Treating Numbness Tingling and Burning Caused by Neuropathy
My name is David Northcutt. I'm oneof the podiatrists here at Dallas Podiatry Works. Today I want to discuss diabetic peripheralneuropathy. There are several reasons for the development of peripheral neuropathy,but diabetic peripheral neuropathy is one of the most common. Diabetic peripheral neuropathy simply meansnerve damage that is caused from having diabetes. This is not something that develops rapidly,but is a slowly worsening and progressive condition which happens over the period ofseveral years. The loss of sensation that occurs with nerve damage from diabetes makesthe patient more prone to developing open
sores or ulcers. Patients often do not know that they havea sore or wound, due to this lack of sensation. This can lead to significant complicationsincluding amputations. Diabetic peripheral neuropathy usually occurs in patients whodo not maintain their blood sugar well, however it can occur in anyone with diabetes. The symptoms of neuropathy include numbness,tingling, pain, burning in the feet which can progress up to the legs, there's oftenloss of muscle tone, loss of balance, and changes to foot structure. To determine whetheryou have diabetic peripheral neuropathy, a
history and physical will be performed. Simple,in office, noninvasive testing helps to diagnose the problem. Neurologic tests sometimes areordered. Sometimes a biopsy of the peripheral nerves in the skin may also be performed.Treatment of diabetic peripheral neuropathy begins with good control of your blood sugar.There are oral medications as well as topical medications that may reduce your symptoms.Prevention of diabetic peripheral neuropathy includes maintaining good blood sugar levels. If you have any symptoms of numbness, burning,tingling in your feet or legs, please give us a call at Dallas Podiatry Works. We willwork to get the correct diagnosis to help
relieve your symptoms.
Electrical Signal Therapy to Treat Nerve Pain
This is Silvester at the Next Step Footand Ankle , and I'm going to talk to you a little bit today about somethingthat, for our neuropathy patients, has been a real game changer. It's really given usanother powerful tool in being able to eliminate or significantly decrease the symptoms ofpainful peripheral neuropathy. There's also significant evidence that this procedure,this treatment that we do, actually helps the nerves regrow helps the nerves to healand become better. It's a matter of circulation in the nerve, it's also a matter of openingthe gates that how a nerve functions is that there are gates that allow electricalcurrents to pass down the nerve, and the nerve
uses a lot of energy to keep those gates eitheropen or closed, depending on what it's trying to do. The anatomy of a nerve is such that if youtook a nerve out of this young lady's back and down to her foot. If you spread that nerveout and magnified it at maybe 1000 times, the relative proportions of the nerve wouldbe like a string the length of a football field.A nerve uses more energy than any cell in the body, so the nerve, being that long andthat skinny, the nerve's ability to heal itself and deliver energy to all those littlegates all along that nerve is somewhat hampered.
This treatment tends to restore that and helpsthe nerve heal. It's a very simple procedure, and I'm going to show you this is themachine, it's called the Neurogenx 4000 Pro. It has an electrical current that goesinto the nerve and helps fire the nerve repeatedly over a period of time. Our treatments lastabout 3045 minutes, depending on the severity of the patient's symptoms. We do this withan integrated nerve block. I'm going to show you where the nerves comedown into your leg. There's one right here, and this is called the common peroneal nerve.We're going to put one patch there. There's a nerve right back here, and this is the tibialnerve, and that comes down right there, and
we'll put a patch there. All the nervesthat innervate the bottom of the foot come through here, and this is called the tarsaltunnel and the plantar nerves. Then on the top of the foot there's also a deep peronealnerve and there are also branches of the superficial peroneal nerve that are up here. Dependingon where the symptoms are the worst, we kind of move the pads to try and treat the nervesthat we're involved with. If you don't have very many symptoms on the deep peronealnerve, we do it up here at the superficial peroneal nerve. The first pad goes over the common fibularnerve, the next one goes back here where the
tibial nerve comes down into the leg and it'skind of deep right there. Most of the time we'll treat the superficial peroneal nerve.Then, on the inside of the foot, the area of the tarsal tunnel. Now that's all setup for nerve treatment, and all we do is turn the machine on, and we just bring up the intensityuntil the patient feels it. It shouldn't be uncomfortable, but you should be able tofeel it when it's working. It's a fairly substantial current. The next thing that wedo with this is either during or after the procedure, we give local anesthetic blocksinto those nerves that are most badly affected by nerve disease. We determine that with oural examination. Those injections consist
of just a longacting local anesthetic andso the patient leaves, they may be numb for a while or they may not feel any numbness.What happens is, the signal therapy followed with the local anesthetic therapy causes thenerve to be able to reestablish itself as far as the surrounding environment with nutritionalsupport, vasodilation and really helps the nerves heal themselves. This has been, inabout 80% of our patients who undergo this therapy, they have significant relief of theirperipheral neuropathy. It's not a one time thing. We have to do it 13 times, and sometimeswe extend it beyond that. 13 treatments in general, but sometimes we extend it beyondthat. That's electrical nerve stimulation
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