serious damage that requires medical care.

Pinched nerves are mostly avoidable, and a good self-care routine can help reduce inflammation and keep pressure from building up around the nerves.

What is diabetic peripheral neuropathy?

Diabetic peripheral neuropathy is a condition caused by long-term high blood sugar levels, which causes nerve damage. Some people will not have any symptoms. But for others symptoms may be debilitating.

Between 60 and 70 percent of people with diabetes have some form of neuropathy, according to the National Institute of Diabetes and Digestive and Kidney DiseasesTrusted Source (NIDDK).

Peripheral neuropathy, the most common form of diabetic neuropathy, affects the legs, feet, toes, hands, and arms.

Many people do not know that they have diabetes. People unaware of their diabetes may not know what’s causing some of the unusual sensations they’re experiencing.

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What causes nerve damage?

Nerve damage is the result of high levels of blood glucose over long periods of time. It isn’t entirely clear why high glucose levels damage nerves.

A number of factors may play a role in nerve fiber damage. One possible component is the intricate interplay between the blood vessels and nerves, according to the NIDDKTrusted Source.

Other factors include high blood pressure and cholesterol levels and nerve inflammation.

Diabetic peripheral neuropathy usually first appears in the feet and legs, and may occur in the hands and arms later.

Feeling numbness

A common symptom of diabetic peripheral neuropathy is numbness. Sometimes you may be unable to feel your feet while walking.

Other times, your hands or feet will tingle or burn. Or it may feel like you’re wearing a sock or glove when you’re not.

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Shooting pain

Sometimes you may experience sudden, sharp pains that feel like an electrical current. Other times, you may feel cramping, like when you’re grasping something like a piece of silverware.

You also may sometimes unintentionally drop items you’re holding as a result of diabetic peripheral neuropathy.

Loss of balance

Walking with a wobbly motion or even losing your balance can result from diabetic peripheral neuropathy. Wearing orthopedic shoes often helps with this.

Loss of coordination is a common sign of diabetic peripheral neuropathy. Often, muscle weakness affects the ankle, which can affect your gait. Numbness in the feet can also contribute to loss of balance.

My foot looks funny

Your foot may begin to look injured. This is the result of unusual shifts in weight caused by walking abnormally and the loss of nerve function, which can affect the muscles.

One type of injury is called hammertoe. It occurs when one of the three toes between the big toe and the little toe becomes misshapen at the joints.

Why am I sore?

You may begin to notice sores or blisters on your feet that you can’t explain. It could be that you hurt yourself and didn’t feel it at the time.

Sometimes you don’t feel pain or injury because of the nerve damage. This can be very dangerous. For example, you could scald yourself with hot water because you’re unable to feel a pain response to heat.

Hot and cold

Diabetic peripheral neuropathy can also result in exaggerated sensations. Holding a cup of warm coffee may feel painfully hot. It may also hurt when a person with cold hands touches you. And your hands or feet may feel hot or cold for no apparent reason.

When pain affects sleep

Diabetic peripheral neuropathy often worsens at night. You may hurt so much that even a bed sheet feels very heavy and painful. This can make it difficult to fall asleep or sleep through the night.

Take care of yourself

You should be able to manage your condition by working with your healthcare provider and taking the proper medication.

Limit alcohol and avoid tobacco if you have diabetic peripheral neuropathy. These substances may worsen symptoms.

Good nutrition is important, as vitamin deficiencies can exacerbate the condition. Those on metformin should talk to their doctor about a vitamin B-12 supplement.

Unchecked wounds can potentially lead to infections that can sometimes spread to the bones. And infection in the bones can lead to amputation of feet and toes.

Make sure you see your doctor regularly and immediately attend to any sores you notice.

Alternative treatments for peripheral neuropathy

About 20 million people across the country live with a form of peripheral neuropathy. Peripheral neuropathy is nerve damage disorder that typically causes pain in your hands and feet. Other common symptoms of this disorder include:

muscle weakness

numbness

tingling

poor balance

inability to feel pain or temperature

Treatment options typically focus on pain relief and treating the underlying cause. However, studies show that exercise can effectively preserve nerve function and promote nerve regeneration.

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Exercise techniques for peripheral neuropathy

There are three main types of exercises ideal for people with peripheral neuropathy: aerobic, balance, and stretching.

Before you start exercises, warm up your muscles with dynamic stretching like arm circles. This promotes flexibility and increases blood flow. It will boost your energy, too, and activate your nerve signals.

Aerobic exercises

Aerobic exercises move large muscles and cause you to breathe deeply. This increases blood flow and releases endorphins that act as the body’s natural painkillers.

Best practices for aerobic exercising include routine activity for about 30 minutes a day, at least three days a week. If you’re just starting out, try exercising for 10 minutes a day to start.

Some examples of aerobic exercises are:

brisk walking

swimming

bicycling

Balance training

Peripheral neuropathy can leave your muscles and joints feeling stiff and sometimes weak. Balance training can build your strength and reduce feelings of tightness. Improved balance also prevents falls.

Beginning balance training exercises include leg and calf raises.

Side leg raise

Using a chair or counter, steady your balance with one hand.

Stand straight with feet slightly apart.

Slowly lift one leg to the side and hold for 5–10 seconds.

Lower your leg at the same pace.

Repeat with the other leg.

As you improve balance, try this exercise without holding onto the counter.

Calf raise

Using a chair or counter, steady your balance.

Lift the heels of both feet off the ground so you’re standing on your toes.

Slowly lower yourself down.

Repeat for 10–15 reps.

Stretching exercises

Stretching increases your flexibility and warms up your body for other physical activity. Routine stretching can also reduce your risk of developing an injury while exercising. Common techniques are calf stretches and seated hamstring stretches.

Calf stretch

Place one leg behind you with your toe pointing forward.

Take a step forward with the opposite foot and slightly bend the knee.

Lean forward with the front leg while keeping the heel on your back leg planted on the floor.

Hold this stretch for 15 seconds.

Repeat three times per leg.

Seated hamstring stretch

Sit on the edge of a chair.

Extend one leg in front of you with your toe pointed upward.

Bend the opposite knee with your foot flat on the floor.

Position your chest over your straight leg, and straighten your back until you feel a muscle stretch.

Hold this position for 15 – 20 seconds.

Repeat three times per leg.

Outlook

Exercise can reduce pain symptoms from peripheral neuropathy. Be sure to stretch after any workout to increase your flexibility and reduce pain from muscle tightness.

Mild pain is normal after stretching and regular activity. However, if your pain worsens or if you develop joint swelling, visit your doctor.

What helps nerves heal faster at home?

What is peripheral neuropathy?

Peripheral neuropathy is a condition that causes weakness, pain, and numbness in your extremities (typically the hands and feet).

Your peripheral nerves send messages from your brain and spinal cord to the rest of your body. When those nerves are damaged, these messages are interrupted and affect how your body responds to pain, temperature, and other reflexes.

It’s often a result of damage to the peripheral nerves. A few things can cause this damage:

diabetes mellitus

traumatic injury

alcoholism

infection

The effects of peripheral neuropathy can develop suddenly or can spread slowly over time.

Treatment methods vary depending on the cause of the condition. Many natural and traditional methods focus on alleviating pain symptoms.

Peripheral neuropathy symptoms

Symptoms from peripheral neuropathy depend on the type of nerves damaged. The three types are motor nerves, sensory nerves, and autonomic nerves.

Motor nerves

Your motor nerves send messages from the brain to the muscles so you can control your movements.

If your motor nerves are affected, you may experience symptoms including:

muscle weakness or atrophy

difficulty moving your arms or legs

muscle spasms or uncontrolled twitching

decreased reflexes

Sensory nerves

Sensory nerves send messages from other body parts to the brain and trigger your senses. When you experience a cold sensation or touch something sharp, you are using your sensory nerves.

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If your peripheral neuropathy affects your sensory nerves, you may experience:

tingling or numbness

sensitivity to touch

decreased sensation

inability to feel temperature changes or pain with hot and cold

loss of reflexes and coordination

Autonomic nerves

These nerves control involuntary and semi-voluntary functions including blood pressure, heart rate, bladder functions, and sweating.

If your autonomic nerves are affected from peripheral neuropathy, you may experience symptoms including:

nausea

vomiting

dizziness while standing or changing position from sitting to standing

excessive sweating

inability to control bowel and bladder functions

irregular heart rate

difficulty swallowing

8 natural treatments for peripheral neuropathy

Treatment for peripheral neuropathy depends on the cause. Some common treatments involve physical therapy, surgery, and injections for increased nerve pressure. Other treatments focus on reducing pain and discomfort with over-the-counter painkillers such as ibuprofen or aspirin.

There are also a number of natural treatments to help reduce symptoms and peripheral neuropathy.

1. Vitamins

Some cases of peripheral neuropathy are related to vitamin deficiencies. Vitamin B is essential for your nerve health. A deficiency can lead to significant nerve damage.

While you can get vitamin B from your meals, your doctor may also recommend taking a supplement. Stick to the recommended dose to prevent toxicity and worsening symptoms.

Vitamin D can also help prevent nerve pain. Your skin typically produces vitamin D in response to sunlight. A deficiency can cause neuropathy pain. Taking a supplement can help reduce the symptoms of neuropathy.

2. Cayenne pepper

Cayenne pepper contains capsaicin, an ingredient in hot peppers that makes them spicy. Capsaicin has been used in topical creams for its pain relief properties. It decreases the intensity of pain signals sent through the body.

Incorporating cayenne pepper in your diet or taking a capsaicin supplement can help to reduce neuropathy pain.

Topical capsaicin ointments can also be used on the body. Although it may initially burn, continued use will gradually reduce neuropathy sensations.

Be sure to discuss this treatment method with your doctor before using it to prevent adverse symptoms.

3. Quit smoking

Smoking affects your blood circulation. The blood vessels narrow and less oxygenated blood can get through. Without proper blood circulation, you may experience increased numbness and pain from your peripheral neuropathy. Eliminating smoking habits can help to improve your symptoms. Let this motivate you to make positive changes.

4. Warm bath

Taking a warm bath can be soothing and can also alleviate pain symptoms from neuropathy. Warm water increases blood circulation throughout the body, decreasing pain symptoms from numbness.

If your sensory nerves are affected from peripheral neuropathy and you’re not as sensitive to temperature, be careful not to make your bath water too hot.

5. Exercise

Regular exercise can help to combat pain and improve your overall health. Being active can reduce your blood sugar, which, in turn, can reduce or slow down nerve damage. Exercise also increases blood flow to your arms and legs and reduces stress. These are all factors that help to reduce discomfort and pain.

6. Essential oils

Some essential oils, including chamomile and Roman lavender, help to increase circulation in the body. They also have pain-relieving and anti-inflammatory properties that could boost healing.

Dilute essential oils (a few drops) in 1 ounce of a carrier oil such as olive oil. Applying these diluted oils to the affected area can reduce stinging and tingling pains from peripheral neuropathy.

7. Meditation

Meditation techniques can help people struggling with neuropathy symptoms live through their pain. It can help to lower stress, improve your coping skills, and decrease your pain intensity. Taking a mind-body approach is a noninvasive technique that provides you with more control over your condition.

8. Acupuncture

Acupuncture promotes natural healing by stimulating the body’s pressure points. This technique triggers the nervous system to release chemicals that can change the pain experience or threshold. Acupuncture helps to provide an energy balance to the body that can affect your emotional well-being.

Outlook

Prevention works so much better than treatment. Keeping your blood sugars within the normal range will help prevent your neuropathy from worsening. If your neuropathy is related to alcohol intake, stop drinking now to prevent the condition from getting worse.

Natural remedies have some success in alleviating the pain symptoms of peripheral neuropathy. However, be sure to consult with your doctor prior to participating in a new treatment method. If you begin experiencing irregular symptoms from natural remedies, or if your conditions worsen, visit a doctor immediately.

How do you get rid of nerve pain fast?

Nerve pain can be a symptom of many different conditions, including cancer, HIV, diabetes, and shingles. For some, nerve pain is frustrating; for others, nerve pain is devastating and life-changing.

Whether it feels like burning, pinpricks, or sudden shocks of electricity, nerve pain can disrupt your life at home and at work. It can limit your ability to get around. Over time, it can grind you down. Studies show that people with nerve pain have higher rates of sleep problems, anxiety, and depression.

When you have a serious medical condition such as cancer or HIV, dealing with the additional misery of nerve pain can be especially hard. But there is good news. While nerve pain can't always be cured, it can be treated -- and there are a lot of good options available.

If you're struggling with nerve pain caused by diabetes, cancer, HIV or another condition, here are some answers.

What Causes Nerve Pain?

Countless nerves in the body convey sensations to the brain, including pain. While we might not like pain much, it does have an important function: it prevents injury. When your foot begins to step on a nail, it's the pain sensation that alerts your brain to the danger.

That's how it's supposed to work, at least. But in people with nerve pain, that messaging system isn't working correctly. Your brain receives a pain signal, and you feel the pain, but there's no obvious cause. Now, it's just pain without a purpose -- and because of this, there's no immediate way to relieve it. Since you can't take away the external threat (there isn't one), you have to treat the internal source of the pain or the experience.

What makes the nerves behave this way? Usually, it's damage from a physical injury or disease.

Degenerative joint or disc disease in the spine with spinal cord or nerve compression are very common causes that nerve pain. Also a herniated disc can cause nerve pain.

Cancer and other tumors can cause nerve pain. As they grow, tumors can press on the surrounding nerves. Cancers can also grow out of the nerves themselves. Sometimes, treatments for cancer -- such as chemotherapy drugs -- can damage the nerves, leading to pain.

HIV can cause painful nerve damage. Nerve pain affects up to one-third of people with HIV, and nerve pain in the hands and feet is often the first symptom that appears. Treatment with antiretroviral drugs can also lead to nerve damage that causes pain.

Diabetes is a common cause of nerve damage in the U.S. Over time, high levels of glucose in the blood (blood sugar) can injure the nerves.

Shinglescan be followed by a painful condition called postherpetic neuralgia. This type of nerve pain can be particularly severe and sudden.

Physical injuries can result in nerves that are compressed, crushed, or severed.

These are only a few examples of diseases and conditions that can cause nerve damage and nerve pain. Others include repetitive stress, vitamin deficiencies, hormone imbalances, heart disease, stroke, multiple sclerosis, Guillain-Barre syndrome, chronic inflammatory demyelinating polyneuropathy, Lyme disease, alcoholism, and more. In some cases, nerve pain develops for no apparent reason.

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Nerve Pain Symptoms

Symptoms of nerve damage can vary from person to person. Sometimes, the nerves become hypersensitive. Something that normally feels painless -- a breeze on your arm, the sensation of a bed sheet on your body -- becomes painful.

Damage to the sensory nerves doesn't only cause pain. It can also result in:

Numbness

Tingling

Pricking

Loss of reflexes

In extreme cases, nerve damage can cause paralysis and affect things like digestion and breathing.

The severity of nerve pain is usually linked to the severity of the underlying disease. So in general, nerve pain tends to be worse as people get older.

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Diagnosing Nerve Pain

If you think you might have nerve pain, you need to see your doctor now. Sometimes, the cause might be fairly clear, especially if you have already been diagnosed with a condition known to cause nerve pain, like HIV, cancer, or diabetes.

But in other cases, the cause of nerve pain can be hard to sort out. Because so many conditions can trigger nerve pain, your doctor might need to run a number of lab tests. You'll also need a thorough neurological exam, and possibly other tests -- like CT scans, MRIs, nerve conduction studies and electromyographies. Sometimes, a doctor will recommend a biopsy of the skin or a nerve to examine the nerve endings.

Treating Nerve Pain

When nerve pain is caused by a condition like diabetes, HIV or cancer, getting treatment for the underlying disease is obviously the priority.

But treatments for the underlying disease might not necessarily help with your pain. Nerve pain may need its own treatment, separate from treatment for the disease that's causing it.

The most effective and suitable treatment for nerve pain varies, because it depends on the specifics -- like the patient's health, the underlying cause, the risks of potential side effects, and the costs. However, doctors generally use the same set of treatments for nerve pain, whether it is caused by cancer, HIV, diabetes, or another condition. Here’s a rundown of the basic options.

Topical treatments. Some over-the-counter and prescription topical treatments -- like creams, lotions, gels, and patches -- can ease nerve pain. They tend to work best for pain that's isolated in specific areas on your skin.

Anticonvulsants. These drugs were originally developed to treat epilepsy, but some also help control nerve pain. To boost their effects, they are often used in combination with antidepressants. They might not work as well with all types of nerve pain.

Antidepressants . Certain types of antidepressants can help with nerve pain. Studies have shown that using them along with anticonvulsants may have bigger benefits than using them alone. However, some studies have indicated that while tricyclic antidepressants may help with diabetic nerve pain, they might not help with nerve pain caused by HIV or cancer chemotherapy.

Painkillers. Powerful opioid painkillers might be a first choice for people with especially severe pain or nerve pain caused by cancer. However, for other kinds of nerve pain, doctors generally try anti-inflammatories, over the counter pain relievers, antidepressants and/or anticonvulsants first. Opioids can have serious side effects with a real potential for addiction. Over-the-counter painkillers may not work very well for moderate to severe nerve pain.

Electrical stimulation. A number of treatments use electrical impulses to block the pain messages sent by damaged nerves. These include TENS (transcutaneous electrical nerve stimulation) and repetitive transcranial magnetic stimulation (rTMS.) Both are noninvasive and painless. Some other electrical stimulation approaches are more complex and require surgery.

Other techniques. For nerve pain caused by bones or discs in your back, epidural injections with steroid can be very helpful. (There is a little lidocaine=anestheic in them, but mostly it's the steroids that help.)

Complementary treatments. Many people find that alternative approaches -- like acupuncture, meditation, and massage -- can help relieve nerve pain. If you're interested in dietary supplements for nerve pain, talk to your doctor first.

Lifestyle changes. While they won't cure nerve pain, making some changes to your habits could help you feel better and ease some of your discomfort. Exercising more, eating a healthy diet, quitting smoking, and making time to practice relaxation techniques could all help.

How can I heal my nerves naturally?

Living with nerve pain can be a long-term proposition. Some neuropathic pain gets better with treatment or on its own, but that can take months or years. Other nerve pain stays the same for years or worsens slowly. Some nerve pain can't be reversed.

Your doctor can help you identify and treat neuropathic pain with the best available therapies. But there are also plenty of things you can do on your own to take care of pain.

What Causes Nerve Pain?

Neuropathic pain comes from nerve damage. Most commonly, this is caused by medical conditions such as diabetes, side effects from drugs or chemotherapy, or injuries.

Damaged nerves are more likely to misfire, sending pain signals when there is no cause for pain. They can also put you at risk for more serious problems such as foot infections.

All the causes of nerve pain are still largely a medical mystery. Researchers have identified several different ways nerves can misfire, and this has led to treatments that help many people.

Still, in surveys of people with nerve pain, most say they still have pain despite the best efforts of doctors. If you're one of them, you may want to look beyond conventional medicine for relief. Almost half of those with nerve pain report trying complementary or alternative approaches to improve their pain.

Strategies for Easing Nerve Pain

In addition to relieving pain, many self-care and home treatments can help prevent more serious problems and protect overall health. Some of these strategies may even trigger the body's natural painkillers, having the added benefit of making you feel good.

Keep on top of diabetes. If you have diabetes, keep blood sugar under control. Normal blood sugar levels are the best possible treatment for diabetic nerve pain.

Walk it off.Exercise releases natural painkillers called endorphins. Exercise also promotes blood flow to the nerves in the legs and feet. Researchers believe that regular exercise may create a long-lasting expansion in blood vessels in the feet, nourishing damaged nerves back to health. Start with a daily walk, gradually increasing pace and distance.

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Pamper your feet. If the feet are affected by nerve pain, it's time to focus on good foot care. Nerve pain usually means impaired sensation, making injuries and infections more likely. Reduce the risk by examining your feet daily, wearing comfortable shoes, and seeing a podiatrist regularly. No wound or injury to your feet is too minor for a consultation with a doctor.

Soak it away. A warm bath might be the easiest -- and least expensive -- home treatment for nerve pain. Warm water temporarily increases blood flow to the legs and can help ease stress as well. Avoid burns by measuring water temperature with your arm before stepping in.

Skip happy hour. Heavy alcohol use is toxic to nerves and can worsen nerve pain. There's no magic number for how many alcoholic beverages you can have and still avoid nerve pain, but some experts advise four drinks or less per week.

Sleep on it. Nerve pain can worsen at night, disrupting sleep and making it more difficult to cope with pain. Help break the cycle with good sleep habits. Limit afternoon caffeine intake, keep a consistent bedtime that allows for eight hours of sleep, and reserve the bedroom for sleep and sex.

Burn it out.Capsaicin cream, made from hot chili peppers, causes an uncomfortable burning sensation when initially applied. Some individuals find the burning sensation to be intolerable, especially when they are already suffering from a painful condition. But those who stick with it for weeks often report improvement in nerve pain (and less burning over time).

Numb it up. The anesthetic lidocaine -- in gel, ointment, or patches -- is available in prescription and over-the-counter preparations. The relief from lidocaine is satisfying, although temporary.

Rub it out. Some studies have shown that applying botanical oils such as geranium oil can reduce the pain of postherpetic neuralgia. Other oils, such as lavender oil, have been shown to help relax people, which may also help take the mind off nerve pain.

Meditate on it. Techniques such as guided imagery, meditation, biofeedback, and hypnosis help some people with nerve pain live better. Finding the right professional at a reasonable price can be challenging. Do your homework and ask for a referral from your doctor or someone whose advice you trust.

Is apple cider vinegar good for the nervous system?

Dementia linked with cognitive impairments is the most prominent indication of Alzheimer's disease (AD). In the current investigation, we have examined the streptozotocin- (STZ) induced cellular toxicity in mouse neuroblastoma (N2A) cells, and Zn with the high-fat diet- (HFD) induced neurotoxicity in mouse brain. These cells and animals were pretreated with apple cider vinegar (ACV), Chrysin, and Rivastigmine to examine their protection against cellular toxicity and neurotoxicity. Experiments have affirmed that pretreatment of ACV, Chrysin, and Rivastigmine has displayed protective outcomes in MTT reduction, tau phosphorylation, amyloid aggregation, attenuated memory impairment as well as oxidative stress, and protected cholinergic hippocampal neurons from degeneration. ACV showed better antioxidant and neuroprotection potential as compared with Chrysin and Rivastigmine. So the existence of excitatory/inhibitory enzymatic activity and higher antioxidant potential indicate that ACV, as a food beverage in a regular diet, could be promising and effective against neurological complications such as AD. PRACTICAL APPLICATIONS: In the Urban lifestyle, HFD and stress are the critical factors of various chronic and prevalent diseases, including diabetes, obesity, cardiovascular, and neurodegenerative disorders like AD. We are already familiar with the multiple benefits of ACV, such as weight loss, antimicrobial activity, diabetes, skin disorders. So in the current research work, we have gauged the effectiveness of ACV against neurological complications in comparison with a synthetic flavonoid (Chrysin) and an anti-Alzheimer's drug (Rivastigmine). To enhance the pragmatic orientation of our results, we have used the ACV in our study, which is readily available in the market for domestic consumption. All the cellular, biochemical, behavioral, and histopathological data revealed that ACV had high antioxidant potential. Our findings suggest that the addition of ACV as a food additive in the daily diet may reduce the threat of multiple neurodegenerative diseases. Therefore, our study could be the precursor of a new pharmacological therapeutic approach via ACV toward cognitive impairments associated with Alzheimer's disease.

Keywords: AChE activity; HFD; Neuro2A cells; apple cider vinegar (ACV); oxidative stress markers; streptozotocin (STZ).

 How do I use apple cider vinegar for nerve pain?

It’s no secret that nerve pain can interrupt your day to day routine and become debilitating. However, relieving the pain doesn’t have to be complicated; you can do it while at home. Most of these methods do not require any special equipment or a trip to the doctor’s office, making them quick and effective. Try one of these home remedies for nerve pain next time you experience it.

EPSOM SALT

This mineral is great at relieving nerve pain when used in a hot bath. This naturally occurring salt is rich in magnesium that has a soothing effect on the pain caused by sciatica. Magnesium is not naturally produced in the body but is needed to help get rid of pain cause by sciatica, so an Epsom salt bath soak can ease the pain. Just add 2-3 cups of Epsom salt to your next bath. Once the tub is full and the salt is dissolved, soak for about 30 minutes to help relieve your pain.

APPLE CIDER VINEGAR

Apple cider vinegar can help treat many types of illnesses, including helping to relieve nerve pain. The minerals found in it, like magnesium, phosphorous, calcium and potassium, are all essential for getting rid of nerve pain. Also a great anti-inflammatory agent, apple cider vinegar can help combat the inflammation caused by nerve pain. To reap the benefits of apple cider vinegar, just mix 2-3 tablespoons of the vinegar in a glass of warm water. You can add a teaspoon of organic honey to help it taste better. Drink this concoction twice a day for a few weeks and you should start to feel less pain.

WHITE WILLOW TEA

White willow extract is a natural remedy that has been used for relief of all types of pain. Salicylic acid is produced from the salicin content found in White Willow as it is being absorbed into your body, and salicylic acid is a very effective painkiller. As bonus, white willow does not have an acidic effect when consumed. To make this healing tea, take 2-3 teaspoons of white willow bark extract and combine with boiling water. Allow to simmer for about 10 minutes, strain and drink it hot.

Treatment for Nerve Pain

HOT AND COLD COMPRESSES

One of the best home remedies for nerve pain, alternating between hot and cold compresses can majorly reduce pain and promote healing. A hot compress will help bring more blood to the area and reduce stiffness and muscle spasms (remember, though, that a hot compress should not be used for the first 48 hours of following an injury or the onset of pain). A cold compress will numb the area to relieve pain and reduce inflammation and swelling. By alternating hot and cold packs on the affected areas, you can both lower inflammation and loosen the muscles, increasing the likelihood of reducing pain. For a hot compress, you can use a heating pad or any type of hot compress. Ice packs, bags of frozen vegetable or a bag of ice work well for a cold compress. In both instances, make sure to wrap a cloth around the compress so that it isn’t directly touching your skin.

TURMERIC

This super spice is loaded with health benefits, including helping to relieve nerve pain. Because of its anti-inflammatory properties, turmeric can be added to your diet to help improve your pain. As a way to add turmeric to your daily diet, combine 1-2 teaspoons of it with warm milk. Drink the mixture while it’s hot. Repeat this once a day for about a week to see results.

Yashar Neurosurgery is one of the top spine surgeons and neurosurgeons  in Los Angeles. Located in Beverly Hills, Dr. Yashar and our team are dedicated to providing our patients compassionate and effective care that guides them through each step in their treatment process. Whether a patient needs surgery or non-surgical treatment, Dr. Yashar will provide them with an individual treatment plan, tailored to their specific needs.