Exercise therapy

Does alpha lipoic acid help with polyneuropathy?

Does alpha lipoic acid help with polyneuropathy?

Many patients wonder if you can get some relief from polyneuropathy with alpha lipoic acid. You sometimes read about great successes with to alpha lipoic acid. However, it is difficult to assess the credibility of such reports.

I have therefore looked at what research findings there are on the subject and what statements about alpha lipoic acid in polyneuropathy can be supported by scientific data.

In a nutshell:

Alpha lipoic acid can help with polyneuropathy caused by diabetes. For other causes of polyneuropathy, the data are somewhat unclear. It is certain that infusions with alpha lipoic acid have better chances of success than capsules. Unfortunately, so far there is only research evidence on short-term application. How the long-term effect of alpha lipoic acid is not yet clear.

Scientific sources

In order to give a reliable answer to the question "Does alpha lipoic acid help with polyneuropathy", I searched the largest medical database "Pubmed".

The most important question about treatment for polyneuropathy is: what causes polyneuropathy?

This is because the cause of the polyneuropathy is, of course, also decisive for the treatment. Of course, if the nerve damage is caused by diabetes, treatment must be different than if it is caused by chemotherapy or alcohol.

In scientific research, diabetic polyneuropathy receives by far the most attention, and that is why there are the best sources on it.

Diabetic polyneuropathy

The best source of information on the question of whether alpha lipoic acid helps diabetic polyneuropathy that I could find is an article from the Journal of American Family Physician.

This magazine has the so-called "Help Desk", where doctors can ask questions to specialists. These experts then provide an answer based on current research.

The specialists reported that intravenous administration of alpha-lipoic acid in diabetic polyneuropathy somewhat improved symptoms after three weeks. On a scale of 0 (no pain) to 14.6 (constant pain, numbness, burning, and discomfort), improvement of 2.8 points was reported. In this study, 600 mg of alpha-lipoic acid was given intravenously daily.

According to the experts, if the alpha lipoic acid was swallowed as a capsule instead of giving it as an infusion, there is also some effect. However, it is much weaker. The improvement was then only 1.8 points on that scale. (You can read the article here ).

However, the capsule still seems to be a good alternative, as daily infusions are quite difficult to get in everyday life. Because first of all, you have to find doctors who will carry out such a treatment at all and then just visit the practice every day to get the infusion.

So far there are no long-term studies on alpha lipoic acid in diabetic polyneuropathy.

However, there are only study results on what happens in short periods of time. The existing studies only looked at periods of 3 to 5 weeks.

The long-term effects have not yet been clarified.

To find out what the long-term effects are, we have to be patient until further studies are published.

However, these results are encouraging!

Alpha lipoic acid in polyneuropathy due to chemotherapy.

There has been very little research on the question of whether alpha lipoic acid helps with polyneuropathy caused by chemotherapy. I could only find one review paper on the subject from the Sapienza University in Rome.

In the paper, the authors note that there is still too little research to make conclusive statements. However, it is reasonable to assume that alpha lipoic acid is also helpful here.

However, these scientists also believe that alpha lipoic acid is more promising as an infusion than as a capsule.

You can read the study here.

 

Alpha lipoic acid may interact with chemotherapy

However, cancer patients should not experiment with alpha lipoic acid on their own. This is because alpha lipoic acid can interact with medications.

In particular, the effect of some chemotherapies can be reduced by alpha lipoic acid.

Therefore, if you want to try alpha lipoic acid, be sure to talk to your doctor first.

 

There is still too little research on polyneuropathy of other cause

Of course, there are a variety of other causes of polyneuropathy. However, there is little research on this yet and I could not find any robust studies on this.

Whether alpha-lipoic acid helps in polyneuropathies that are not caused by diabetes or chemotherapy is therefore not known yet.

 

 

What does this mean for you?

At first, the results of the studies presented may not seem very spectacular. At second glance, however, one notices that the results are very positive after all, at least as far as polyneuropathy due to diabetes is concerned.

Because, normally, polyneuropathy slowly gets worse and worse. However, the administration of alpha lipoic acid stopped the deterioration and there was even a slight improvement.

If one assumes that this effect continues longer than the 3-5 weeks mentioned, then the polyneuropathy is not cured, but its course is significantly slowed down.

This means that although no significant improvement can be expected from alpha lipoic acid, the deterioration can at least be slowed down, which would already be a great success.

Since alpha lipoic acid has relatively few side effects and is also not very expensive, it might be a good idea to simply try it after consulting with a doctor. If you can't find a doctor or therapist who will give you an infusion, you can certainly try capsules, as long as you're not taking any medications that alpha lipoic acid may interact with. However, this should also be discussed with a doctor.

It is important to consume a sufficient amount. In the scientific studies, 600 mg daily was used.

You also need to be patient, there is no overnight cure to be expected. If your polyneuropathy doesn't get any worse, that's already a big success!

 

 

Side effects in case of overdose

By the way, you should not take too much alpha lipoic acid.

Taking too much alpha lipoic acid often results in dizziness, nausea and vomiting. Therefore, stick to the specified 600 mg. If you still feel bad after taking it, omit alpha lipoic acid in the future or, if necessary, inform the doctor or therapist who prescribed it.

Exercise for polyneuropathy

What has also been proven to help with polyneuropathy is targeted exercise.

You can find exercises here:

Exercise therapy

Polyneuropathy and Life expectancy

Do you die earlier if you have polyneuropathy?

Everyone who suffers from polyneuropathy wonders if the disease will cause you to die sooner in addition to the many limitations it causes. I have read the scientific studies on the subject for this article and would like to answer the question: Does polyneuropathy reduce life expectancy? Or is polyneuropathy even fatal?

And if so, what can you do about it?

Briefly summarized

People with polyneuropathy live slightly shorter lives on average than people without polyneuropathy (80 vs. 86 years).
However, polyneuropathy itself is not fatal. Reduced life expectancy results from several factors:
The physical weakness due to limited activity, the higher risk for falls, and the diseases that trigger polyneuropathy such as diabetes, alcohol addiction, and cancer.
To maintain life expectancy despite polyneuropathy, targeted physical training is helpful. If another disease (e.g. diabetes) has triggered the polyneuropathy, it should be closely monitored and treated by a physician.

People with polyneuropathy live slightly shorter lives on average

To find out how long the life expectancy is in polyneuropathy, I searched scientific databases, especially Pubmed. There I found a study by an American research group. They compared the life expectancy of polyneuropathy patients with that of people without polyneuropathy. This involved collecting data on health from people in an entire county since 1966. The study included nearly 3000 people who suffered from polyneuropathy.

The researchers now compared those who had polyneuropathy with study participants who did not.

In this study, the average life expectancy of people with polyneuropathy was 80 years. Study participants who did not have polyneuropathy lived to 86 on average (You can read the study here: Hoffmann et al. 2015)

I also found two other studies that looked at diabetics. Life expectancy of diabetics with polyneuropathy and diabetics without polyneuropathy was compared (Simoneau et al. 2019, Hsu et al. 2012). Diabetics with polyneuropathy had a lower life expectancy than diabetics without polyneuropathy.

But does that mean that polyneuropathy is deadly? According to the studies mentioned, it is not clear why people with polyneuropathy died earlier. Thus, polyneuropathy is explicitly not listed as a cause of death.

People with polyneuropathy die slightly earlier on average - is polyneuropathy fatal?

Does polyneuropathy lower life expectancy? Or are there other reasons?

Because dying earlier with polyneuropathy does not mean dying OF polyneuropathy.

Indeed, the nerve damage in polyneuropathy rarely leads to death. This is because it does not affect vital organs. The disease usually limits nerve function in the periphery of the body. This means that the problem initially affects the hands and feet and only in later stages also the thighs and upper arms. This is bad, but not acutely life-threatening.

The disease would be life-threatening if the nerves that supply vital organs were damaged to such an extent that the organs could no longer function and you would die because of that. There are actually nerve diseases where this can happen. For example, the nerves that supply the respiratory muscles or the heart may stop working, and as a result the work of these organs may deteriorate (for example, in cardiac autonomic neuropathy). However, this rarely happens in polyneuropathy. So polyneuropathy is not fatal (or only very rarely and in special cases).

The reason for the shorter life expectancy of people with polyneuropathy therefore lies elsewhere. The studies mentioned above also provide indications about what the reasons for the lower life expectancy may be.

One reason is that people with polyneuropathy suffer disproportionately more often from other serious diseases that then cause polyneuropathy. This applies to diabetes as well as to cancer and alcoholism, kidney damage and circulatory disorders. These diseases in themselves lower life expectancy. Thus, the statistically lower life expectancy of people with polyneuropathy compared to healthy people may be caused by the severe diseases that result in polyneuropathy.

However, the scientists mention other reasons as well:

The people with polyneuropathy had a much higher risk of falling and were much more likely to have limited mobility. They also more frequently had problems with managing their daily lives alone and more disorders of blood circulation, problems with their heart as well as lung diseases. In other words, they were physically weak and suffered from diseases related to lack of exercise.

How can you increase life expectancy despite polyneuropathy?

Can life expectancy be maintained normally despite polyneuropathy?

For me as a therapist (and certainly for you as a patient), it is not enough to know, that people with polyneuropathy die earlier.
I want to know:

What can be done about it?

So, how can life expectancy be increased despite polyneuropathy? According to my education, I look at this question from a sports science point of view. Of course, other disciplines can contribute to better health despite polyneuropathy, but I will stick to my own area of expertise. So I am explicitly not talking about medical treatment here, but concentrate on the possibilities that physical training offers.

Proper exercise produces impressive effects on everyone's health. Physically active people therefore have a higher life expectancy, even if they suffer from polyneuropathy. Therefore, in this article I would like to show you how physical activity can help despite polyneuropathy. To do this, it is important to know what problems are common among people with polyneuropathy that contribute to lower life expectancy and that can be improved through training.

 

Falls and physical weakness lower life expectancy

Two problems that almost all people with polyneuropathy have in common are an increased risk of falling and reduced physical performance.

Falls are much more dangerous than most people realize - especially in old age. Among those over 65, falls account for up to one-fifth of emergency hospital admissions (Peel et al. 2011).

Anyone who falls and is seriously injured in old age runs the risk of loosing his or her ability to live independently. This is not only true for the famous femoral neck fracture. Falls are also one of the most common causes of brain trauma and spinal injuries. Once you suffer such an injury, you often get into a downward spiral that unfortunately quite often ends with people no longer being able to care for themselves and ending up in a nursing home. Of course, further health problems then follow and life expectancy also decreases.

However, the risk of falling is significantly increased when suffering from polyneuropathy. Most people with polyneuropathy know this from their own experience and numerous patients have already told me about how they fell.

Therefore, in order to improve your safety, life expectancy and especially quality of life despite polyneuropathy, you should try to reduce the risk of falls as much as possible. At the same time, however, you should remain as physically active as possible. This may seem like a contradiction, because someone who moves a lot is more likely to fall than someone who spends their days sitting on the couch.

However, if you stop moving for fear of falling, you will suffer all the negative health consequences of the lack of movement. Muscle strength and bone strength, for example, decrease, making you more susceptible to injury. In addition, movement control deteriorates, increasing the risk of falls. In addition, there are numerous other negative effects of inactivity, such as the heart becoming weaker and the risk of stroke increasing.

So simply not being active anymore to reduce the risk of falling is not an option!

It is much better to do specific exercises that reduce the risk of falls.

Balance training protects against falls

Training your balance protects you from falling

Targeted training for balance is surprisingly effective in this regard. Those who have better balance stand more stable and therefore fall less often. This is not only logical, but has also been proven by a large number of scientific studies.

Paticipants in those studies statistically reduced their risk of falling by about one third through training. However, if you exercise more than they did and therefore improve your balance more, you can also reduce the risk even more.

One of my patients was so successful at this that he didn't fall once in the entire year of 2020, after crashing virtually monthy in 2019 and even being hospitalized twice.

Of course, such success stories are not the case for everyone, but it is true for almost everyone that the risk of falling is lower if you are better able to keep your balance and control your movements.

 

Training helps against symptoms of polyneuropathy

The same training, interestingly, helps many people reduce the symptoms of polyneuropathy. Pain and discomfort often diminish after exercise.

This is because balance training directly addresses the nervous system. In fact, in order to keep a good balance, it is not important to have big muscles and physical strength, but to be able to perceive and control the body accurately - which are tasks of the nervous system.

Therefore, when you train your balance, you not only reduce the risk of falling, but many people also report an improvement in the symptoms of polyneuropathy. The nervous system seems to learn to compensate for the damage caused by polyneuropathy through training. Thus, training does not cure polyneuropathy, but you can train your body awareness despite the nerve damage. Balance training therefore has the potential to improve quality of life, which is at least as important as life expectancy.

Exercise guide

Detailed information on exercises specifically for polyneuropathy can be found at the following link:

Exercise for polyneuropathy

Übungen bei Polyneuropathie

Lower fitness = Higher mortality

However, falls are not the only physical limitation that reduces life expectancy in polyneuropathy. Another crucial risk factor is that people with polyneuropathy are usually less physically fit.

However, those who are more physically fit live longer and healthier lives. This is especially true if you suffer from a chronic disease. Because physical fitness protects against their consequences.

As early as 2002, a research group led by Jonathan Meyers of Stanford University investigated the influence of physical fitness on mortality in people with various diseases. They found, that people who are physically fit, although suffering from chronic diseases, have an impressively lower mortality than physically weak people with the same diseases. (You can read the study here: Meyers et al. 2002)

I have presented the data from this study in the figure on the right. You can see the statistical risk of death as a function of physical fitness and various chronic diseases. You can see so-called MET (Metabolic Equivalents). 1 MET corresponds to energy expenditure at rest. 8 MET would therefore be eight times the energy consumption at rest. This corresponds to walking at 8 km/h, for example.

People who can work at 8 MET for a long period of time (i.e., walk at 8 km/h for several kilometers) have almost no limitations in their life expectancy, even if they suffer from chronic diseases such as diabetes or hypertension.

As you can see in the figure, people who fail to reach 8 MET have a significantly higher risk of death. Those who achieve less than 5 MET have more than twice the relative risk of death than people who manage more than 8 MET. By the way, the same is true for almost all diseases and basically also for healthy people: physical fitness increases life expectancy.

Physical fitness protects - despite illnesses

Those who are fitter have better functioning organs!

The reason for the higher life expectancy of fitter people is that fitness means nothing other than well-functioning organs.

To be physically fit, you need a well-functioning heart, healthy lungs and good healthy blood vessels to bring blood and oxygen to your muscles.

The nervous system, which controls the muscles to perform the task at hand, also has to function well and becomes more efficient through training. The stability of the bones must also be great in order to be able to convert the force of the muscles. So the bones of physically fit people do not break as easily.

Physical fitness is therefore nothing other than a sign of well-functioning organs and thus good health. And whats even better: If you become fitter, stronger and more endurant through training, your organs will also function better!

For example, if you can walk farther and faster by training today than you could a month ago, you have a better functioning heart, better functioning muscles, and better functioning blood circulation.

Those who are physically fit are less likely to get sick

Therefore, the risk of very many diseases decreases if you are physically fitter.

This also applies to diseases that you would not have thought of at first. For example in fit people, the immune system also functions better, which leads to infections not being as bad.

Very fit people are therefore much less likely to contract pneumonia, for example. This is because your immune system is able to fight infections in the respiratory tract before they can develop into a dangerous disease.

And even if you get sick with pneumonia, fit people have better chances of a mild course of the disease. This is because their lungs are more efficient in the first place and are therefore able to take in enough oxygen to supply their body, even if they no longer function as well due to pneumonia. (A study on this can be found here: Kunutsor et al. (2017)

Oxygen uptake capacity is the most common measure of endurance in sports science. So the better your endurance, the better your oxygen uptake, the better the function of your lungs and, also the function of your heart and the blood vessels that carry oxygen from your lungs to your body.

Better fitness means better functioning organs!

Physical activity is more difficult with polyneuropathy

So we see that fit people also have a higher life expectancy. Thus, one can expect that better physical fitness will improve life expectancy even if you have polyneuropathy.

Now, of course, it's harder to stay fit if you have polyneuropathy. Because if you are in pain with every step or have problems keeping your balance, you obviously can't exercise as easily as someone without limitations.

Therefore, I assume that the reduced life expectancy of people with polyneuropathy, is at least in part caused by the fact that people with polyneuropathy are physically less active and therefore less fit. As a result, their organs do no function as well, heart attacks, strokes, and falls are more common, and they get plenty of other problems associated with the lack of exercise.

 

Physical fitness increases the quality of life

But it's not just about increasing life expectancy. It is at least as important to maintain the QUALITY OF LIFE. And here, too, physical fitness plays a very important role.

After all, someone who is physically fit is able to do more and also to tolerate more than someone who already has difficulties with simple everyday things.

For example, those who are physically fit have no problems climbing stairs or carrying groceries. This makes life easier and allows for more fun activities. Last but not least, you are less likely to need the help of others if you are physically stronger.

So keeping physically fit is not just a health issue. It's not just about living as long as possible. In concrete terms, it's about living more comfortably.

You can stay fit despite polyneuropathy!

Those who remain active despite polyneuropathy benefit even more

So you see, especially with polyneuropathy, it's important to stay active anyway.

It is obvious that you are less active in everyday life because the disease simply makes life more difficult. That's why it's important to create routines for physical training.

For example, if you set fixed times for your workouts and work out on schedule during those times, you can make great progress with very little time commitment.

If you start training despite polyneuropathy, you usually have great success in the initial period. After some time, however, you reach a plateau where you can't improve further. After all, the disease causes limitations that you can't simply ignore. However, just keep going!

Keep in mind that it is already a huge success if you manage to maintain the current level of fitness despite polyneuropathy. Because people who don't exercise slowly but surely become weaker, shakier and ultimately less independent. You can at least slow down this process with targeted exercises.

Exercises to do at home

More information and special exercises for polyneuropathy can be found on my page "Exercise for Polyneuropathy".

There you will find numerous exercises as well as all the important information about the training. By the way, you can easily perform the training independently at home.

Exercise recommendations for diabetic polyneuropathy

To help yourself against polyneuropathy when it is triggered by diabetes you need to use targeted training for sugar metabolism in addition to balance training.

Everyone knows that diabetics should exercise a lot. However, very few people know that it is possible to specifically train the sugar metabolism. In fact, depending on how you move, the body can get the energy for movement from different sources. These are mainly sugar and fat. Therefore, to improve your diabetes you should do things that actually burn sugar. This is the case when doing things that require energy to be provided quickly. If you move slowly but steadily, such as walking, fat is used as the main source of energy. However, diabetics benefit more from burning sugar than fat.

For more information, see my page on training for diabetics:

Exercise recommendations for polyneuropathy due to chemotherapy.

After surviving cancer, many patients struggle with the physical consequences. In particular, those who have developed polyneuropathy as a result of chemotherapy have less confidence and exercise less.

However, cancer patients benefit in many ways from physical exercise. The relapse rate, and thus long-term life expectancy, is much more favorable in physically active people. This is particularly true for breast and colorectal cancer. A research group at the Dana-Farber Institute in Boston followed colorectal cancer patients over 12 years and compared their physical activity levels. Patients with the greatest physical activity were 53% less likely to die from colorectal cancer during these 12 years (Meyerhardt et al. 2009).

Of course, patients who were more seriously ill were also less active, and therefore there was a higher mortality in this group. However, most scientists now agree that physical training increases the chances of surviving cancer by 10-25%.

It is important to strengthen the entire body. That is, balance exercises for polyneuropathy should be supplemented with strength exercises to maintain muscle strength and bone strength. It is also very important to do endurance training because it improves heart and lung function and strengthens the immune system. Even brisk walking may be sufficient as endurance training. It is important not to overexert yourself physically during and after such a stressful illness, too.

Detailed information on training for cancer patients can be found here:

Exercise therapy

Why does polyneuropathy hurt?

Fewer signals and still pain? Why does polyneuropathy hurt?

In polyneuropathy, damage occurs in the nerves, resulting in fewer signals from the periphery (mostly hands and feet) reaching the brain.

The fact that this causes pain is actually paradoxical. Because actually, getting fewer signals to your brain should mean you feel less sensations in general and not more pain.

Also, it is quite common that polyneuropathy does not actually cause pain, but simply causes you to not be able to feel your toes, feet, and fingertips anymore. So why do people with the same disease have completely opposite symptoms?

In this article, I explore the question, "Why does polyneuropathy hurt?"

A very detailed article on self-help for the pain can be found here: Pain in Polyneuropathy and what you can do about it.

Feelings are made in the brain

For example, in order to feel touch on your toes, the pressure on the toes must be sensed by a nerve. It reports its perception by sending a signal to the brain.

There is an brain area for each body part that receives and interprets the signals. It is through this interpretation that the feeling we perceive as touch is created. This interpretation of the signals also determines exactly how a touch feels.

Try the exercises here: Exercise for polyneuropathy

Whether one feels a touch as a light caress or strong pressure, as tickling or scratching, depends on how the signals from the nerves are interpreted in the brain.

So the pain originates in the brain, not in the feet!

Polyneuropathy affects the brain!

If a nerve is damaged by polyneuropathy, it sends misleading signals to the brain.

This means that if, for example, a light touch was previously reported, this signal is now altered by the nerve damage. What still arrives in the brain can no longer be interpreted as clearly as before because the data transmission is disrupted.

It is similar to interference with cell phone or radio reception: The receiver no longer understands the signal and instead of a clear sound, only crackling and noise arrive.

Hypersensitive brain areas cause pain

The nervous system responds by making the receiver more sensitive. The brain areas that receive and interpret the signals from the damaged nerve become more sensitive, literally. They develop a higher basic activity, more nerve cells grow there and the response to the nerve signals is increased.

This has the unpleasant consequence that normal everyday stimuli are felt excessively strongly and trigger pain. That is why, for example, even light touch can hurt.

If you feel pain as soon as your feet touch the floor or even the bedsheets touching your feet triggers a painful pressure, this is therefore not only due to problems in the feet, but especially in the brain.

The same applies, by the way, even if you feel uncomfortable heat sensations, tingling or other types of discomfort:

Polyneuropathy causes problems in the brain, not just in the hands or feet!

If you want to read more on the topic, here is a scientific study that describes the connections: Domingues et al. 2018

Brain training reduces the pain

If you train the brain, you improve polyneuropathy!

This is also the reason why it often does not help to work on your the feet or the hands in order to reduce the pain. Some people can get some relief by using foot baths and creams or applying other treatments. But that only helps in the short term, the pain will still come back.

A better way to manage the discomfort is to train the brain to reduce hypersensitivity. Balance training is excellent for this purpose. So this means to practice standing in unstable or even wobbly positions.

Because in order to keep your balance, you need to be constantly aware of your body and feel it very precisely. You also need to respond appropriately to sensations such as pressure on the soles of your feet. This improves the body's perception and makes the brain's work more efficient.

Maintaining balance is one of the most complicated tasks we face in everyday life - even if we often don't realize it. It is necessary to perceive, evaluate and react appropriately to movements of all parts of the body, their position in relation to each other and the tension of the muscles with the highest accuracy.

This means that in order to maintain balance, signals from the body must be constantly received, transmitted and interpreted.

This can lead to a reduction in pain.

You can find practical exercises for this here: Polyneuropathy pain and what you can do about it

87% of patients report less pain and discomfort after training

according to Streckmann et al. 2014

Training compensates for nerve damage

In a study at the University of Freiburg, such balance training was tried out with people suffering from polyneuropathy (Read the study here Streckmann et al. 2014).

As expected, the training improved the patients' balance. More importantly, 87.5% of patients reported fewer symptoms of polyneuropathy. That is: the pain and discomfort got better! In the control group, which did not exercise, not a single patient reported improvement in symptoms at the same time point.

By the way, it was measured whether the nerves in the legs of the patients recovered. For this purpose, the nerve conduction velocity was measured, by which neurologists can recognize how severely a nerve is damaged. The measurements showed no change as a result of the training, even though the symptoms got better.

This means that the improvement of symptoms did not originate in the damaged nerves in the feet or hands, but in the brain!

 

The brain is the most adaptable organ!

This is excellent news. Because it means that the nerve damage that occurs in the feet or hands can be compensated for by exercise that stimulates the brain.

Because, unfortunately, there are still few ways to heal the nerves that are damaged in polyneuropathy. But if you can improve the "data processing" in the brain, you can still reduce the pain!

Surprisingly simple exercises

If you now suspect that such a training is highly complex and difficult to implement, don't worry.

Training your balance is easy. You can easily perform such training by yourself at home - if you know how to do it.

The most important thing is to choose the right level of difficulty. Because, of course, someone who walks on a walker can't exercise at the same level as a healthy fit person.

On my page "Exercises for Polyneuropathy" you will find numerous exercises in various degrees of difficulty to try out. You'll also find all the background information you need to get started right away. Even more specific instructions for training against the pain can be found here: Pain in Polyneuropathy and what you can do about it.

You can also order a book with exercise instructions.

Muscle pain and nerve pain reinforce each other.

The pain in polyneuropathy often comes from the muscles!

Very often, however, the pain is not only triggered by the nerves - even if you suffer from polyneuropathy. This is because pain from the muscles is very often added to the pain caused by the nerve damage. Muscles that are tight can cause incredible pain.

Most people have already experienced this themselves. What not everyone knows is that in some cases, muscle tightness cannot resolve by itself and therefore cause permanent pain. And this can happen without the patient noticing that there even is a tight muscle.

This is because the muscle tightness can form tiny cramps, often only a centimeter in size. Nevertheless, they can cause tremendous pain in entire parts of the body. This is medically called Myofascial Pain Syndrome and it is one of the most common causes of pain.

Referred pain from the muscles

This problem arises particularly often when the interaction between muscles and nerves no longer functions properly and the muscles are overloaded. This is particularly common in polyneuropathy. So one reason why polyneuropathy hurts is that the nerve damage results in problems in the muscles.

Very often the nervous system is not able to relate the pain to the correct area. The pain is then felt in a different place than where the actual problem is located - this is called referred pain.

This happens especially often with muscles in the lower leg. The pain triggered there is then often felt in the feet. For example, problems in the long toe flexor (flexor digitorum muscle) often cause pain in the toes, even though the muscle itself is located in the calf.

Nerve pain and muscle pain are indistinguishable

Unfortunately, it is practically impossible to distinguish whether the pain you feel is caused by nerve damage or muscle problems. Because your nervous system only tells you that pain is there, not which structure is reporting it. However, my personal experience is that almost all patients with polyneuropathy have an additional problem in their muscles.

This actually is good news! Because we know how to improve the function of the muscles - through training. So if the nerves can't be cured, at least the muscles can be worked on.

Muscles are usually ignored in polyneuropathy

Unfortunately, few people think about the fact that you could help yourself by working your muscles if you suffer from polyneuropathy. Polyneuropathy is a nerve disease and the connection with the muscles is not that obvious.

Therefore, patients are very rarely told that treating the muscles can help with the pain, even if it does not cure the polyneuropathy.

Learn how to help yourself!

In addition, the muscle problem cannot be solved with medication or a few simple physiotherapy techniques. It is possible to treat the muscles with exercise, stretching and massage, but the nerve damage in polyneuropathy makes treatment much more complex and difficult than in other patients.

Therefore, it is very difficult for therapists to make real progress. Especially because there is not enough time and the therapy sessions are too short. Therefore, the best solution is to learn what you can do for yourself.

Therefore, in my Pain Relief Set you will find the exercise guide "Exercise for Polyneuropathy" with numerous exercises for training balance and body awareness. For the treatment of the muscles you will receive the book "How to treat your own foot pain", describing the massage and stretching of all relevant muscles of the feet and lower legs.

So, with the Pain Relief Set, you get everything you need to help yourself against the pain of polyneuropathy.

 

Exercise therapy

Polyneuropathy and coffee – you can still drink it

Can coffee be harmful in polyneuropathy?

Coffee consumption and polyneuropathy are issues that many patients worry about. Since the disease often severely restricts the quality of life, one is often quickly unsettled by such considerations. In medicine, however, coffee for people with polyneuropathy is rarely discussed and you can hardly find any information on how to deal with this stimulant.

In this article, I will therefore try to summarize the scientific facts on the subject of coffee and polyneuropathy and to clarify as many open questions as possible. One thing up front: I do not want to keep you from drinking coffee if you suffer from polyneuropathy!

Briefly summarized:

There is no scientific evidence that coffee may be harmful in polyneuropathy. If you suffer from polyneuropathy due to diabetes, coffee might even have a rather positive effect.
There is no reason to generally avoid coffee in polyneuropathy. Only if your doctor advises for good reasons, you should refrain from coffee consumption.

Is coffee harmful in polyneuropathy?

Polyneuropathy and coffee

Polyneuropathie und Kaffee

That was news to me!

A few days ago, a patient asked me, somewhat concerned, whether she was still allowed to drink coffee because of her polyneuropathy.

She had read that with polyneuropathy you should limit coffee consumption because it aggravates nerve damage. I didn't know that polyneuropathy and coffee were related, so I started researching.

More information about nutrition in polyneuropathy can be found here.

Alleged disturbance of the autonomic nervous system

At first, when you search for information, you hardly find anything. One can only find a few websites that recommend limiting coffee consumption in polyneuropathy because it affects the autonomic nervous system and impairs coordination in the nervous system.

It is true that coffee affects the autonomic nervous system and this is one of the reasons why coffee is a stimulant, but does it harm or even worsen polyneuropathy? In most cases, the nerve damage in polyneuropathy is not primarily located in the autonomic nervous system. (The autonomic nervous system, in simple terms, is the part of the nervous system that makes us awake or tired and regulates things like breathing rate and digestion that occur unconsciously, there are particular forms of polyneuropathy that harm it especially, but these are not the most common ones).

Most people suffer from pain, numbness and insensitivity in the feet and hands. And they do not arise from problems in the autonomic nervous system.

So are claims about coffee being harmful just assumptions rather than statements based on facts?

What does science know about polyneuropathy and coffee?

To find reliable information, I looked for scientific studies. To do this, I searched medical databases where most studies can be found.

In such cases, the best address is "Pubmed", the most important database for medical studies. If there is evidence about medically relevant effects of stimulants, it can pretty certainly be found here. Unfortunately, however, almost no studies can be found on the subject. At least not with humans. Apparently, hardly any researchers have ever asked the question whether polyneuropathy and coffee are related.

The only thing I could actually find are two studies with mice that had diabetes. Diabetes induced damage to the auditory nerves in these mice (they suffered from auditory neuropathy). When the animals were given coffee, it actually protected the auditory nerves. The nerves functioned better and could process signals better. So the mice could hear better because their nerves worked better when they got coffee. Here is the link to one of the studies.

 

Does coffee actually protect against polyneuropathy?

More likely to have a protective effect?

So in humans, there is no research at all on whether coffee is harmful in polyneuropathy. In animals, there is evidence that coffee may even be protective. However, that is still not enough data to give a good recommendation.

So we don't really know much about the topic yet, and studies that directly examine the effect of coffee in patients with polyneuropathy don't even exist yet. This means that from a scientific point of view, one can, if at all, only make assumptions based on the animal experiments. So there is really no reason for prohibiting patients from drinking coffee.

But what else is known? We know that coffee has some effects on our body and our health. Which effects, then, might be related to polyneuropathy?

Coffee tends to be helpful in diabetic polyneuropathy

What can be said for sure is that regular coffee consumption helps rather than harming you if you have diabetes. And diabetes is one of the most common causes of polyneuropathy.

Coffee consumption reduces the risk of developing type 2 diabetes. As you can see from the graph below, the risk decreases by about a third if you drink six cups a day. (If you click on the graphic you will get to the study from which the data originate)

By the way, the risk decreases further if you drink more than 6 cups of coffee a day. However, you have to be a big coffee lover to drink such quantities and you can well assume that such quantities exceed the healthy measure.

If you suffer from diabetes you may be interested in my training against diabetes

Exercise against polyneuropathy

With the right exercises you can help yourself against polyneuropathy.

The nerve damage in the hands and feet can be compensated by proper training of the brain. This helps you learn to walk more safely again and avoid falls. Often even the pain gets better.

Here you will find exercises to do at home:

Coffee protects diabetics from secondary diseases

Even if you already have diabetes, regular coffee consumption can somewhatlower blood sugar. Regular consumption seems to be able to reduce long-term blood glucose HbA1c by a maximum of 0.5. That's not a huge difference, but it's impressive for a simple drink. Interestingly, this effect only occurs in the long term. Immediately after drinking coffee, blood sugar even rises for a short time.

Coffee also seems to reduce the risk of heart attacks and strokes in diabetics a bit. Unfortunately, these occur particularly frequently in diabetics, and coffee lowers the risk somewhat. Of course, this only applies if you do not sweeten the coffee too much with sugar 😉

But then, if coffee has a positive effect on blood sugar, why would it be harmful in diabetic polyneuropathy? There is neither statistical evidence nor other claerly valid arguments for this. In fact, it seems to be more likely that coffee helps against diabetes and thus against the nerve damage causing polyneuropathy.

So if your polyneuropathy was triggered by diabetes and you like to drink coffee, go for it! You are more likely to do yourself some good than harm. And you already have to do without so many things you probably like, that it is probably nice to be able to treat yourself to a coffee at least once in a while.

Can coffee compensate vitamin B deficiencies in polyneuropathy?

In addition, coffee contains niacin (vitamin B3) and it promotes the absorption of vitamin B12. A deficiency of B vitamins can also trigger polyneuropathy, therefore a deficiency of B vitamins should absolutely be avoided and an appropriate amount of B vitamins should be included in your diet. ( You can find out more about nutrition in polyneuropathy here).

However, the amounts of B vitamins in coffee are not very large, so the hot beverage alone will not make a huge difference if you are suffering from acute B-vitamin deficiencies.

At the same time, however, coffee seems to lead to a loss of vitamin B1. But this effect is not so great that you would have to give up coffee because of it. Especially if you otherwise pay attention to a good diet. Regarding vitamin B1, it is more important to avoid alcohol, which deprives the body of this important nutrient to a much greater extent.

However, as far as vitamins are concerned, in general, the potential for curing polyneuropathy is limited. Of course, if you suffer from nerve damage caused by a deficiency of vitamins, it makes perfect sense to take them. Also if a deficiency has been measured in your blood, you should of course compensate for it.

However, as far as vitamins are concerned, there is a general rule:

Taking more vitamins than necessary is not beneficial!

That is, a normal supply of vitamins of all kinds is enough. If you are not deficient in vitamins, taking vitamin pills or eating a diet rich in them won't help. That is why all attempts to cure polyneuropathy with vitamin pills have failed so far.

So possible effects on the vitamin balance are also no reason for polyneuropathy patients to ban coffee from their diets.

You already have to refrain from enough

So don't let polyneuropathy spoil your coffee. Being a polyneuropathy patient you have to pay attention to so many things. The disease already brings about enough problems and limitations.

There is no need to worsen the quality of life by giving up coffee as well. Especially because there are no real reasons for this. As I said, there is no scientific basis for not drinking coffee because of neuropathy.

Recommended in Chinese medicine

In Chinese medicine, in some cases, it is recommended to reduce coffee consumption when suffering from polyneuropathy. If you are being treated by doctors or naturopaths and a proper diagnosis has been made, which is the basis for such a recommendation, this may well be valid.

Experienced professionals certainly have good reasons for advising you against coffee in some cases.

But this is not generally true for all people with polyneuropathy. These are individual recommendations.

For the general public, there is no reason to generally skip coffee if you have polyneuropathy!

If you want to know more about nutrition in polyneuropathy, you can find more information at the following link:
Nutrition in polyneuropathy

Targeted exercises for the nervous system in polyneuropathy

The nervous system is the part of the body that responds most quickly to physical training. Exercises that help you to cope well with everyday life despite the damage caused by polyneuropathy can be found here:

Exercise therapy

Training against pain in polyneuropathy

Pain is the worst symptom in polyneuropathy, along with insensitivity and numbness. However, recent research shows that proper exercise can help. The best part is that you can do such training for polyneuropathy-pain by yourself at home!

By the way, you can find a very detailed description of pain management in polyneuropathy here: Pain in polyneuropathy and what you can do about it.

Scientifically proven: Polyneuropathy pain gets better with exercise!

It has been known for several years that targeted exercise in polyeuropathy helps to increase balance and gait safety. Therefore, scientists as well as patients wondered for a long time: Could training also help against pain in polyneuropathy and even against numbness and loss of sensitivity? Now there are scientific studies that prove just that. I would like to present two of them in this article.

The results are clear: pain in polyneuropathy can be reduced

The studies show: Targeted training reduces Polyneuropathy symptoms. Study participants reduced uncomfrotable heat and cold sensations, as well as numbness and tingling in their hands and feet through training. The studies explicitly point out that a control group that did not train did not succeed in doing so: Training pays off! Noticeable. Therefore, scientists even tell physicians to recommend this beneficial training to their patients. This should be enough evidence for you to do it yourself. The exercises are easy and can be done at home. Here is the link to it:

Those who want the exercises handy in the form of the popular booklet, or the useful Balance Pad or even the whole Balance Set, will find everything they want here:

Too old for it?

Some patients tell me: "At my age, I don't do sports anymore!" And as a matter of fact it is not necessary to do actual sports. The exercises are not a "sport" like soccer or skiing. In fact, the exercises are so simple that virtually anyone of any age can do them at any time - and have a lot of fun doing them. Many patients also say, "At my age, it's not going to get better anymore." This is also contradicted by the first study in particular: for older participants, improvements in symptoms were even greater than for younger ones. Finally, age pays off for a change! So it's never too late for improvement.

Even better reflexes!

A second study, primarily by researchers at the Sport University of Cologne, Germany, had PNP patients undergo balance training and vibration training. Here they showed that it reduced their pain and even improved their reflexes. Balance training also has a nice advantage: you can do it at home in your own four walls. You don't need a gym, a trainer, a doctor, a physical therapist to do this. It couldn't be easier or more enjoyable.

Effort need not be - if you practice with brains

By the way, the exercises were not about trying as hard as possible. This is not about fitness training. The point is to train the nervous system, not muscles or endurance.

If you try very hard, it even leads to a small training effect. Because the nervous system can adapt better when you are recovered and can still concentrate well. It is more of a learning process than a fitness training. Because you learn new movements and especially to keep your balance better.

This causes the nervous system to adapt to the new tasks. And this adaptation leads to compensate the nerve damage that causes polyneuropathy. And this makes the pain better.

Strength and endurance training as a bonus

If you do strenuous strength and endurance training then the training is mainly directed at the muscles and the cardiovascular system. The nervous system is not in the foreground.

Polyneuropathy patients who do strength training or endurance training accordingly do not achieve great effects on the nerves. Of course, the training has very very many positive effects on the body and health. However, it alone is not enough to help against polyneuropathy. In studies in which patients with polyneuropathy completed such training, there were slight improvements, but the effect was so small that the effort was disproportionate to the benefit.

However, if you perform training for the nervous system and then add strength and endurance training, the effects complement each other and you achieve greater improvements.

The effect of training on the nervous system is improved and polyneuropathy improves faster. At the same time, strength and endurance training also works better because the better functioning nervous system results in better coordination and allows muscle strength to be used more effectively.
By the way, the effect of strength and endurance training is particularly pronounced in diabetic polyneuropathy. There are even better values for nerve conduction velocity, and more nerves seem to grow in the feet of diabetics when they exercise. Scientific studies on this can be found here: Singleton et al. (2014); Kluding et al. (2012).
Detailed exercise recommendations for diabetes and diabetic polyneuropathy can be found here: Diabetic Polyneuropathy, Exercise for Diabetics.

So, it is best for polyneuropathy patients to combine special exercises for the nervous system with strength and endurance training. However, if you only have time for one or the other, you should focus on the nervous system.

Try it for yourself

You will feel the beneficial effects of the training on your own body and in your own everyday life. So as it is as simple as that: try it! Why not try it today? It's worth it. Get started!

Sample exercises can be found here:

Those who wish are welcome to read the original study texts:

https://www.ncbi.nlm.nih.gov/pubmed/29243164

https://www.ncbi.nlm.nih.gov/pubmed/30382392

Exercise therapy

Gloves for chemotherapy – a simple trick with huge…

Prevent polyneuropathy with gloves during chemotherapy!

Doctors are trying to to help patients with chemotherapy - but unfortunately often unintentionally and unavoidably harm them: chemotherapy has severe side effects, one of which is polyneuropathy. But now a study shows there may be a simple, risk-free, low-cost way to reduce the incidence of polyneuropathy significantly. The crucial tool - rubber gloves - costs just a few cents ...

Gloves protect against polyneuropathy during chemotherapy

Briefly summarized

Wearing compression gloves during chemotherapy infusion can significantly reduce the risk of polyneuropathy. Simple surgical gloves are sufficient for this purpose. These should be selected one size too small. Also, two gloves should be worn on top of each other to achieve sufficient compression.

Amazing help from gloves during chemotherapy infusion

Until now, doctors and therapists have been relatively powerless against polyneuropathy triggered by chemotherapy. There were no means to prevent polyneuropathy and hardly any to treat it once it occurred. However, there is new hope. Now, a Japanese study led by Shigeru Tsuyuki of Red Cross Hospital in Osaka has come up with a solution that is as amazingly simple as it is effective: gloves. No, not high-tech, fully digitalized gloves 4.0, but just normal surgical gloves for a few cents a pair.

Gloves for chemotherapy

90 minutes, amazing effect

The Japanese scientists had their subjects wear the surgical gloves while administering the drug. Starting 30 minutes before the administration of chemotherapy, during the 30 minutes of administration and 30 minutes afterwards. So all in all, just 90 minutes for a surprising, unexpectedly great effect.

The trick

Because now, of course, everyone wonders why simple gloves can prevent polyneuropathy: There was a trick to it. The patients did not wear gloves of their actual size, but one size smaller. And they wore not one pair, but two. At this point, every experienced nurse recognizes the active principle behind it: Compression. Which is obvious, of course, but what science would like to confirm through additional studies.

You can also help yourself against polyneuropathy with the right exercise!

Try it for yourself

For the time being, this further clarification can be dispensed with in the treatment of cancer patients, because the effect of the simple gloves in the Japanese study during chemotherapy was enormous: the incidence of chemotherapy-induced polyneuropathy fell from 76.1 percent to 21.4 percent for sensory polyneuropathies and from 57.1 percent to 26.2 percent for motor polyneuropathies. That's stunning. And all because of a pair of gloves; more precisely: because of two pairs.

Gloves for chemotherapy Polyneuropathy (motor)

Brilliant design

The design of the study was brilliant in order to avoid confounding (falsified results): It was not tested as usual with a test group and a control group, but much simpler: All subjects wore the gloves on one hand only. The other remained without treatment - and suffered. This may be inconvenient for those affected, but it is practically ideal for proving efficacy.

The principle of action of the gloves in chemotherapy

The compression provided by the gloves reduces blood flow: less chemical agent is flushed into the fingers and thus the nerves of the fingers are also less damaged. If you are worried about not enough blood reaching your hands: No, a surgical glove, even one size too small and worn twice, cannot constrict a human hand to the point of causing damage. Quite the opposite. Which is not a question anyway, because: Nobody forces patients to put on the glove. If patients start to feel uncomfortable with the compression, they can remove the gloves at any time. The only important thing is: there is no risk if he or she keeps the gloves on during the administration of chemotherapy.

Ice gloves during chemotherapy have the same effect

By the way, another Japanese study shows that the same effect can be achieved by cold (Kanbayashi et al. 2020). To do this, the scientists gave a group of test subjects cooling gloves that resemble a cold pack into which you put your hand. They wore these for 60 minutes while receiving chemotherapy. A second group received compression gloves, which they used exactly as described here. The result of the two groups was almost identical.

So if you have access to such cold gloves you can choose what you are more comfortable. If you suffer from latex allergy you should also try to get ice gloves. Otherwise, you can simply take the rubber gloves described.

Why hasn't everyone been doing this for a long time?

If a simple glove works so brilliantly, why don't all clinics and practices have it put on? Because the Japanese study is brand new in terms of scientific time spans: it was only published in September last year. If you are the first person in your practice or on your ward to find out about it: Please talk about it!

For one simple reason: this is the only way the interested party will find out about it. That was also the case for me: I got the tip about the study from Dr. Isabell Pfeiffer, who works at Celgene in Munich. If you would like to read the study: click here.

Pass it on!

Now it is a matter of spreading the good news to as many people as possible as quickly as possible. So that no human being has to suffer unnecessarily. And so that the glove trick can be tested in practice. This is the only way to get useful feedback, which I am of course very interested in. Why don't you write me what you think about it and/or what the discussion among your colleagues has revealed? Email

Or share this article.

By the way, here is a detailed article on exercises for polyneuropathy due to chemotherapy
If you are interested in physical training despite cancer you will find detailed information here: Training against cancer

You can also help yourself against polyneuropathy with the right exercise!

[]