What causes peripheral neuropathy
http://www.endneuropathynow.com/ Hi. This is Dr. Peters. I just wanted to take a minute to shoot a quick video about a question that I’ve been asked at least 500 separate occasions. And that question is, “Dr. Peters, why are you able to figure out what could be causing my neuropathy when no other doctor that I’ve been to has been able to do that, from other chiropractors to medical neurologists to physical medicine doctors and why is that?” I’m gonna explain that to you shortly in this video.
So, I’m a functional neurologist. And what that means is I have over a thousand hours of training in functional neurology, specifically how to treat neurological disorders and neurological problems. What we’re gonna talk about today is a really important part of the process of doing a comprehensive physical exam and the reason why. A lot of times patients who maybe don’t have a good medical experience don’t understand that most of the diagnosis comes from history and our physical examination. And that’s actually an art form that’s lost today. But in neurology, in neuroscience, that is… It’s vital. It is extremely important, especially in cases of neuropathy and I’m gonna explain to you why.
Let me point to the nerve chart here. This is something that I use often in my office. An axon means nerve and this essentially says nerve classifications. What’s important to realize is there’s different types of nerves and they do different things. Essentially, there is two main types of nerves. There’s groupings called large fibers and groupings called small fibers. The large fibers are very thick. They have a lot of covering on them that… You see there, that’s called myelin, and those can get damage in certain processes. For example, metformin causing B12 deficiency or anemia, intrinsic factor type anemia. Or it can also be caused by other diseases in fact, late stage diabetes can cause that. Not early on but late stage, and even spinal and back problems. When we see that, usually that correlates to just numbness. There’s usually lack of balance or a loss of balance or unsteadiness on the feet. That’s a very important part of our testing.
Now these nerves right here, these are called small fibers and those are involved in pain. Well, why is that important? Well, number one because many times when a person has neuropathy, they have burning, they have cramping, they have sharp and stabbing pain, sometimes even a restless leg component. What we’re really looking at when we look at small fibers are these ones here, the type III and the type IV. The type IV actually have no covering on that. Those oftentimes are destroyed early on many times even before a patient is ever diagnosed with diabetes. Studies have shown that those nerves can be affected up to two to five years before the diagnosis of diabetes is ever made. That’s something that we look at because we wanna know there are certain things that damage these nerves, there are certain things that damage those nerves, if they’re all infected, there is certain things that cause that and we look at those. Based upon that, that’s what sets us off in the direction, clinically, do we head east or do we head west because it’s a lot easier to look at that in the beginning. And that tells us what may be causing your problem.
Many of the videos that you may see, that in many of those cases about 50% before they come to see me, they do not know the cause of their neuropathy. The doctor tells them, “I don’t know.” I just saw a patient just yesterday. So that’s why we’re doing this video because most of the time once we see that, we can look for the specific causes that damage those nerve fibers. So I hope this video was helpful. I look forward to meeting you and getting to know you and thank you for watching this video. Have a great day.
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