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HOLISTIC SUPPORT FOR NEUROPATHY


Introduction

The effective management of neuropathy requires a holistic therapeutic approach. It is

because neuropathy may result from various diseases, and significant symptom treatment demands multidisciplinary and natural remedies.


WHAT DO YOU KNOW ABOUT NEUROPATHY?

Disorders of peripheral nerve cells (nervous system) and fibers are referred to as peripheral neuropathies and can develop due to disease variety. Neuropathy consists of three categories: mononeuropathies, multifocal neuropathies, and polyneuropathies.


Mononeuropathies; They are damage to a single nerve, typically one close to the skin and a bone. Carpal tunnel syndrome is one of the most well-known types of mononeuropathy.


Multifocal neuropathies; These are rare forms of inflammatory neuropathies known as multifocal motor neuropathies (MMN) and characterized by asymmetric distal limb weakening that progresses without sensory loss. 


Polyneuropathies are the most prevalent form of peripheral nervous system dysfunction in adults, especially in the elderly. The causes must therefore be determined as precisely as possible via an adequate diagnostic evaluation to decide the therapy alternatives. 


WHAT ARE THE CAUSES OF PERIPHERAL NEUROPATHY?

There are many causes of peripheral neuropathies, including metabolic, systemic, and toxic factors. 

The underlying etiologies to take into account are:

  • Diabetes mellitus

  • Chronic drinking

  • Nutritional inadequacy (B1,B6, B12, vitamin E)

  • Inflammatory diseases (vasculitis)

  • Hypothyroidism

  • Immune disorders (such as Sjogren syndrome, lupus, and rheumatoid arthritis)

  • Infections (Lyme infection, Epstein-Barr virus, hepatitis C, shingles, leprosy, HIV)

  • Guillain-Barre disease

  • Toxins (heavy metals, chemicals)

  • Chemotherapy substances

  • Medications (antibiotics, cardiovascular medications)

  • Tumors (secondary to compression or associated paraneoplastic syndromes)

  • inherited disorders (e.g., Charcot-Marie-Tooth disease, familial amyloidosis)

  • Trauma/injury

  • therapies for multiple myeloma

  • Undetermined significance of monoclonal gammopathy (MGUS)

A direct cause might not always be evident. 


WHAT ARE THE CLINICAL MANIFESTATIONS OF NEUROPATHY?

Finding the cause of the neuropathy and, if feasible, treating it are the main objectives of the examination. However, even when the cause of the neuropathy is treatable (such as diabetes mellitus, a vitamin B12 insufficiency, or toxins exposure), the treatment's chief goal is to stop the neuropathic symptoms from worsening.

Peripheral neuropathy may be indicated by 

  • Sensory symptoms (such as numbness and tingling), 

  • Motor symptoms (chronic wasting and weakness of intrinsic foot muscles 

  • Autonomic symptoms (such as early satiety, impotence, orthostatic hypotension, irregular sweating),  

  • Neuropathic (burning, stabbing, electrical) pain.





THE HOLISTIC MANAGEMENT OF NEUROPATHY.

Symptoms present at the beginning of therapy or after removing a harmful chemical may get better or occasionally go away.

Management is symptomatic when patients continue to have symptoms related to the neurologic injury and where the neuropathy is idiopathic or incurable.

Disorders of the peripheral nerves are common and frequently curable. There could be pharmacological, non-pharmacological, and natural remedies for neuropathy. 


Pharmacological: There are several pharmacologic alternatives available to treat neuropathic pain. These includes 

  • Antidepressants 

  • Anti-seizure drugs, such as gabapentin (Neurontin), topiramate (Topamax), carbamazepine (Tegretol), and pregabalin (Lyrica) (e.g., amitriptyline). 

  • Topical patches and sprays containing lidocaine (Lidoderm) or capsaicin (Zostrix) 


Non-pharmacological; The multidisciplinary team contributes to non-pharmacological pain treatment. They consist of 

  • Physical therapists, 

  • Occupational therapists, 

  • Speech-language pathologists 

  • Psychologists 

Therapy can control the consequences of peripheral neuropathies. The rehabilitation objectives are: 

  • Maximizing functional capacities, 

  • Preserving independent function and mobility, 

  • Inhibiting or preventing physical deformities, 

  • Facilitating access to full integration into society with a high quality of life.

Preventive and palliative treatments include 

  • Counseling

  • Foot care, 

  • Weight reduction, and 

  • Sensible shoes, boots, or ankle-foot orthoses.

  • Strengthening exercises

  • Exercises that educate balance, coordination, and proprioception as well as increase stability when standing and walking

  • Transcutaneous electrical nerve stimulation (TENS).


Natural remedies; Natural treatments, especially herbal ones, are one of humanity's most traditional forms of treatment. They have fewer problems and unfavorable effects compared to synthetic medications. The usage of these natural remedies for the treatment of painful neuropathy has increased globally. 

Some of the natural medicines are;

  • Acorus calamus

  • Ocimum sanctum

  • Pterodon pubescens Benth

  • Emblica officinalis

  • Cannabis sativa

  • Naringin

  • Quercetin

  • Phyllanthus amarus


TAKEAWAY

One of the most prevalent neurological diseases is peripheral neuropathy. Different medical conditions can lead to the development of neuropathy, and a multidisciplinary treatment approach is the holistic management of neuropathy.










REFERENCES 

Azhary, H., Farooq, M. U., Bhanushali, M., Majid, A., & Kassab, M. Y. (2010). Peripheral neuropathy: differential diagnosis and management. American family physician, 81(7), 887-892.

Bernetti, A., Agostini, F., de Sire, A., Mangone, M., Tognolo, L., Di Cesare, A., ... & Paoloni, M. (2021). Neuropathic pain and rehabilitation: A systematic review of international guidelines. Diagnostics, 11(1), 74

Carter, Gregory T (2005). Rehabilitation Management of Peripheral Neuropathy. Seminars in Neurology, 25(2), 229–237. doi:10.1055/s-2005-871331 

Forouzanfar, F., & Hosseinzadeh, H. (2018). Medicinal herbs in the treatment of neuropathic pain: a review. Iranian journal of basic medical sciences, 21(4), 347–358. https://doi.org/10.22038/IJBMS.2018.24026.6021

Ginsberg L. (2020). Acute and chronic neuropathies. Medicine (Abingdon, England : UK ed.), 48(9), 612–618. https://doi.org/10.1016/j.mpmed.2020.06.009

Hammi C, Yeung B. Neuropathy. [Updated 2021 Aug 2]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK542220/

Hanewinckel, R., Ikram, M. A., & Van Doorn, P. A. (2016). Peripheral neuropathies. Handbook of clinical neurology, 138, 263–282. https://doi.org/10.1016/B978-0-12-802973-2.00015-X

Hughes R. A. (2002). Peripheral neuropathy. BMJ (Clinical research ed.), 324(7335), 466–469. https://doi.org/10.1136/bmj.324.7335.466

Sommer, C., Geber, C., Young, P., Forst, R., Birklein, F., & Schoser, B. (2018). Polyneuropathies. Deutsches Arzteblatt international, 115(6), 83–90. https://doi.org/10.3238/arztebl.2018.083

Watson, James C.; Dyck, P. & James B. (2015). Peripheral Neuropathy: A Practical Approach to Diagnosis and Symptom Management. Mayo Clinic Proceedings, 90(7), 940–951. doi:10.1016/j.mayocp.2015.05.004

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