Is foot pain keeping you up at night? Some symptoms may include burning, tingling, or numbness that wakes you from sleep. Patients describe the sensation as pins and needles in their feet or a sock balled up on the bottom of their foot. If this sounds familiar, you may be experiencing symptoms of neuropathy.
What is Neuropathy?
Neuropathy is nerve damage that often results in a loss of sensation. Some causes of neuropathy include diabetes, infections, autoimmune disorders, long-term heavy alcohol use or alcoholism, vitamin deficiencies, and chemotherapy. This is not an exhaustive list of causes, just some of the most common I see in patients.
How to Diagnose Neuropathy
There are two different ways to diagnose neuropathy:
1. Perform an EMG/NCS
Electromyography (EMG) and Nerve Conduction Studies (NCS) are tests that measure muscle and nerve function using acupuncture size needles. This test is done in our office by Dr. Mark Brooks and testing normally takes about an hour, so we need to schedule the test in advance.
2. A nerve biopsy called an epidermal nerve fiber density test (ENFD)
This sounds super complicated and invasive, but trust me, it is a lot simpler than it sounds. An ENFD is a simple punch biopsy that tests the function of small fiber nerves in your lower extremities. This procedure is performed in-office and usually requires about 15 minutes. The biopsy is sent to the lab to be evaluated under a microscope, so it takes approximately two weeks to receive the results.
While we wait on results from either test, you will go ahead and order blood work to evaluate for a vitamin deficiency and start to treat your symptoms.
Treatment for Neuropathy
Neurontin or Gabapentin is an oral medication that decreases the symptoms of neuropathy. This does not treat neuropathy, but it makes you more comfortable. We wait until the results of your test before prescribing this medication, but you should know that it is a treatment option. Patients start on a low dose and will slowly increase the dose as needed, which allows your body to adjust. This medication is cumulative and takes approximately one month to feel the maximum benefits.
If you are trying to repair your nerve damage instead of simply masking the symptoms, laser therapy is a great option. We target the damaged nerves using an MLS cold laser and attempt to heal them by bringing circulation to the area. The increased blood flow promotes an increase in nourishment to the damaged nerves. Additionally, laser treatments are not painful and encourage healthy nerve function and a reduction in symptoms.
If you choose this option, I recommend a minimum of nine laser treatments to start and then maintenance treatments once a month.
This dietary supplement contains a medical-grade dose of Alpha Lipoic Acid, Benfotiamine, Vitamin B6, and B12 to increase nerve health in patients with neuropathy. It will not interfere with any other medications you are currently taking and encourage great efficacy in those already taking Gabapentin/Neurontin/Lyrica. Some patients report that they can decrease the dose of their current neuropathy medications with the use of NeuRx.
We carry NeuRx in the office and it is available for pick up at the front desk.
Prescription Compound Cream
A compound cream is a combination of medications, such as a muscle relaxer and nerve medication, that have been compounded into a cream to alleviate the symptoms of neuropathy. It can be applied to your feet 3-4 times daily. For instance, I recommend using it right before bed if your symptoms are worse at night.
Soothe is an over-the-counter CBD cream that contains eucalyptus, tea tree oil, and 1000mg of CBD to help soothe and relieve pain caused by neuropathy. This cream comes in the form of a roll-on to make it easily applicable. You can find it in our office or online.
Put an end to painful nights! There are certainly many effective treatment options available. Call the office at or schedule an appointment online to discuss which option is best for you. Take the first step to get a good night’s sleep.