Understanding Neuropathy

Neuropathy, also known as peripheral neuropathy, sensory peripheral neuropathy, or peripheral neuritis, is a painful condition that usually results from major or irreversible damage to the nerves. Many people with peripheral neuropathy experience: persistent burning, sharp and shooting pain or tingling in legs, calves, toes, and numbness or cramping; as well as weakness in their limbs.

Peripheral neuropathy is a debilitating disorder that effects nearly 20 million Americans today. Did you know that there are over 130 risk factors that cause neuropathy? The peripheral nerves — motor, sensory and autonomic — connect your muscles, skin and internal organs to the spinal cord and brain. The smallest nerves are affected the most.

Diabetic neuropathy is the most common diabetes-related comorbidity. Diabetic neuropathy impacts between 60 to 70 percent of all patients with diabetes. The burden to treat this disorder will only intensify as current trends predict that more than 360 million individuals worldwide will be diagnosed with diabetes by the year 2030.

Small fiber neuropathy (SFN) is one prevalent form of neuropathy that affects small fiber sensory neurons. Small fiber neuropathy results from nerve ischemia, direct effects of hyperglycemia on neurons and intracellular metabolic modulations that impair nerve function. Small somatic nerve fibers innervate the skin and voluntary muscles whereas autonomic fibers innervate cardiac and smooth muscles. Ischemia-induced small-fiber nerve degeneration results in clinical symptoms including pain or discomfort, numbness, and loss of temperature sensation.

Clinical Presentations of Neuropathy

The clinical presentation of individuals with small fiber neuropathy includes pain, paresthesias, loss of two-point discrimination, loss of thermal perception, xerosis and sometimes diminished Achilles deep tendon reflex and loss of the superficial reflexes. The diagnosis of small fiber neuropathy with traditional methods including nerve conduction studies is difficult as small fibers are undetectable. Therefore, the diagnosis of small fiber neuropathy often occurs as a result of positive sensory symptoms.

Patients often complain that they have a feeling of a tight band around their foot or describes a sensation of wearing a tight sock that can feel bunched up, even when barefoot. Pain can be constant or can occur at certain times, such as when they are in bed or with sitting. Slight touch can become quite painful. This may include the wearing of shoes or irritation from sheets while in bed. However, positive sensory symptoms are not associated with only small fiber neuropathy as pain is also a common symptom of large fiber disorders.

Patients with small fiber neuropathy may also present with negative symptoms including numbness, tightness and coldness. Generally, a patient’s symptoms are initially localized to the digits and plantar aspect of the foot but over time can spread proximally to the distal third of the leg.

The clinical manifestation of neuropathic pain is derived from the degeneration of large diameter or small diameter sensory nerves. Large fiber sensory nerves are responsible for the transmission of proprioception and vibration sensation. Large fiber disruption commonly leads to paresthesias, muscle weakness, impaired balance and absent or reduced tendon reflexes.

Researchers have also reported involvement of small autonomic nerve fibers. Autonomic symptoms can include modulation of sweating, skin discoloration, dry eyes and mouth, or facial flushing. Widespread autonomic involvement can have generalized distribution involving the gastrointestinal system, erectile dysfunction and cardiovascular and peripheral vascular involvement, which can cause the development the onset of retinopathy. The diverse clinical presentation of small fiber neuropathy requires an interdisciplinary approach to effectively treat this disorder.

AdvaCare Interdisciplinary Approach to Neuropathy

This interdisciplinary approach is at the core of the Advacare approach. We combine the best that Chiropractic research and treatment can offer, along with Acupuncture, Medical non-steroid nerve blocks to reduce the acute pain issues. We then can incorporate Homeopathic therapy via oral, IV or injection into the integumentary tissues where the autonomic, perineural, lymphatic system function. We also offer nutritional supplements and IV nutrition options to help your tissues regenerate and repair. The biggest therapy “secret weapon” is our use of Class 4 laser therapy.

Many people with peripheral neuropathy experience: persistent burning, sharp and shooting pain or tingling in legs, calves, toes, and numbness or cramping; as well as weakness in their limbs. Download our printable Neuropathy Symptom Relief Information Sheet.

Because of the complex nature of neuropathic pain, no one therapy is completely successful. A multi-disciplinary, integrated approach to managing the pain is often useful. Many are realizing that “alternative” health care offers effective options to treat neuropathy, regardless of the cause.

If you or someone you know suffers from peripheral neuropathy, call to schedule an appointment with AdvaCare Clinic TODAY at 952-835-6653, fill in our online form, or email us at

Please check out our printable Neuropathy Informational Download!