Fig 1. Field irrigation
Neuropathic pain is constant pain, that doesn’t seem to get any better, whatever you do
What causes it?
Lots of things – only a few of which have been identified
One of the commonest causes of neuropathic pain is Diabetes. High blood sugar damages the nerves (causing neuropathy – medical words for nerve – neuro & damage – pathy)
Small nerve damage, from almost any cause, such as long-term Raynaud’s disease, high blood pressure, nerve compression from spinal disease
Neuropathic pain comes from damage to the tiny nerves which do things like regulate tiny blood vessels, making sure that tissue gets enough blood. At the tiniest level, blood moves through the tissues because tiny blood vessels open and close directing the blood flow to places that need it and moving it away from places that don’t.
The tiny nerves act like gatekeepers and who irrigate paddy fields making sure that the fields get enough water at the right time. Equally the nerves open and close tiny blood vessels to make sure that the tissue gets enough blood. If the tissue does not get enough blood, then toxins, like lactic acid, build up and cause pain as the tissue becomes more acidic.
This micromovement of blood is critical in the skin – which helps regulate body temperature, by directly warm blood to the outside and by causing sweating to help cool the body. Equally when its cold, blood needs to be kept away from the skin, in order to conserve heat. Part and parcel of some very delicate mechanisms ensuring we/our bodies stay at the correct
In addition to pain, people have ridiculous levels of fatigue and tiredness. It does not take much for people with neuropathy to become exhausted. Again this is because of tissue not getting enough blood, particularly muscles. This means someone does not have enough energy even to finish simple everyday tasks, like keeping their house tidy and their laundry up to date. It also makes work very difficult, especially full-time work.
What is the treatment?
At present, there is no specific treatment for this condition. Improving your health and fitness helps. For people with Diabetes, controlling their blood sugar better does help. Being fitter and generally healthier means you can use the energy you do have better. Whether this in itself can be curative has not been researched.
In the absence of a cure – painkillers are the only medical option. Doctors offer drugs such as Amitriptyline, Gabapentin, Pregablin, Tramadol (morphine) to help symptoms. The problem is that, because the underlying condition may continue to get worse, the person has to continually increase their dose of painkillers. Pain clinics specialise in finding the most effective painkiller and adjusting the dose. However, they never take patients off medication and usually discharge their patients back to their General Practitioner.
Before deciding whether to take painkillers, you need to decide whether you would rather put up with the pain, or spend the rest of your life dependent on painkillers.
Personally, I find turmeric, ginger and regular exercises help my feet as much as anything. I do specific exercises to get them back in shape. I don’t believe in taking long-term medication. I prefer natural remedies and natural solutions that solve the underlying problems and have been around for many generations.
The approach you choose is up to you. There are benefits on both sides, You may prefer easy and convenient, or you may prefer to delve deeper. The medical approach can be very seductive offering quick solutions to lifelong problems, but it is rarely that easy! On the other hand looking at what is causing your pain and finding ways to improve it, without resorting to drugs can be a voyage of discovery that not everyone has the stomach for, but will keep you alive and interested in your health for years to come.