Neuropathy


Robert G., Canoga Park, California, 2012. Idiopathic neuropathy.

Robert, a 72 years old constructor presented with burning pain and tingling sensation in both feet for about 2 years. He was found to have irregular heart beat which was not need to be treated. He is not a diabetic. Thoroughly examination including MRI there would not define a proper cause of his symptoms. Nerve conduction test had shown nerve damage in his both feet which was the cause his sufferings. Pain medications were given to treat without positive effects. He was referred by his friend for acupuncture treatment  who has been helped for the similar condition.  He is a big size man with 5’8” in height and weight 200 pounds. No any physical abnormality was detected except atrial fibrillation with a slow heart rate. Pain level was 7 on a 10-point scale. Electroacupuncture was given with 2 sessions a week. Evaluation performed at the 5th treatment, the pain level of his feet was dropped to 5/10 with much less tingling sensation. His condition was progressively improved and was free of symptom at his 11th treatment. Follow up 5 months no recurrence was found.

Claire G., Tarzana, California, 2012. Nerve demage by compression.

Claire G., a 84 years old, came for acupuncture with chief complaint of pain, numbness and decreased sensation in both legs and feet for about one year. She had suffered spinal stenosis with lower back pain in 2006. Treatments with physical therapy, injection and medication were not help in controlling her pain symptom. A spinal cord stimulator was implanted in 2010 to control her chronic pain with effective. During examination, swelling of both legs with moderaated diminished of touch sensation were detected. Regular acupuncture treatment had been started on 5/11/2012. Painful and numbness sensation of both lower extremities were declined progressively as treatment giving. Total 20 treatments had been provided and she was dismissed in a condition of no numbness and pain in her lower extremities.      

Thamban M, Tarzana, California, 2011. Diabetic neuropathy.

Thamban, a 62 years old post office worker, presented with burning pain and tingling sensation in his both legs for about 5 years. He is a diabetic patient controlling his blood sugar with insulin and oral hypoglycemic drugs. The pain symptom was aggravated by standing longer than one hour on his job. Anti-inflammatory drugs and analgesics had been used and did not show any obvious effects. A diagnosis of Diabetic Neuropathy was made by nerve conduction test. Acupuncture treatment was suggested by his neurologist. We saw him and started acupuncture on 9/7/11. Electro acupuncture was applied on selected points in the lower legs and feet. He started to feel the effect of treatment on the 7th treatment with lesser pain (pain level was dropped from 7/10 to 5/10) and shorter duration (from 7 hours decreased to 5 hours in work). Burning pain and tingling were subsided after the 17th treatment. Another 5 treatments were provided further and concluded on 12/14/11.

Three months later, on 3/5/12 he came back with a recurrent mildly burning sensation in his feet for two weeks. The symptoms would occur after he stood for 3 hours in work. Repeat acupuncture with 9 treatments were given and dismissed in a good condition. Follow up for 8 months and no recurrence was found.         

Neuropathy, generally referred as peripheral neuropathy, is a condition of damage that occurs in the peripheral nervous system result from traumatic injuries, infections, metabolic problems and exposure to toxin.  Neuropathy usually causes pain, tingling, burning and numbness in the extremities.

Neuropathy can affect motor nerves (muscle movements), sensory nerves (sensations) and autonomic nerves (internal organs). In the United States, about 20 million people suffer from neuropathy. About 30% of neuropathy cases are of unknown cause, and other 30% are due to diabetes. About 50% of diabetic patient develop some type of neuropathy. Recently, poison exposure, from toxins such as heavy metals and chemotherapeutic drugs, has an increasing tendency.  Feet and legs are the most common involved areas.

During cancer treatment, certain chemotherapies can cause varying degrees of peripheral neuropathy.  Patients’ quality of life can be seriously impaired through loss of sensation, pain or mobility problems. Conventional medications routinely used to manage neuropathic symptoms have poor side-effect profiles and there is little or no evidence justifying their use to treat chemotherapy-related neurotoxicities.  There are studies suggesting that acupuncture may be an effective therapy in treating peripheral neuropathy across a number of different causes.  Acupuncture had been shown that it may reduce symptoms in about three-quarters of people with peripheral neuropathy. However, you may need multiple acupuncture sessions before you notice improvement.

Demography of neuropathy patient and treatment results of our clinic

Study data draw from 2003 to 2007. Age: 45 to 80, average 63. Gender: F: M=3:1

Diagnosis % of total pain patients % of Improvement % of marked improvement Average treatment
Neuropathy 9.96 81.6 70.9 12

Literature Review

Kasuya D. Acupuncture for painful diabetic neuropathy. Rinsho Shinkeigaku. 2012;52(11):1290-3.

Thirty-eight patient with diabetic neuropathy divided into two groups, 20 treated with acupuncture, and 18 treated with drugs. Both were treated for one month with either one acupuncture session per week or pharmacologically. The change of subjective symptoms was significantly better in the acupuncture treatment group than in the drug treatment group. 

Schroeder S. et al. Acupuncture for chemotherapy-induced peripheral neuropathy (CIPN): a pilot study using neurography. Acuonuct Med. 2012 Mar;30(1):4-7. doi: 10.1136/acupmed-2011-010034. Epub 2011 Dec 5.

A pilot study was conducted to evaluate the therapeutic effect of acupuncture on Chemotherapy-induced peripheral neuropathy (CIPN)  as measured by changes in nerve conduction studies (NCS) in six patients treated with acupuncture for 10 weeks in addition to best medical care and five control patients who received the best medical care but no specific treatment for CIPN. In five of the six patients treated with acupuncture, NCS improved after treatment. In the control group, three of five patients did not show any difference in NCS, one patient improved and one showed impaired NCS. The data suggest that acupuncture has a positive effect on CIPN. The encouraging results of this pilot study justify a randomized controlled trial of acupuncture in CIPN on the basis of NCS.

Donald GK, et al. Evaluation of acupuncture in the management of chemotherapy-induced peripheral neuropathy.  Acupuncture Med. 2011 Sep;29(3):230-3. doi: 10.1136/acupmed.2011.010025.

Eighteen patients of neuropathy were treated with acupuncture for 6 weeks. 82% of patients reported an improvement in symptoms following their course of acupuncture. Some patients derived additional benefits from the treatment including a reduction in analgesic use and improved sleeping patterns. Although these results are encouraging, they are uncontrolled. They suggest that acupuncture could be an option for these patients and controlled trials using validated patient-reported outcome measures are justified.

Xu WR, et al. Clinical randomized controlled study on acupuncture for treatment of peripheral neuropathy induced by chemotherapeutic drugs. Zhongguo Zhen Jiu. 2010 Jun;30(6):457-60.

Sixty-four cases of peripheral neuropathy induced by Chemotherapeutic drugs, Paclitaxel or Oxaliplatin, were randomly divided into an acupuncture group and a medication group, 32 cases in each group. The acupuncture group was treated with therapeutic principle of dredging meridians and collaterals, tonifying qi and eliminating blood stasis, supplementing liver and kidney, nourishing blood and tendon. The medication group was treated with intramuscular injection of Cobamamide (Vitamin B12). The neurotoxicity of two groups was compared with questionnaire of peripheral neuropathy induced by chemotherapeutic drugs before and after treatment.

The total effective rate for sensory nerve disorder of acupuncture group was 66.7% which was superior to that of 40.0% in medication group. The results shown that Acupuncture is more effective than Cobamamide for treatment of peripheral neuropathy induced by chemotherapeutic drugs, especially for moderate and severe sensory nerve disorder induced by paclitaxel.

Zhang C, et al. Clinical effects of acupuncture for diabetic peripheral neuropathy. J Tradit Chin Med. 2010 Mar;30(1):13-4.

Totally 65 patients were randomly divided into two groups with a treatment group of 32 cases and a control group of 33 cases. Acupuncture was used in the treatment group, and inositol was orally administered in the control group. During a 3-month treatment, changes in the symptoms were observed. In the treatment group, 16 cases were markedly relieved, 12 cases improved, and 4 cases failed, with a total effective rate of 87.5%. In the control group, 7 cases were markedly relieved, 14 cases improved and 12 cases failed, with a total effective rate of 63.6%. There was a significant difference in the total effective rate between the 2 groups. Acupuncture may show good effects for diabetic peripheral neuropathy.