There are at least 30 known causes of peripheral neuropathy, a condition due damage of the nerves-resulting in pain, numbness, burning, pins and needles sensation in the feet. Diabetes is the cause of peripheral neuropathy. It is estimated that over 60% of all diabetics will develop some form of peripheral neuropathy. The following are other common causes of peripheral neuropathy:

Neuropathies Caused by Autoimmune Diseases:

An autoimmune disease is a condition in which the immune system destroys or attacks its own bodily tissues. Autoimmune diseases that may result in neuropathy include rheumatoid arthritis, systemic lupus erythematosus and Guillian-Barre syndrome.

Neuropathies Caused by Cancer:

Cancers that have linked neuropathy are multiple myeloma, chronic lymphocytic leukemia and lymphoma and small cell lung cancer.

Neuropathies caused by lack of certain vitamins and nutrients:

Deficiencies of vitamins B-12(cobalamin), B-1(thiamine), B-6 (pyridoxine) can cause neuropathy. The best way of obtaining these nutrients is through proper diet or supplementation with products containing these vitamins such as Nerve Health Essential Nutrients (an over-the counter vitamin supplement) or by a prescription of Metanx, an FDA approved medical food.

Neuropathy Caused by Hereditary Conditions:

Charcot-Marie-Tooth Disease A number of inherited conditions have a neuropathy component. Charcot-Marie-Tooth disease is a genetic, inherited disease. It initially causes typical neuropathy symptoms of numbness and pain and usually progresses, causing muscle weakness and muscle atrophy.

Neuropathy Caused by Injury:

Injury, excessive pressure or repetitive motion to a specific nerve can result in nerve damage causing peripheral neuropathy symptoms. The most common neuropathies in this category are carpal tunnel (affecting the wrist and fingers) and tarsal tunnel syndrome (affecting the bottom surface of the foot and the toes).

Neuropathies caused by toxins:

Exposure to certain toxins such as arsenic, lead, mercury, thallium, chemical solvents and nitrous oxide, can cause nerve damage.

Other Causes of Neuropathy:

Chemotherapy agents that aggressively “attack” cancer cells often have a toxic effect on the nerves as well. The extent of nerve damage depends on the cumulative dose and the type of drugs used. Neuropathy Caused by Excessive Alcohol Intake- Prolonged and excessive use of alcohol will invariably have a toxic effect on nerve tissue. Nutritional deficiencies often associated with alcohol abuse can exacerbate neuropathy symptoms. Neuropathies Caused by Chemotherapy – Chemotherapy agents that aggressively “attack” cancer cells often have a toxic effect on the nerves as well. The extent of nerve damage depends on the cumulative dose and the type of drugs used.

Idiopathic neuropathy:

most neuropathy sufferers fall into this category In many cases no specific cause of peripheral neuropathy can be identified. This called idiopathic neuropathy and it is estimated that over 65 percent of all neuropathies fall into this category. A person can all the symptoms of neuropathy-pain, burning, tingling and numbness and nerve conduction test could also confirm neuropathy; however the exact causative factors are unknown.

Every year some new home remedy for foot problems seems to make the rounds.  But just because something seems to be popular doesn’t mean it’s safe!

One of our guiding principles as health care professionals is Do no harm. Accordingly, as long as any particular home treatment does no harm, it may be tried, regardless of its medical efficacy. But if a proposed home treatment is potentially harmful to the patient, it must be avoided.

Let me share with you some of the more common “home remedies” that you may have heard of, along with my observations as to their safety or danger:

1. Soaking feet in Epsom Salts – Safe

Epsom Salt foot soaks are commonly used to soothe tired, aching feet. Some people use it to treat foot infections.

It is safe for the purpose of relieving aching, tired foot-but don’t make the salt bath so hot that it burns your feet – comfortably warm water is just fine – and be aware that daily use of Epsom Salts may cause the skin to become cracked, dry and flaky. Infections are another matter-foot infections, including ingrown toenails can be quite serious-and the problem is compounded if a person has diabetes. Foot infections should be treated by a podiatrist as often antibiotics are necessary to resolve the infection.

2-         Medicated corn and callus pads – Harmful

Medicated pads are sold over-the counter at pharmacies. The are used to “burn off” thick calluses on the bottom of the feet and corns on the toes.

The medication used in these pads is usually Salicylic Acid. USE OF SALICYLIC ACID CAN BE DANGEROUS, ESPECIALLY FOR DIABETICS AND PEOPLE WITH POOR CIRCULATION!  Salicylic acid can cause second and even third degree burns. I’ve even seen foot and leg amputations resulting from the misuse of this product.

3-         Vicks VapoRub for treating toenail fungus – Safe

Vick’s Vapor is a popular home remedy for thick, discolored, fungal toenails.

For some strange reason, this has become a very popular home remedy of late. Vicks VapoRub contains an ingredient called thymol which has been to known to “kill” bacterial infections.  However, thickened and yellow toenails are usually caused by a fungal organism, not bacteria. So, although use of this product is not be harmful, its effectiveness is questionable.

4-         Soaking feet in Clorox® – Harmful

Bleaching agents are often used by people who have thick, discolored toenails-nails that appear yellow or black. Thick, discolored toenails are often  common symptoms of fungal toenails. Beaching agents should definitely not be used on fungal toenails.

Clorox® (chlorine bleach) is an excellent bleaching and whitening agent – for clothing, not skin! Bleach is a highly caustic substance and can easily burn skin tissue.  NEVER use any bleaching agent to try to lighten or eliminate yellow toenails and discolorations on the skin.

OK, I admit it-with such a famous name, I am partial to swimming as a most beneficial activity.  For over 35 years now, I am asked on a daily basis, “are you the Olympic swimmer—or “can I see your gold medals?”  Overall it has been fun, and I might add has worked to my advantage on occasion. I have gotten front seats in the theater and have been able to get a reservation in restaurants that have been booked for weeks.  When they ask me if I am the “real” Mark Spitz, I am being truthful (maybe stretching it a bit), when I answer, yes. After all I am “real”-just ask my patients as I have been a practicing podiatrist in Orange County California for the past 35 years.

Let me get serious for the moment and discuss the subject at hand, swimming.  From a sports medicine viewpoint, swimming and other water activities can greatly enhance cardiovascular and muscle function.  Due to the consistency of water, it is a “great equalizer”.  This means that a 35 year-old, 250 pound football player has no real advantage over an 80 year-old, 100 pound female.  This is true because of the resistance created in a water environment, as well of the minimal effects of gravity while in the water.  Add to the equation that swimming and other water activities are the ultimate low impact workout-which creates only minimal stress on the bones and joints of the foot and leg.

Swimming itself will benefit the cardiovascular system, can help reduce cholesterol levels and lower high blood pressure.  When swimming you are utilizing and enhancing muscles of both the upper and lower body.  Water aerobics have also become more popular and are offered by many public and private facilities.  Water aerobics consists of fun and beneficial activities such as “jumping-jacks”, unique stretching exercises, and in water race competitions.

Swimming and water aerobics are especially beneficial for people who have peripheral neuropathy. Peripheral neuropathy often affects one’s balance- making exercise a challenge. In the water, a person can undergo a rigorous work-out without the fear of falling.  Additionally the Mayo Clinic recommends regular exercise programs for people with diabetes along with proper diet and nutrition-and swimming is a perfect fit! While on the subject of fee-swimming and pool activities are very beneficial in the treatment of other foot ailments such as plantar fasciitis, Achilles tendonitis,  sprains, strains and other foot and leg injuries. Professional trainers often recommend water activities in the rehabilitation process for a  variety of injuries.

As with any new endeavor check with your physician first.  If you get the OK, head to the nearest pool-and tell them Marc Spitz sent you!

People who suffer from peripheral neuropathy and diabetic neuropathy describe their symptoms in many different ways. Some of the more commonly  descriptions include pain, burning, “pins and needles” sensations, electric shocks, tightness of the skin and the sensation of walking on cardboard or sandpaper.  Many of the prescription medications used for the treatment of neuropathy such as Neurontin or Lyrica, are not always successful in reducing the discomfort of neuropathy. In fact studies show that these medications are effective less than 50% of the cases. In addition Neurontin and Lyrica have many associated side effects. More common side-effects include extreme fatigue and sleepiness, loss of concentration and weight gain. Newer, more effective treatments must be developed for relieving neuropathy discomfort.

Botox which is the most common administered cosmetic treatment in the world is now under study for treating peripheral neuropathy.  Botox (known as botilinum toxin type A), is actually a toxin that selectively paralyzes or relaxes certain muscle groups in the body. Clinical studies conducted around the world have been encouraging as an effective means in reducing neuropathy pain and discomfort. A recent clinical study at the New York University School of Medicine suggests that Botox can provide pain relief for several types of neuropathy including diabetic neuropathy. Similar studies were conducted in France and Canada with similar conclusions: Botox can help reduce chronic neuropathy pain.

The Foot Pain Center is studying the effects of Botox in relieving neuropathic pain. Allergan, a multi-specialty health care company, based in Irvine California, a manufacturer of Botox, has been extremely helpful in providing literature and case reports  for the study.