Neuropathy; If you have numbness, tingling or pain, who should you visit first?

Neuropathy; If you have numbness, tingling or pain, who should you visit first?

Neuropathy is often used to describe feelings of numbness or pain in a particular region of the body. Wikipedia offers this common definition of the condition which they refer to as Peripheral Neuropathy:

Peripheral neuropathy, often shortened to neuropathy, is a general term describing disease affecting the peripheral nerves, meaning nerves beyond the brain and spinal cord. Damage to peripheral nerves may impair sensation, movement, gland or organ function depending on which nerves are affected; in other words, neuropathy affecting motor, sensory, or autonomic nerves result in different symptoms. More than one type of nerve may be affected simultaneously. Peripheral neuropathy may be acute (with sudden onset, rapid progress) or chronic (symptoms begin subtly and progress slowly), and may be reversible or permanent. ”

It can be caused by inflammatory diseases such as diabetes, radiation treatment, cancer treatment and even by an autoimmune disease that can cause pathology of a nerve or set of nerves that are away from the spine.

Most people with numbness do not have diabetes which affects 10% of the population, or have had any of these diseases that are either inflammatory or caused by a medical treatment.   Diabetic neuropathy can occur in up to 50% of the diabetic population many years later and is due to the effects of too much glucose and its effect on both the small fibers of the nerves as well as the circulatory system.

The term neuropathy is often broadly used to describe numbness or tingling and the most overlooked and common mechanism is actually musculoskeletal.

Visiting your primary doctor regularly if you have any of these conditions is important, especially if your diabetes has been controlled medicinally or by an insulin pump.  This can help reduce the incidence of diabetic neuropathy later in life.

Since most people who have numbness, pain and tingling are not ill and do not have any disease, they should visit a specialist who has the training their medical providers do not have in the musculoskeletal system.  Most people are unaware that their medical providers have minimal training in the musculoskeletal system. This drives up costs and as anyone who has been in the system already knows, they end up going from doctor to doctor and they are often given drugs that may relieve the condition, but does not resolve it. It is this mechanism that has resulted in the current opioid crisis.

Systems of the body are interconnected, so hormones, pain, movement, movement adaptation by the brain through neuroplasticity, circulation which includes the heart and the lungs and the digestive tracts all affect one another.  Integrated systems require a holistic or integrated approach to understand and diagnose properly.   Our current system is anything but holistic, with primary care looking for disease development which can be seen as symptoms that do not go away.   Currently, the average primary doctor has 10 minutes or less to diagnose and treat or refer the patient.  Often, with numbness or tingling, that would be to a neurologist or a therapist who will use protocols to run tests or treat a body part that is symptomatic. Rarely, does this lead to a solution to the patients problem.

Sports chiropractors are primary care for the spine, extremities and the musculoskeletal system in general. By training, they are holistic and evaluate your symptoms, and then examine how you stand, how you move in addition to the orthopedic and neurological tests most doctors are trained to perform. They will check your blood pressure as well to diagnose possible risk your primary doctor may need to know about.  They may refer you to the appropriate medical provider if needed. Chiropractic medicine is so much more than just manipulation, a method that they are best known for.

Poor movement patterns develop from when we are young.  We are highly adaptive, as is discussed in the book Cheating Mother Nature, what you need to know to beat chronic pain.   Without an understanding of the musculoskeletal system, many tests are done for symptoms that can be easily explained and treated in a chiropractic office.

Body imbalances that result in numbness and tingling, which is medically referred to as neuropathy often occur in diabetics and in people who have had chemotherapy as well as people with autoimmune diseases.

Seeing a chiropractor first may eliminate the need for a painful and costly NCV test for nerve velocity, an upper or lower GI if the stomach complaints are from the abdominal muscles or the diaphragm (quite common) Many people who are athletic and get numbness when sitting or standing improve markedly when their body mechanics improve with chiropractic care.

A typical first chiropractic visit in our office consists of a complete history, evaluation, treatment (manipulation, myofascial release) and foot orthotics may be recommended if the problem requires a structural fix from the ground up.   Follow -up visits will track your progress and we use active evaluation methods to test your body mechanics and make sure your physical abilities improve which results in less pain, tightness and fewer exacerbations in the future. Once you have achieved your goals, you are released from care.   Many patients understand that periodic visits with a chiropractor keeps them feeling and functioning great.

Seeing a chiropractor first, as Optum healthcare has the data to show saves on costs, unnecessary tests and treatments and improves patient satisfaction for neck, back, shoulder, hip and knee problems.  Many of these problems are actually problems of movement and chiropractors use multiple methods that the Annals of Internal Medicine 2017 February edition suggested are helpful for lower back pain and they are a one stop shop for most back pain patients.

Who should you consider seeing first for neuropathy, and symptoms of numbness and tingling?  All roads lead to the chiropractor.