Can you stop the pain of diabetic peripheral neuropathy? It is worth doing a trial of laser and vitamin B12. Both are safe and effective treatments.
B12 supplements are known as one of the easiest and safest ways to help relieve this problem – could utilizing laser coupled with supplements increase the results?
Julie Waldfogel, a Johns Hopkins doctor of pharmacy, authored a paper specifically referring to those diabetics who suffer from the excruciating shooting and burning pain of peripheral neuropathy – here’s what we know: The common drugs prescribed for neuropathy come with some serious side effects.
Duloxetene (better known as Cymbalta) also used to treat fibromyalgia, can cause difficulty breathing, swelling of your face, lips, tongue, or throat, anxiety and panic attacks, depression and suicidal thoughts.
Pregabalin, which goes under the brand name Lyrica and is already prescribed for nerve pain from shingles and diabetes, can cause things such as agitation, aggression, and “dangerous impulses.” As if that wasn’t enough, some of the more common side effects are dizziness, blurry vision, weight gain, and swelling of your hands and feet. It has also been linked to the development of blood vessel tumors.
Duloxetene and venlafaxine are said to potentially increase serotonin levels in the blood — something that can be life-threatening.
On the good side, Vitamin B12 is non-toxic, and has been proven to be effective in helping diabetics with this kind of nerve pain. Doctors learn in medical school that a classic symptom of a B12 deficiency is peripheral neuropathy! And guess what has been found to be “unequivocally demonstrated as the prime factor” linked to a B12 deficiency? None other than the popular diabetes medication called metformin.
A study done at Bethesda Diabetes Research Center in the Netherlands, found using metformin could increase the risk of a B12 deficiency by 19 percent. On top of that, around 25 percent of people in the U.S. are deficient in B12, whether they’re diabetic or not.
Another group of drugs draining your B12 are the acid-suppressing meds called proton pump inhibitors (PPI) like Nexium and Prilosec. So, if you have neuropathy please get your B12 levels checked and make sure you don’t have B12 deficiency. If you’ve been on metformin for any length of time, or have been taking one of those PPI drugs, it makes perfect sense to have your B12 levels checked.
And since we know there is plenty of research that laser helps peripheral neuropathy, do a trial of the TheraLase class 3B laser on the feet, legs and lower lumbar spine. It makes sense to take a B12 supplement and try the TheraLase laser!
Chronic low back pain is the most common and important clinical, social, economic, and public health problem of all chronic disorders. There is a need for improvement to help reduce chronic pain and learn how to manage it. Contemporary pain neuroscience that I use to help persistent chronic low back pain includes
- Identification of central nervous system pain (brain memories of pain) vs actual lower back region pain
- Decreasing chronic inflammation in the body and in the brain itself (Glia cell activation or gliopathy) using laser therapy, extracorporal shockwave therapy and nutrition;
- Improving sleep (poor sleep can increase pain and anxiety);
- Optimize gentle movement therapy to your capacity
My main goals for you include decreasing pain, improvements in coping with pain symptoms, decrease the threatening nature of pain, anxiety, and cognitive speed. I am a specialist in teaching patients how to move again without that “dangerous’ or fear-memory taking over.
If you suffer from chronic low back pain feel free to call for an appointment at 310-444-9393
Does shockwave therapy such as EnPuls and PiezoWave stimulate stem cells in inhibiting disc degeneration and disc herniation? The research and my clinical experience suggest the answer is ‘Yes’. Stem cells can be injected into the area of local damage but this is invasive and costly. We are using EnPuls and PiezoWave pulse therapy and laser (all non-invasive) to stimulate stem cells to interact with the local stem cells and immune system cells to achieve successful disc pain relief and tissue regeneration.
The current theory is that the combination of these non-invasive deep tissue treatments stimulates stem cells that are able to bring more oxygen to the damaged disc and accelerate healing by reversing the low-oxygen (degenerative or dying) environment in the spine. Also inflammation comes in many forms. To keep it simple one type is healing and another type is non-healing inflammation. Research supports stem cells are able to reduce or prevent herniation by suppressing the non-healing inflammation.
Here’s what we think is happening when a shock wave and laser treatment is applied to a damaged joint causing you (in your joints):
- Stem cell stimulation occurs which sends signals to the local stem cells and other growth factors to regroup and begin repairing damaged joints.
- Mesenchymal stem cell (MSCs – connective tissue stem cells) suppress inflammatory T–cell proliferation and provide anti-inflammatory effects. Applying these (Piezo Wave, EnPuls, TheraLase, Light Force) treatment modalities inhibits damaging chronic inflammation.
- Mesenchymal stem cells express various growth factors – these are active molecules that stimulate local tissue repair. These growth factors, and the direct cell to cell contact between MSCs and chondrocytes (the present remaining cartilage cells in the joint), have been observed to influence chondrogenic differentiation and cartilage matrix formation – in simple terms – stem cells regenerated cartilage.
Can shock wave repair disc lesions and other degenerated joints? We are seeing clinical outcomes that suggest it does. Do I think you should try this before more expensive and risky injections of stem cells? The answer is Yes!
Is Shock Wave Therapy Right For You?
My treatment goal is to help you relieve pain as fast as possible. My bigger goal is to help you slow the aging process of muscles, tendons and joints and change the internal environment of the joints from a degenerative condition to a healing condition.
When EnPuls (radial shockwave) therapy or PiezoWave (acoustic waves) is applied to the spine or joints it interacts with the skin, the fascia, the muscles, the blood vessels, nerves, and lymph to cause a mild controlled trauma that will restart the inflammatory and healing cycle. Part of that cycle is stem cell stimulation – the immune cells become ‘re-stimulated’ or ‘re-awakened’ to the site of damage. This will begin or restart the repair process needed.
These newer technologies called ‘shock wave’ are helping the body to re-start the healing cycle, especially if you have had a poor quality of healing take place. Poor quality of healing is probably felt as pain or stiffness in the area of a trauma or where there has been repetitive trauma even after a sufficient amount of time has passed by.
Cartilage is the soft padding that keeps your bones from grinding against each other.
When you’re young, the cartilage between your bones is moist and thick…but as you get older, that soft padding can start to get dry, wear thin or tear. Knee cartilage is meant to be smooth so you can walk, run, and even jump. If you have muscle imbalances this can cause excessive and uneven wear and tear in the joint cartilage.
Over time, friction may develop in the joint and you feel inflammation, burning, discomfort, and pain.
Cartilage pain relief – Patients ask me “Can I regrow and rebuild my joints?” The answer is yes!
I see this happen in patients who get laser and shock wave or pulse wave therapy. You can also make your joints fluid and flexible by decreasing inflammation by losing extra fat if you are overweight. I also recommend water-based “lubrication” supplements that help keep your joints soft and moist. If you need certain exercises I will teach you those.
These new technologies (laser and shock wave) are non-invasive without the pain and risk of costly surgeries or addictive drugs.
Some patients start to feel relief within the first 12-24 hours.
I used this very same procedure of laser and shockwave to help rebuild my knee when I had a meniscus tear years ago. I remember when the radiologist said “You need to go see an orthopedic surgeon”. After seeing the ortho surgeon I decided to use my own machines and it helped me avoid surgery and years of endless pain… and I think it could help you, too.
Laser and Shockwave is the Missing Technology that
Lets Your Body Build MORE Cartilage and Repair Tendons
Call 410-444-9393 for an appointment
We are the only office in West Los Angeles with two types of laser and two types of shock wave devices
I use two different types of shock wave devices for pain relief in my practice. One is a radial pulse wave (EnPuls) and the other is an acoustic wave (PiezoWave). Both carry energy that can be targeted and focused noninvasively to affect a selected region like the shoulder, hip or foot. When these devices are applied to the soft tissues, the impulses or shock waves interact with the targeted tissues and induce a cascade of biological reactions. This results in the release of growth factors, which in turn triggers new blood vessel formation (neovascularization) of the tissue with subsequent improvement of the blood supply and oxygen to the tissues. This helps healing.
Another effect of shock wave therapy is related to the stimulation of cell proliferation, tissue regeneration, and a process through which new blood vessels form from pre-existing vessels called angiogenesis.
The therapeutic effects of shock wave therapy can be used on patients who need pain relief and reduction of inflammation even in cases with diabetes, nerve pain, soft tissue injury, arthritic joint irritation, and healing of bone (2013, Qiu et al; 2013 Liu; 2013 Siegfried).
My practice is located in Brentwood, CA. I can be reached at 310-444-9393.
Chiropractic care or medication/shots?
Bone marrow stem cell injections vs non-surgical, non-invasive therapy?
DC’s, PT’s and MD’s know that chronic tendon pain is a challenge to treat. Chiropractors and Physical therapists use non-invasive procedures while medical doctors use cortisone shots and now some are using stem cell therapy injections. Research by doctors at the National University of Singapore suggest that bone-marrow derived stem cells accelerate tendon healing.1 Resolving ongoing inflammation is the key to management of these cases.
This is why the great excitement in stem cell therapy, it has the potential to reduce inflammation. BUT, so does TheraLase laser therapy and the use of PiezoWave and EnPuls. These are non-invasive therapies that the general public are not aware of yet.
Even the Center of Translational Regenerative Medicine researchers, in Torino, Italy say: “Tendon injuries represent even today a challenge as repair may be exceedingly slow and incomplete. Regenerative medicine (Tucker’s note – meaning laser and shockwave like the EnPuls & PiezoWave) and stem cell technology have shown to be of great promise.”2
I would much rather have patients try these non-invasive and less expensive therapies before getting a cortisone shot or going through expensive stem cell therapy first.
Tendons are small, strong, thick bands of connective tissue that connect the muscle to the bone. Tendinitis describes ‘inflammatory pain’ in a tendon area. A little inflammation in the beginning of an injury is expected and useful to help heal the injured area. Tendinopathy is a broad term and the symptoms include tenderness on palpation, pain when exercising or with movement. Tendinosis occurs at a later stage when the tendon shows wear, but no inflammation. And this is often due to anti-inflammatory medications, which block the regeneration of collagen, the major constituent of the tendon. Yes, inflammation is needed for healing.
Tendinitis is typically from a new injury during the early phase when the injury is causing inflammation, a sign that the body is trying to heal the tendon. Many tendon injuries we see are from workout classes, weight training, and in people who move any joint improperly that stretches a tendon and strain it. The place that a tendon, ligament, or muscle attaches to bone is called the enthesis, and if the strain (tendon or muscle injury) or sprain (ligament injury) occurs at that junction to bone, it is called an enthesopathy. And regenerative medicine is the best way I know to heal that.
My non-invasive laser and shock wave treatments are demonstrated to be effective in the long term – we go head-to-head with anti-inflammatory medications and cortisone shots which do not have a healing effect. In fact they can lead to a non-healing tendon or ligament.
Can fish oils help my arthritis?
Health benefits of using Omega 3 fish oils include lowering your risk of heart disease, blood vessel disease, lowering triglycerides, and “thinning” the blood (reducing the risk of clots). It may improve brain development, concentration, learning ability and behavior in children as well as enhancing brain function in adults (60% of the brain is fat and half of that is DHA). I do find it helpful for my arthritic patients (see dose below). Along with recommending supplements for arthritis I use lasers directly over painful joints. These offer a deep heat sensation and helps relieve pain in arthritic joints.
Do tinned and smoked fish count?
Regarding eating fish, I would say that ALL fish is good for you. It is a very lean source of protein. It’s normally the way that fish is cooked that detracts from its goodness – think battered and fried (Not good). Oily fish such as fresh salmon, herring, mackerel, and sardines contains the ‘healthy’, or polyunsaturated, fats that we are advised to eat more of. These types of fish are high in Omega 3 which is called an essential polyunsaturated fatty acid – it is ‘essential’ because our bodies cannot make it so we need to consume it through our diets.
If a product’s been tinned or smoked it will have fewer micronutrients (vitamins and minerals) than the fresh version, however it will still be a good source of protein, low in fat and contain a certain amount of vitamins and minerals. The fish to really avoid are the ones that have been battered, breaded or already have cheesy or creamy sauces on them. Also, fish to eat the least often are deep sea fish (especially large fish) such as shark, marlin, tuna and swordfish. These may contain particularly high levels of mercury. These fish should be avoided by pregnant women and children under 16 years old. Mercury is potentially harmful for children and it can harm fetuses.
How Much Fish Oil Do I Need?
It is recommended that adults and children over 12 years old eat 2 portions of oily fish per week – a portion is 140g cooked fish and it will contain approximately 450mg of Omega 3’s. I typically recommend that clients take supplements of 3 grams of Omega 3 fish oils each day (order at www.DrJeffreyTucker.meta-ehealth.com)(try EPA-DHA 720 or SPM Active). If a client has acute or chronic pain I may recommend even higher doses.
There are some vegetarian sources of omega-3’s like walnuts, flaxseed (linseed) oil, canola oil, soybean oil, etc., all of these are short chain polyunsaturated acids which must be converted by the body into longer chain PUFAs to be useful. Since fish oil already contains long chain PUFAs, it’s the best dietary source. For vegetarians I recommend Biotics Mixed EFA’s.
When taking fish oil supplements, it is generally a good idea to take vitamin E (3 mg for every 1 gram of fish oil) to protect against oxidation. Omega-3s are polyunsaturated fatty acids and Vitamin E counteracts free-radical formation from unsaturated oils.