What helps with polyneuropathy?
You still hear very often that you can't do anything against polyneuropathy. Therefore, every patient asks themselves "what helps with polyneuropathy?".
In fact, the treatment is very difficult and must be different for each individual. In Internet forums and from many providers you can find reports about various remedies that are supposed to help. Mostly, however, these are only individual experiences and not really reliable. But there are things that often help and for which there is scientific evidence. I will try to give an overview about it here for orientation.
1. Balance training helps with polyneuropathy
The RIGHT exercise helps against polyneuropathy
The nervous system can be trained specifically and this helps with polyneuropathy.
However, it must be very targeted movement. Many people have tried to achieve something through endurance or strength training themselves. Therapists and scientists have also tried this.
Unfortunately, this has not been very successful. Such exercise, while very helpful for overall health, does little to help polyneuropathy (unless you have diabetes, see box). The same applies to stretching exercises.
The nervous system is the most adaptable organ!
The nervous system is best trained with balance exercises. The posture, muscle tension and movement of the body must be constantly perceived and adjusted in order to keep your balance. This improves the perception of one's own body and the precision with which movements can be controlled.
Physical exertion is not necessary to do this.
Also, training effects can be seen much faster than with classical fitness training, because the nervous system adapts extremely quickly! Therefore, the balance improves even after a short time if you practice diligently!
You can find exercises to try out immediately here:
Pain and discomfort improve
These improvements in the nervous system help with the pain and discomfort of polyneuropathy. It has also been shown in a variety of studies that this improves walking ability and balance.
In addition, patients who do such exercises also report less pain and discomfort from polyneuropathy. The nervous system apparently learns to compensate for nerve damage through such training.
You can find an example of a study here
You can find a detailed article on polyneuropathy and pain here: Pain in polyneuropathy and what you can do about it.
The biggest advantage: you can train by yourself at home!
You don't need a gym or even a therapist to do balance training - if you know how the training works.
That is why I developed the BalanceSet for polyneuropathy.
You will receive detailed instructions for training at home, a balance pad on which you can practice and an exercise ball.
Stretching exercises and massage can help with the pain
For many people with polyneuropathy, the way they move changes and muscles get weaker because of the disease. This often leads to overloading of the muscles and consequently to hardening and cramping.
These cause pain, in addition to that caused by the polyneuropathy itself.
Special types of massage and stretching of the affected areas can therefore often significantly reduce the pain of polyneuropathy patients. This does not cure nerves, so the polyneuropathy remains. However, the pain often subsides anyway. As soon as cramps in the muscles are released through massage and stretching, the pain is also reduced.
You can find more information on this in the following two articles:
Massage for polyneuropathy
Pain in polyneuropathy and what you can do about it
A guide on how to treat your own pain can be found in this video or my book “How to treat your own foot pain”
2. Vibration training helps with polyneuropathy
Balance training is not the only form of exercise that helps with polyneuropathy. Vibration training can also help.
To do vibration training, you stand on a special plate that vibrates. The vibrations trigger reflexes in the nerves, which trigger adaptation of those nerves and the way the nerve signals are processed by the brain. It is often claimed that these vibrations cause huge training effects. This is often exaggerated, at least as far as healthy people are concerned. However, people with nerve disorders - such as polyneuropathy - actually seem to respond very positively.
Some patients report less pain and symptoms after such training.
Talk an expert before starting
If you decide to use vibration training, be sure to talk to a professional first, because there are big differences between vibration machines.
The effects on polyneuropathy reported in scientific studies are also highly variable.
There are several systems of vibration plates. Some plates vibrate in a side-alternating manner, i.e. they rock from side to side. In others, the entire plate moves up and down. There are also so-called 3D plates, which move in all directions, and rotating plates, which make the body vibrate. Which system is most effective for polyneuropathy has not yet been determined to my knowledge. Based on my personal experience and the presumed effect on the nervous system, I assume that side-alternating systems are the most promising. However, there is currently no scientific evidence to support this assumption.
In addition, there is a risk of overloading oneself during vibration training, because the effort is almost imperceptible at first. After exercise it is very common to have tight muscles and even pain due to overworked muscles. That's why you should only train for a very short time in the beginning and slowly increase the training time.
Vibration training and balance training work best together
Balance training and vibration training affect the nervous system in different ways. In a study of patients who developed polyneuropathy as a result of chemotherapy, the two training methods were shown to have different effects. (Here: Sreckmann et al. 2018 you can read the study). It was observed that vibration training works relatively well on pain. However, the improvements of gait and balance are less than with the balance training described above.
Therefore, if you do vibration training, be sure to add balance exercises, as they add a lot of value with little effort and hardly any cost. After you have practiced for some time and have good balance, you can also do balance exercises while standing on a vibration plate. This additionally improves your balance while doing the vibration workout. (Make sure to not run any risk of falling while doing this, though)
A simple way to do this would be to close your eyes for a short period of time while standing on the vibration plate. This eliminates the eyes as the main sense to control posture and forces you to rely on how well you can sense your body. This can lead to better control of your movements and improve how well you can sense your body and counteract its worsening due to polyneuropathy.
However, the balance exercises should be repeated later on the normal floor, so not on the vibration plate. After all, you train to be as safe and mobile as possible moving arroung on the regular floor in your everyday life.
Vibration training to do at home
By the way, if you want to buy a vibration plate there is good news:
Until recently, the devices cost several thousand euros, but there are now numerous inexpensive alternatives. Devices from well-known manufacturers such as Galileo or Power Plate are certainly very good devices for professional providers, but for most people suffering from polyneuropathy their prices are too high. In the meantime, however, there are also devices for around €200 that are completely sufficient for your training at home. Among other things, these have the great advantage that they are quite small and light. Thus, they save space and can be transported without any problems.
Pay special attention to safety during vibration training for polyneuropathy
When doing vibration training, it is also important to pay attention to safety. Especially when you are new to this training, there is a risk of falling. Because the vibration of the plate can surprise you at first. In addition, you stand with both feet on the moving plate and have no free leg on which you can support yourself if you lose your balance.
Therefore, be sure to have something to hold on to before you start vibration training. In the best case, at least for the first workout, ask a physically strong friend or family member to stand next to you and support you if necessary. Because the last thing that should happen is falling and hurtting yourself while trying to do something about your polyneuropathy.
Do not apply vibration for too long
When doing fitness training on vibration equipment, a duration of 10-20 minutes is usually recommended. While this is good for healthy people, it is clearly too long for patients with polyneuropathy!
The goal of vibration training in polyneuropathy is to trigger an adaptation of the nerves so that the pain and discomfort improve. The nerves also react very strongly to the vibration, but they become insensitive after quite a short time and virtually no longer react to the vibration at all. Therefore, after about 1 minute on the vibration plate, you should take a break of 1 minute. In scientific studies, training was usually done 5x1 minute with one minute of rest in between.
If you use vibration for a long time without taking a break, you risk overloading you body. Many people who use a vibration device for the first time suffer from pain in various parts of the musculoskeletal system afterwards. This is usually due to the fact that the vibration is applied too intensely and for too long. Your body first needs to get used to the unfamiliar stimulus.
You can find more information about vibration training here: Physiotherapy for polyneuropathy (in German)
3. alpha lipoic acid helps with polyneuropathy
Alpha lipoic acid is proven to help with diabetic polyneuropathy - when used correctly
Alpha lipoic acid has been tried in various studies. These showed that it actually does reduce the symptoms of polyneuropathy.
However, this has only been proven for diabetic polyneuropathy. And a really significant improvement is only seen when alpha lipoic acid is given as an infusion. I still think it makes sense to consider alpha lipoic acid in capsules or pills as well, since presumably it can at least slow down the deterioration.
If you do not suffer from diabetic polyneuropathy, but from another form of polyneuropathy, the effect of alpha lipoic acid has not yet been proven, but it has not been disproven neither. There simply have not been enough studies done on it yet. Therefore, it makes sense to ask your doctor before you try it.
It is essential to clarify any risks beforehand
If you want to try alpha lipoic acid, be sure to talk to your doctor first. Alpha-lipoic acid can interact with drugs and, for example, reduce the effect of some drugs for chemotherapy.
So clarify such risks first and get advice from an expert.
L-acetyl carnitine might helo during some chemotherapies
Another promising dietary supplement is L-acetyl carnitine. There are reports that it might help patients suffering from polyneuropathy due to chemotherapy.
However, it depends on which chemotherapy exactly is involved. There are chemotherapy drugs (platinum derivatives) where L-acetyl carnitine caused significant positive effects. On the other hand, with other chemotherapies (taxanes), it did not help against polyneuropathy.
Detailed information on nutrition in polyneuropathy can be found here: Nutrition in polyneuropathy (in German)
4. electrotherapy can sometimes help with polyneuropathy
Again, it helps if you do it right.
There are very many and very different types of electrotherapy. The two most relevant types for polyneuropathy are the so-called TENS and high tone therapy.
TENS: short-term pain relief
TENS (Transcutaneous Electrical Nerve Stimulation) is commonly used for polyneuropathy.
Many patients report relief of pain after applying TENS. Unfortunately, this only lasts for a very short time. After a few hours, everything is back to the way it was before.
So TENS can not permanently help with polyneuropathy. However, it has the advantage that you can get a TENS unit to use at home for very little money and then get at least short-term relief.
High tone therapy is more promising
The second method, high tone therapy might be more helpful.
Some studies have reported positive effects that are long lasting. This type of stimulation might even trigger a regeneration of the nerves.
You can find a sample study here.
However, such studies are so far only available for polyneuropathy due to diabetes and due to kidney damage. Thus, whether high tone therapy is helpful for people with other forms of polyneuropathy remains to be scientifically proven.
However, the reports I receive from my patients about high tone therapy are usually not very positive. Especially if the polyneuropathy is not caused by diabetes. I know some patients who have already purchased a high-tone therapy device and used it for months without noticing any improvements.
This treatment is also very time-consuming, as one session lasts about an hour and you need at least three sessions per week. While there are devices for self-application at home, they are quite expensive. Before trying this yourself you should also talk to your doctor, since there are some health risks, especially if you have implants such as artificial joints.
5. omega-3 fatty acids help with polyneuropathy
Omega-3 fatty acids were tried in a study (here's the link) with breast cancer patients who were receiving a form of chemotherapy that often causes polyneuropathy (paclitaxel).
The patients who consumed these fatty acids developed symptoms of polyneuropathy less frequently than those who did not take them.
Animal studies with diabetic mice also showed a protective effect on the nerves.
Omega-3 fatty acids also seem to help with diabetic neuropathy. How big the effects are, however, is still unclear. What is certain, however, is that you have to take them for a long time to actually see an improvement.
A scientific paper on omega-3 fatty acids in diabetic polyneuropathy can be found here: Menson et al. 2021.
By the way, only certain omega-3 fatty acids seem to be helpful. Algae or fish oil are more effective, while omega-3 fatty acids from flax or olive oil are ineffective.
Only positive side effects to be expected
To be able to make a reliable statement on the effect and dosage of omega-3 fatty acids, there are currently not enough and scientific studies. However, only positive side effects can be expected from them. For example, they help keep the heart and blood vessels healthy. Accordingly, you can simply try omega-3 fatty acids with confidence and without much risk.
There are a variety of companies that offer preparations with omega-3 fatty acids. Recently, also specifically for patients receiving chemotherapy. However, those who prefer the natural option can simply consume fish or algae oils, which contain many omega-3 fatty acids. These seem to be more effective than vegetable oils due to the special ingredients. Unfortunately, it is not yet clear exactly how much should be consumed.
Detailed information on nutrition in polyneuropathy can be found here: Nutrition in polyneuropathy