Pain Manager

Advanced therapy program relieves condition’s painful symptoms.

Here’s something to think about. Sixty to 70 percent of people with diabetes experience burning, tingling and numbness in their feet that often keep them up at night. These are all symptoms of diabetic neuropathy, which is the most common type of a larger condition known as peripheral neuropathy.Dr. Hal Tobias of Back In Action Medical Wellness Center in Palm City discusses peripheral neuropathy and the center’s protocol for treating it. Dr. Sarah Sabol has stem cell therapy on her injured left knee.

An estimated 20 million people in the United States suffer with some type of peripheral neuropathy, a condition caused by damage to the body’s peripheral nervous system. The peripheral nervous system is the vast network of nerves that transmits information to and from the central nervous system – the brain and spinal cord – and the rest of the body.

There are many symptoms of neuropathy, and they vary depending on which types of nerves are damaged.

“There are three types of nerves in the body: motor, sensory and autonomic nerves,” explains Hal M. Tobias, MD, a board-certified neurologist at Back In Action Medical Center in Palm City. “Most causes of neuropathy involve all three types of nerves, although patients may only be aware of one or two, even as their condition advances.”

Motor nerves control voluntary movement of muscles. Damage to these nerves most often results in muscle weakness, twitching, painful cramps and shrinking of muscle tissue.

Sensory nerves transmit information to the brain. That is then interpreted by the brain as a feeling of comfort or pain. There are a wide variety of symptoms when sensory nerves are compromised, but most commonly there’s a general decrease in sensation, especially in the legs and feet.

Damage to autonomic nerves causes diverse symptoms because these nerves control automatic organ activities, such as breathing, digestion and heart function. Symptoms of autonomic neuropathies include loss of bladder control, inability to sweat and a sudden drop in blood pressure when a person moves from sitting to standing.

“High glucose [sugar] levels in the blood can damage nerves in people with diabetes, but there are many other causes of neuropathy as well,” acknowledges Dr. Tobias. “Neuropathy might develop when nerves become entrapped or compressed from an injury or repetitive motion, as is the case with carpal tunnel syndrome.

“Certain disorders can also impair the proper functioning of the nerves and result in neuropathy. These include kidney and endocrine disorders, as well as some autoimmune diseases, cancers and infections. Exposure to toxins, including heavy alcohol consumption, and genetic mutations are other potential causes of neuropathy. Sometimes, however, the cause is simply unknown.”

Although there are excellent chemotherapy treatments for cancer, sometimes there can be painful neuropathy side effects from the treatments. Dr. Tobias may be able to help with these
neuropathy side effects.

Treatment Advancement

Although neuropathy is relatively common, many people don’t realize that the numbness and tingling, the feelings of heat, cold or stabbing pain and the decreased sense of balance when walking are symptoms of a recognized medical condition, observes Dr. Tobias.

“Often, people with neuropathy fail to seek help and suffer needlessly while their conditions deteriorate and their symptoms intensify,” he says. “Over the years, neuropathy treatment was limited to medications.

“When I first started practice, amitriptyline was essentially the only medicine used to treat patients with neuropathy. Now, we basically use three medicines – gabapentin, pregabalin and duloxetine – that are anti-seizure and antidepressant medicines.”

Recently, Dr. Tobias asserts, there was an advancement in neuropathy treatment that allows for neuropathy’s uncomfortable symptoms to be managed in a new way through a multi-dimensional program that is now offered by Back In Action Medical Center.

The program uses a team approach headed by Dr. Tobias. It begins with a consultation and thorough neurologic work-up to look for treatable causes for the neuropathy. The experienced medical team at Back In Action Medical Center then addresses any underlying conditions contributing to the patient’s neuropathy.

“Our program uses multiple treatment modalities, specifically tailored to an individual’s needs,” Dr. Tobias describes. “These may include special nerve stimulation, injections, nutrition, laser therapy, stem cell therapy, vibration treatment, physical-type therapy and medications. All of these modalities help relieve painful neuropathy symptoms.

“Those who wish to get off of their neuropathy medication can try this new approach and may find relief without medication.

“The bottom line is, these patients need their neuropathy pain treated. This multi-dimensional approach was developed to try to relieve their pain and give them a better quality of life. Now, there is hope for patients suffering from neuropathy.”

For years, treatment for neuropathy was stagnant, but now, there’s a therapy option that goes beyond the standard medications used for years. The key to treating neuropathy successfully, notes Dr. Tobias, is to treat it as early as possible.

“In many cases, neuropathy is not diagnosed until it is far advanced and has already caused significant, sometimes irreversible, damage,” he warns. “I invite anyone experiencing any of the painful symptoms of neuropathy to contact my office for a consultation. It’s best to get treatment started right away to have the best chance of relieving their pain.”

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