What Causes Neuropathy, Its Different Types, And Treatment Options

One of the common mistakes people make when attempting to treat pain is that they assume all pain is the same. As such, they tend to treat any pain they experience using the same methods, whether acute or chronic. However, doing so will never solve the problem; it only provides temporary relief. This is especially the case regarding neuropathy, which can cause multiple symptoms, including mild to severe pain in various forms. The tricky thing about neuropathy is that there are several forms of neuropathy that can lead to many kinds of symptoms. Not to mention, there are many potential underlying causes.

The following is a guide to understanding what neuropathy is, what can cause it, the different types of neuropathy, and the treatment options available.

Neuropathy

Neuropathy is a condition in which various symptoms are experienced as a result of nerve damage. This nerve damage can be caused by numerous diseases, conditions, and even injuries. It occurs when the body’s nerves malfunction, leading to pain, numbness, tingling, and even paralysis. 

Neuropathy can affect any system of the body that relies on the nervous system, such as muscles and internal organs. Because neuropathy is complex, it can be challenging to understand what causes the disorder and how to treat it. As such, understanding the basics of the nervous system and its different types, as well as their accompanying symptoms and treatment options, is crucial.

Neuropathy And Our Nervous System

The nervous system is a complex and essential system of the body that helps us control our movements, interpret sensations, and even think. It is comprised of two parts:

  • Central Nervous System: The central nervous system is responsible for processing and interpreting incoming sensory information. It includes the brain and spinal cord, forming a communication network between the body and the environment.
  • Peripheral Nervous System: The peripheral nervous system is responsible for controlling bodily functions, such as movement and the function of organs. The peripheral nervous system connects the central nervous system to the body’s other systems, such as the muscles and internal organs. The peripheral nervous system is divided into two parts:

    • Somatic Nervous System: The somatic nervous system is responsible for voluntary movements, such as writing and walking.
    • Autonomic Nervous System: The autonomic nervous system is responsible for involuntary activities like digestion and heart rate.

4 Types Of Neuropathy

Neuropathy is caused by damage to or malformation of the nerve fibers in the peripheral nervous system. When this happens, it can cause various symptoms depending on which nerves are affected. There are four types of neuropathy. Each type has its own set of symptoms. These include the following:

1. Peripheral Neuropathy

Peripheral neuropathy is a disorder that affects your peripheral nerves. These nerves connect your brain and spinal cord to your muscles, internal organs, and skin. Causes of peripheral neuropathy can include injury, infection, or exposure to certain toxins.

It’s estimated that over 20 million people in the U.S. have some sort of peripheral neuropathy. However, because symptoms can sometimes be mild and can be confused with other conditions, many people with peripheral neuropathy are not diagnosed with the disorder.

Signs And Symptoms

Symptoms and signs of peripheral neuropathy include:

  • Numbness and tingling in the feet or hands
  • Burning sensations
  • Loss of coordination
  • Weakness in the limbs
  • Muscle cramps and spasms
  • Loss of reflexes
  • Chronic pain

2. Autonomic Neuropathy

Autonomic neuropathy is a disorder that affects your autonomic nervous system. Autonomic nerves control your involuntary bodily functions such as digestion, heart rate, respiration, perspiration, and urination. Damage to the autonomic nerves can be caused by diseases such as diabetes, alcoholism, or any condition affecting the blood vessels. It can also occur on its own. It’s said to affect more than 70 million people worldwide.

Signs And Symptoms

Signs and symptoms of a damaged autonomic nervous system include: 

  • Diarrhea/constipation
  • Nausea and/or vomiting
  • Bloating
  • Heartburn or acid reflux
  • Lightheadedness
  • Trouble controlling body temperature
  • Sexual dysfunction
  • Dizziness or fainting when standing up
  • Blurred vision or other vision changes
  • Dry mouth and eyes
  • Excessive sweating or lack of sweating
  • Incontinence
  • Slowed digestion or digestive issues
  • Difficulty swallowing

3. Focal Neuropathy

Focal neuropathy is a disorder where only one nerve, or group of nerves, is damaged. It can affect any part of your body and can cause a range of symptoms. It’s most commonly seen in older adults, especially those with diabetes or other metabolic disorders. Entrapments, or nerve compression due to trauma, can also cause focal neuropathy.

Signs And Symptoms

Focal neuropathy can occur suddenly, and the symptoms can last anywhere from a few days to a few weeks. However, when caused by chronic conditions like diabetes or HIV/AIDS, it can persist for much longer. Common signs and symptoms of focal neuropathy include:

  • Pain
  • Numbness
  • Weakness
  • Tingling
  • Loss of sensation
  • Paralysis in the affected area

4. Cranial Neuropathy

Cranial neuropathy is a disorder that affects the nerves in your brain. It can affect any of the 12 cranial nerves, which control different functions in your body. Various conditions, such as diabetes, tumors, trauma, infections, or toxins, can cause it. There are several types of cranial neuropathy, and the symptoms can vary depending on which nerves are affected. These types include the following:

Microvascular Cranial Nerve Palsy

Microvascular cranial nerve palsy (also known as ischemic cranial neuropathy) is the most common form of cranial neuropathy. It is caused by the narrowing or blockage of small blood vessels that supply oxygen to the cranial nerves in your brain, leading to nerve damage and a range of possible symptoms. Common signs and symptoms include:

  • Double vision
  • Facial numbness
  • Drooping eyelids
  • Loss of taste
  • Slurred speech
  • Difficulty swallowing or speaking

Bell’s Palsy

Bell’s palsy is another form of cranial neuropathy. It is caused by inflammation in the facial nerve, which can lead to temporary paralysis of the affected side of your face. Common signs and symptoms include:

  • Drooping on one side of the face
  • Sudden loss of facial movement
  • Pain around your ear
  • Uncontrollable blinking of one eye
  • Difficulty smiling or frowning on one side
  • Sensitivity to sound on one side
  • Headache pain in the affected area.

Third, Fourth, And Sixth Nerve Palsy

Third, fourth, and sixth nerve palsy are other types of cranial neuropathies. They involve damage to the oculomotor, trochlear, and abducens nerves. Common signs and symptoms include:

  • Double vision
  • Headaches
  • Crossed eyes (strabismus)
  • Loss of peripheral vision
  • Trouble focusing on near objects
  • Drooping eyelids.

What Neuropathic Pain Feels Like

Neuropathy can cause many symptoms, many of which depend on the type of neuropathy and what is causing it. However, one of the common symptoms of neuropathy is nerve pain or neuropathic pain. This type of pain is normally described as a burning, tingling sensation, but it can also feel like a shooting, stabbing, or electricity-like sensation. The following examples are of conditions that can cause such neuropathic pain:

  • Postherpetic neuralgia: Postherpetic neuralgia is a complication of herpes zoster (more commonly referred to as shingles) and can cause burning, aching, and sharp pain in the area where the rash appeared. It can last for months or even years after the rash has cleared.
  • Trigeminal neuralgia: Trigeminal neuralgia causes sharp, shooting pain in the face and jaw. It is caused by damage or irritation to the trigeminal nerve. This nerve is responsible for delivering sensation from the face to the brain. It often feels like a stabbing or electric shock and can be triggered by the slightest touch or movement.
  • Diabetic neuropathy: Diabetic neuropathy occurs in people with diabetes. It develops because of high blood sugar and can cause various symptoms, including burning, numbness, tingling, or shooting pain in the hands and feet.
  • HIV-associated peripheral sensory neuropathy: HIV-associated peripheral sensory neuropathy is caused by nerve damage due to HIV infection. HIV infections can damage the nerves by attacking the myelin sheath, which is the nerve fibers’ protective coating. This can lead to burning sensations, numbness, tingling, and shooting pain in the hands, feet, and other areas of the body.
  • Leprosy: Leprosy is an infection caused by the Mycobacterium leprae bacteria. Leprosy can cause nerve damage as a result of inflammation and tissue damage. The nerve damage lead to a burning, tingling sensation and numbness in the affected area. Other symptoms may include weakness or paralysis of the face and other parts of the body.
  • Peripheral nerve injury pain: Peripheral nerve injury pain is caused by peripheral nerve damage, which can result from trauma, surgery, tumors, or radiation. It can cause burning, stabbing, and shooting pain in the affected area.

Other Symptoms That Accompanies Neuropathic Pain

The following are additional symptoms known to be associated with neuropathic pain:

  • Paresthesia: Paresthesia is the sensation of prickling, tingling, burning, or numbness in the skin. It can result from damage to the nerves that carry sensations from the body to the brain. 
  • Allodynia: Allodynia occurs when a person feels pain from something that wouldn’t usually cause it. It can occur after nerve damage and can cause a person to experience pain from stimuli that wouldn’t normally be painful, such as light touch or even the air passing over the skin.
  • Hyperalgesia: Hyperalgesia is a condition in which pain is felt more intensely than usual. It can be caused by nerve damage and can make even mild sensations of pain feel more intense.
  • Dysesthesia: Dysesthesia is a painful sensation that can occur without any stimulation. This means that it can be experienced without anything touching the skin. It commonly affects the hands, feet, and other areas of the body and can cause sensations of burning, itching, stinging, or electric shock.

Causes Of Neuropathy

Even though neuropathy refers to a wide range of symptoms that are caused by damage to the nerves, the underlying cause of nerve damage can vary. In fact, many different things can trigger different types of neuropathy. The following are the common denominators that can lead to neuropathy as well as some of their sub-causes:

Health Conditions

Many different health conditions can lead to nerve damage, thereby causing neuropathy. The following are some of the health conditions known to lead to neuropathy:

Poorly Managed Diabetes

If you don’t manage your diabetes effectively, it can lead to nerve damage and the subsequent development of neuropathy. If your blood sugar levels are too high for too long, it can lead to small blood vessel damage which may cut off oxygen and nutrients to your nerves. This can lead to nerve damage since the nerves no longer receive the oxygen and nutrients they need to remain healthy. As a result, it should come as no surprise that people with diabetes are more prone to developing neuropathy.

Idiopathic Neuropathy

Although many different things can cause neuropathy (including the health conditions listed here), there are times when no underlying cause can be identified. When this is the case, the condition is called idiopathic neuropathy.

Chronic Alcoholism

Chronic alcoholism interferes with the normal functioning of the nerves, leading to nerve damage and neuropathy. This is because chronic alcohol use can lead to malnutrition and can have a toxic effect on the nerves.

Cancer

Certain types of cancer can lead to nerve damage and the subsequent development of neuropathy. For example, people with lymphoma may experience paraneoplastic neuropathy, which is caused by the cancer cells attacking and damaging the nerves.

HIV/AIDS

HIV/AIDS is a condition that prevents the body from fighting off infections due to a weakened immune system. As a result, HIV/AIDS can lead to nerve damage and neuropathy because it increases the risk of infections that can affect the nerves.

Dietary Causes

Certain dietary deficiencies can sometimes lead to nerve damage and neuropathy. This is because deficiencies in specific vitamins and minerals can make it difficult for the body to repair damaged nerves properly. The following are some of the more common dietary causes that can lead to neuropathy:

Vitamin B12 Deficiency

One of eight B vitamins, vitamin B12 is essential to cell metabolism (meaning how cells use energy), red blood cell formation, and nerve function. If you don’t have enough vitamin B12 in your diet, it can lead to a condition known as pernicious anemia. This form of anemia can cause nerve damage by preventing the body’s red blood cells from carrying oxygen to the nerves.

Copper Deficiency

Copper is a mineral vital for the normal functioning of nerve cells because it helps insulate the outer sheath of nerve cells. Without an adequate amount of copper in your diet, your nerves become more vulnerable to damage.

Excess Nutrient Consumption

Although deficiencies in certain vitamins and minerals can lead to nerve damage and neuropathy, consuming too much of some nutrients can also be problematic. For example, an excess of vitamin B6 can cause nerve damage because it can interfere with the body’s production of neurotransmitters.

Exposure To Toxins In Foods

Certain foods, such as shellfish and other seafood, contain toxins that can lead to nerve damage. These toxins include ciguatoxin, maitotoxin, and okadaic acid. Eating foods that contain these toxins can lead to nerve damage by interfering with the normal functioning of nerve cells.

Diagnosis Of Neuropathy

When you consider the different types of neuropathy, all the different symptoms neuropathy can cause, and all of the potential underlying conditions, diagnosing neuropathy and its cause is no simple matter. As such, there are a variety of medical tests and procedures used to diagnose neuropathy, such as the following:

Electrodiagnostic Testing 

Electrodiagnostic testing involves using electrodes to measure the electrical signals sent by nerve cells. By recording these signals, doctors can look for abnormalities indicating nerve damage and neuropathy.

Blood Tests

Blood tests are used by doctors to look for certain conditions, such as diabetes, vitamin deficiencies, and infections that could be causing nerve damage. Examples of blood tests used to diagnose neuropathy include complete blood count (CBC) and comprehensive metabolic panel (CMP).

Skin Biopsies

Skin biopsies are a type of procedure used to take a small sample of skin. Skin biopsies can help doctors to identify certain types of nerve damage, such as sensory neuropathy. By looking at nerve fibers under a microscope, doctors can look for signs of damage or disease.

Quantitative Sensory Testing (QST)

Quantitative sensory testing is a procedure used to measure how sensitive a person’s skin is to different stimuli. For example, this test can identify nerve damage by looking for differences in how a person’s skin responds to light touch, pinpricks, and heat.

Different Treatments For Neuropathy

There are several neuropathy treatments available, depending on the kind of neuropathy you have, the types of symptoms you’re experiencing, the severity of the symptoms, and the underlying causes. These include

Medications

Medications such as antidepressants, anticonvulsants, and opioids are commonly prescribed to manage the pain associated with neuropathy. Antidepressants can help to reduce nerve pain by affecting the transmission of signals between nerves. Nonsteroidal anti-inflammatory drugs (NSAIDs) — for example, ibuprofen and naproxen — can reduce inflammation and nerve pain. Opioids such as codeine, oxycodone, and fentanyl can be prescribed for severe neuropathic pain.

Although these medications can help alleviate some of the symptoms of neuropathy, you should understand their potential risks. Some medications are known to be addictive and can also cause side effects. These side effects vary but can include drowsiness, nausea, constipation, dizziness, and more. On top of that, medications won’t address the underlying cause of neuropathy — they’ll only mask the symptoms.

Surgery

In some cases, a more conventional doctor might recommend surgery to treat neuropathy. For example, if the nerve damage is caused by spinal stenosis (narrowing of the spine) or a herniated disc, surgery can help release pressure on the affected nerves. In other cases, such as carpal tunnel syndrome, releasing pressure on compressed nerves in the wrist by cutting away any extra tissue can help to alleviate symptoms. 

Of course, like pain medications, surgery comes with its share of risks. Surgery is invasive, which means there is a chance of complications, such as infection, allergic reaction, and nerve damage. Additionally, the recovery time can be long, depending on how complicated the surgery was. Not to mention, there’s no guarantee that the surgery will be successful.

Nerve Stimulation

Electrical stimulation (e-stim) treatments are another option for treating neuropathy. Transcutaneous Electrical Nerve Stimulation (TENS) is one type of nerve stimulation therapy that uses low levels of electrical currents that stimulate the nerves and reduce pain. However, TENS is generally only effective for providing short-term relief. In the case of chronic pain, electroanalgesia is more appropriate.

Electroanalgesia uses a high pulse rate (up to 10,000 pulses per second) to deliver electrical currents deeper into the nerves than TENS is capable of doing. As a result, electroanalgesia can provide long-term relief by stimulating the release of endorphins, blocking pain signals to the brain, increasing circulation, and reducing inflammation. Electroanalgesia is an FDA-cleared therapy that is a critical component of our Neuragenex protocol, which uses a whole-person approach to treating chronic pain.

Alternative And Complementary Therapies

In addition to more traditional treatments, there are alternative and complementary therapies that may help manage neuropathy. Alpha lipoic acid, for example, is an antioxidant found to reduce nerve pain in some people with peripheral neuropathy. Acetyl-L-carnitine is another supplement that may help reduce nerve pain, as well as other symptoms associated with the condition. 

However, speak with a medical professional before you take any supplements, as some may interact with medications or other treatments negatively. Additionally, it’s vital to ensure that any supplements you take are of high quality and reliable.

In addition to supplements, yoga, massage, acupuncture, and biofeedback are some of the many alternative therapies that may help reduce nerve pain or other neuropathy symptoms. Discussing the various options with your doctor before pursuing any of these therapies is best.

Diet And Proper Nutrition

Eating a balanced diet is a critical part of managing neuropathy. Eating foods rich in essential nutrients, like B vitamins and Omega-3 fatty acids, can help to decrease inflammation and improve nerve health. Additionally, it’s essential to avoid foods that may be inflammatory or can cause blood sugar fluctuations, as these can worsen neuropathy symptoms. Finally, staying hydrated is crucial, as dehydration can exacerbate neuropathy symptoms.

Prognosis Of Neuropathy 

The prognosis of neuropathy depends on the underlying condition causing it and how quickly it progresses. In some cases, such as diabetic neuropathy, you can manage the condition with certain lifestyle changes. In these cases, symptoms may improve over time, and the prognosis is generally good. However, in other cases, such as neuropathy caused by a tumor or traumatic injury, the outlook may be more serious, and a more aggressive treatment plan may be necessary.

No matter what the cause, managing neuropathy requires a combination of lifestyle changes and treatments that focus on addressing the underlying cause to help provide long-term relief.

Seek The Most Effective And Safest Neuropathy Treatment

Neuropathy is a complicated condition to treat, and it’s vital to have an experienced team of experts dedicated to finding the most effective and safest treatment option. At Neuragenex, we use a whole-person approach to treating chronic pain, which includes electroanalgesia, IV therapy, and lifestyle counseling. We address each patient’s individual needs by developing personalized treatment plans that may help provide long-term pain relief.

Is IV Therapy Covered By Insurance? Get Answers Here

IV therapy is a form of treatment that delivers fluids, nutrients, or medication directly into a patient’s bloodstream. This type of therapy provides quick and efficient relief for patients requiring rapid intravenous delivery of fluids. IV therapy also helps support the body during illness, recovery, or major surgery. 

Insurance coverage may be available for those seeking IV therapy treatments, depending on the policy and medical diagnosis. You must check with your provider to determine what IV therapy services your health plan covers. 

Here’s how to determine if your health insurance provider covers your IV therapy for pain management at Neuragenex.

 

The Definition Of Medical Necessity In Health Insurance

Medical necessity is an essential factor when considering insurance coverage. The term “medical necessity” is used by insurance companies to determine whether a specific procedure or treatment is necessary for the patient’s health and well-being. 

For IV therapy treatments to be considered medically necessary, a physician must provide detailed documentation outlining the patient’s medical condition and why IV therapy is vital to treatment. 

Insurance companies have varying guidelines on what they consider medically necessary, so it’s essential to check with your insurance provider before beginning treatment to determine if they will cover it. 

 

How Do Patients’ Eligibility Work With Insurance Coverage?

Regarding IV therapy, patients’ eligibility for insurance coverage depends mainly on their policies. Insurance providers may cover some or all of the costs associated with IV treatments, but this will vary from case to case.

If you are eligible for insurance coverage for IV therapy, several factors come into play when calculating how much money is reimbursable. These include the specifics of your plan, the cost of the treatment itself, and any applicable deductibles or copayments that might apply.  

It is also essential to consider whether your policy covers out-of-network providers. Many policies only cover in-network doctors or facilities. If an out-of-network provider administers your IV therapy, you may be required to pay the total cost of the treatment. 

If you are responsible for out-of-pocket expenses, budget accordingly and ask your provider for any available payment plans or discounts. This way, you can focus solely on the benefits of IV therapy without worrying about its financial implications. 

It’s also important to note that coverage for IV therapy may be limited depending on the diagnosis, so be sure to discuss this with your provider. Ultimately, understanding the details of your insurance policy can provide clarity and help you plan for any associated costs ahead of time.  

 

Does Insurance Cover IV Therapy For Pain Management Treatments?

Insurance coverage for IV therapy may depend on the specific insurance provider. Some companies provide a full guarantee for this type of treatment – in which case all associated costs are included in the policy – while others only cover a percentage or a set amount. 

Additionally, many insurance companies offer supplemental coverage that can help cover costs related to IV therapy and other treatments. It is crucial to do your due diligence to understand how much of your IV therapy costs are covered by your insurance policy. With this in mind, you can make informed decisions and plan accordingly.

Neuragenex works with patients to ensure they get the highest quality of IV therapy possible. We understand that many insurance plans have coverage limitations, and we provide services to ensure our patients can access the care they need. 

We work with each patient individually to ensure they get the right treatments. We aim for our patients to receive the highest quality treatments under their insurance coverage. 

 

Insurance Companies And HMOs We Work With

We understand how important it is for all our patients to have access to life-changing treatments, so we strive to ensure everyone gets the care they deserve. 

Here are a few of the insurance companies and HMOs that we work with to provide affordable treatments for our patients:

 

Cigna

Cigna works with Neuragenex to provide coverage for IV therapy, making access to this vital health solution more affordable for customers. By partnering together, Cigna and Neuragenex have brought better healthcare to individuals who may not have before and ensured that we leave no one out of receiving the care they need. 

 

Aetna

Aetna, one of the leading health insurance providers in the United States, has partnered with Neuragenex to provide its members with coverage for IV therapy.  Aetna works with Neuragenex and its experienced team of clinicians so that their members always have access to affordable and quality treatments. 

 

BlueCross BlueShield

BlueCross Blue Shield also provides insurance coverage for IV therapy treatments. This partnership with Neuragenex has allowed individuals enrolled in BlueCross BlueShield plans to access innovative pain management treatments.

 

UnitedHealthcare

United Healthcare also provides insurance coverage for IV therapy at Neuragenex. Through their existing healthcare plan, United Healthcare members can access Neuragenex services, which means that treatments do not require additional out-of-pocket expenses. 

 

Medicare

Medicare recognizes the importance of providing comprehensive physical health treatments to its members, which is why Medicare Part B (Medical Insurance) covers Neuragenex IV therapy services. Patients must first meet specific eligibility requirements to take advantage of this coverage.

 

Don’t Hesitate. Get The Treatment You Deserve Today.

Through partnerships with HMOs and health insurance companies, Neuragenex provides access to IV therapies with minimal out-of-pocket costs for patients. Our team of experts is available to help navigate the complexities of insurance coverage for IV treatments. 

We strive to ensure everyone has access to the care they need to prevent, treat or reverse their medical conditions. Together we are creating a better healthcare experience for all. 

The Complications Of Plantar Fasciitis Surgery: Should You Do It?

If you have plantar fasciitis, unbearable foot and heel pain accompanies even the simplest actions in your daily life, such as walking, climbing stairs, or enjoying your favorite sport or hobby. 

The pain may be so intense that it can prevent you from moving your foot, being productive at work, or living independently. And, for many of the 2 million people suffering from this condition in the US alone, surgery represents the inevitable choice to ease their pain.

But taking medications daily, enduring the risks and side effects of surgery, or undergoing invasive procedures are no longer the only alternatives to regain the function and health of your foot. 

Through the non-surgical, non-chiropractic, and non-pharmaceutical approach pioneered by Neurgenex, you can regain your foot health and restore your quality of life without surgery or medications. Discover the whole-person Neurofunctional Pain Management approach below.

What Is Plantar Fasciitis Surgery?

Plantar fasciitis is an inflammatory condition that occurs when the foot’s fascia becomes inflamed, irritated, or damaged. The fascia is a thick band of tissue that stems from the heel bone and then splits into smaller bands that fan out and attach to each toe. This component of the foot plays a vital role in stabilizing your gait, supporting the arch of the foot, and absorbing shock. 

The fascia can become inflamed due to overuse, excessive or strenuous activities, inadequate footwear, and improper foot mechanics. An inflamed fascia leads to a cascade of symptoms, including pain, stiffness, swelling, and reduced range of foot motion. 

Plantar fasciitis – a condition also known as plantar heel pain (PHP) – accounts for over half a million general and specialist care visits in the US alone, making it the leading cause of heel pain.

Although most patients report reduced pain and improved foot mobility with conservative therapies and medications, the pain may become so intense that it prevents you from being able to stand or walk. If all else fails, surgery may begin to appear as the inevitable choice. 

The aim of plantar fasciitis surgery is to relieve tension in the fascia, ease inflammation, and reduce pain so that you can return to your daily activities and maintain proper foot mechanics. When your doctor suggests this line of treatment, it is important to understand the risks, benefits, and associated recovery times of this procedure. Let’s start by covering the basics.

Plantar Fascia Surgery: Fasciotomy Or Fasciectomy

Plantar fasciitis surgery is an approach to treatment that involves detaching the fascia from the heel bone. 

After surgery, the fascia will heal by creating new connective tissue that stretches to and attaches to the heel bone, thus promoting the lengthening of the connective tissue. After the healing process is complete, a longer fascia can relieve tension, prevent further irritation, and increase foot mobility. 

To achieve these results, your doctor may recommend one of two surgical interventions: fasciotomy or fasciectomy. Although they both have the same goal (to separate the fascia from the heel bone) they are performed in different ways:

  • Fasciotomy: An incision in the fascia is made without removing any tissue.
  • Fasciectomy: An incision is made in the fascia and any damaged or inflamed tissue is removed.

Fasciotomy – also known as Plantar Fascia Release surgery – is the most common type of invasive intervention for plantar fasciitis, and can be either open or endoscopic.

  • Open surgery: This surgical intervention is performed under general anesthesia and involves creating a 2-inch incision under your foot, to expose the fascia. An incision to detach the fascia from the heel is then easily performed by your surgeon, who will also address abnormal bony growth (bone spurs) and trapped nerves.
  • Endoscopic surgery: Endoscopic surgery is less invasive than open surgery and only requires a local anesthetic. During this procedure, the surgeon will create two small incisions that are used to insert an endoscope, which is a thin device with a camera and tiny surgical tools. Using video guidance, the surgeon will use these tools to release the plantar fascia without needing to expose it. 

Although endoscopic surgery is less invasive than open surgery, it involves a greater risk of damage to nearby tissues and nerves. 

Other types of surgical interventions for plantar fasciitis exist, including gastrocnemius recession. This procedure is recommended if the inflammation of the fascia derives from short or thigh calf muscles (gastrocnemius muscles). It involves the surgical lengthening of these muscles to allow the ankle and foot to move more freely.

Why Is Surgery For Plantar Fasciitis Performed?

Given the side effects and risks that come with plantar fasciitis, surgery is often considered the last resort. 

Usually, healthcare providers recommend various treatment options that aim to alleviate the pain from the fascia, improve mobility, and reduce inflammation. Some of the most common ones include:

  • Anti-inflammatory non-steroidal drugs (NSAIDs)
  • Splinting
  • Rest, icing, and compression
  • Orthotic arch support
  • Cortisone
  • Exercise and physical therapy 

These conservative treatments allow 80% of people with plantar fasciitis to make a full recovery from their condition within 12 months. However, 5% of people may require surgery. 

This may be the case if:

  • You have chronic fascia pain even after 6-12 months of treatment (i.e.: pain medications)
  • Your pain is affecting your ability to work or is causing social withdrawal
  • Your pain is causing disability and preventing you from remaining independent in your daily life

If you suffer from chronic fascia pain, your condition may end up affecting your posture, gait, and foot mechanics, leading to severe complications and abnormalities in your legs, ankles, and spine. The pain can also prevent you from living a healthy and active lifestyle, thus exposing you to risks such as obesity, cardiovascular diseases, and diabetes. 

In these cases, undergoing surgery may help you regain control over your life.

Success Rate Of The Procedure

According to a 2017 study, plantar fascia release is successful in 70-90% of cases, in terms of reducing pain, improving patient mobility, and increasing activity levels. In particular, the results are excellent in over 88% of cases and good in over 6%, and pain relief maximizes at around 8 weeks after surgery. Full recovery is achieved between 6 and 18 months after surgery.

Additionally, around 75% of people who need surgery experience less pain than they did before surgical intervention. Nonetheless, it is important to note that surgery does not guarantee that your pain will go away entirely: around a quarter of patients continue to experience pain and discomfort after surgery.

Risks And Complications Associated With Plantar Fascia Surgery

Besides the fact that plantar fasciitis surgery isn’t always successful, this kind of procedure isn’t free of risks and side effects – including infection, nerve damage, and recurring pain. Understanding the possible complications of this line of treatment can help you make a more informed decision. Let’s get started. 

Infection

One of the most common complications of plantar fasciotomy is surgical site infection. An infection may be caused by harmful bacteria that infiltrate the body during surgery. 

While some infections are superficial and only affect the incision’s healing process, some can spread across the body and cause fever, chills, and drainage liquid. Surgical infections can increase your recovery time and need to be treated with antibiotics.

Recurring Heel Pain

With 10-50% of patients left unsatisfied after fasciotomy, recurring heel or foot pain after surgery is a common complication that you should be aware of. This recurring pain may be due to different causes. For example, a nerve damaged during the procedure can lead to chronic pain. 

Alternatively, the fascia release could fail to address the root cause of the irritation or inflammation, not offering the expected results.

Nerve Complications

Especially when undergoing endoscopic fascia release surgery, nearby nerves can become damaged or entrapped. This is commonly the case with Baxter’s nerve, which runs along the inside of the heel. 

When a nerve connection is severed, nerve signals relating to movement, sensation, pain, and touch may be disrupted. This can cause symptoms such as spasms, numbness, tingling, and chronic or acute pain around the foot.

Injury of Nearby Structures

The incision necessary to release the fascia from the heel bone may inadvertently damage nearby components of the foot, including ligaments, muscles, and tendons. Although most of these injuries heal over time, they can slow down the recovery process and cause abnormalities in the foot’s mechanics.

Excessive Release Of Plantar Fascia

The incision necessary to detach the fascia from the heel bone is minimal, which makes errors more likely. Over-releasing the plantar fascia – or detaching it too much from the heel bone – can cause the weakening and the flattening of the foot arch, which can lead to changes in the gait and deformity. 

Some patients also experience the opposite complication if the fascia has not been released enough. This side effect requires follow-up surgeries.

Lateral Column Pain

The plantar fascia plays a vital role in stabilizing the foot’s mechanics during movement. Releasing the fascia from its attachment to the heel can impact these mechanics and create imbalances, leading to pain that could appear after surgery in other areas of the foot. 

In particular, a 2002 study shows that surgical interventions that release over 50% of the fascia are likely to lead to lateral column pain, or pain affecting the bones that line the outer edge of your foot.

Alternative Treatment Options Before Considering Surgery

Surgery can help those with recalcitrant heel pain that has not improved with treatment options such as medication, rest, ice, and compression. However, given the severe side effects and lengthy recovery periods associated with fasciotomy, it is important to explore other conservative treatment options for plantar fasciitis such as the following:

  • Stem cell therapy: Platelet-Rich Plasma and Bone Marrow Aspirate therapies work by stimulating the healing function of the stem cells within the damaged area. 
  • Extracorporeal shock wave therapy: This therapy supports the healing and recovery of the plantar fascia through high-energy electrical pulses delivered to the painful area. 
  • Electrical stimulation: E-stim therapies such as TENS (transcutaneous electrical nerve stimulation) use mild pulses of energy delivered to the fascia to support the circulation of blood, nutrients, and oxygen around the damaged area. E-stim can also reduce the transmission of pain signals and stimulate the release of pain-relieving hormones like endorphins. 
  • Physical therapy: Physical therapy can be used to strengthen and stretch the different components of the foot to improve mobility and conditioning. A physical therapist can also help you understand how to improve your posture and foot mechanics to avoid placing excessive stress on the fascia.
  • Massage therapy and acupuncture: Massages and acupuncture sessions can decrease stress and inflammation, ease muscle tension, and relax tight tissues that may be contributing to your foot pain.

Although these therapies may help you manage your pain during flare-ups, they are not an effective alternative to win over your chronic condition and regain your foot mobility. Here’s where Neurofunctional Pain Management comes in. Let’s discover the Neuragenex approach below.

How Neurofunctional Pain Management Works For Plantar Fasciitis

Pioneered by Neuragenex, Neurofunctional Pain Management is a revolutionary whole-person approach that aims to help patients combat their pain condition without surgery or medications. 

Neurofunctional Pain Management addresses all of those lifestyle factors that may be contributing to your pain and utilizes regenerative medicine therapies to support the body’s ability to fight inflammation and heal damaged tissue. In the treatment of chronic plantar fasciitis, Neuragenex employs tailored treatment protocols based on three pillars:

  • Electroanalgesia:

Electroanalgesia leverages pulses of electrical current to stop pain signals traveling from the diseased area of your foot to the brain, thus providing long-lasting relief from pain. This therapy also promotes blood and oxygen circulation, stimulates the release of endorphins, and supports the healing of damaged tissues. 

Unlike OTC electrical stimulation alternatives, electroanalgesia is able to deliver over 10,000 electrical pulses per second, which makes it a far superior and more efficient alternative. 

  • IV Therapy:

Custom IV therapy plans are designed to address and correct nutritional deficiencies and imbalances that may be contributing to the inflammation, pain, and damage of your foot’s tissues. 

Following comprehensive blood tests, a specialist at Neuragenex will create an IV mix that contains all the essential nutrients, minerals, and vitamins needed to provide long-lasting hydration and support tissue regeneration.

  • Lifestyle Counseling:

An ad hoc Lifestyle Counseling journey is created to help you identify and modify those lifestyle choices that represent risk factors for chronic pain conditions, such as plantar fasciitis. 

For example, if you are overweight or obese, deal with nutritional deficiencies, have a sedentary lifestyle, or have proinflammatory habits like smoking or drinking alcohol, you are at greater risk of high inflammation, circulatory problems, and chronic pain. 

A lifestyle counselor at Neuragenex can help you implement strategies to maintain a healthy weight, choose supportive shoes, start exercising regularly, and, ultimately, create a lifestyle that supports health in the long term.

Know All Your Options Before Signing Up For Surgery 

Surgery for plantar fasciitis can condemn you to months or years of rehabilitation, immobilization, and physical therapy – and it is certainly not free of severe risks. So, before signing up for surgery, make sure you know all of your options and try the non-invasive alternatives offered at Neuragenex. 

Through Neurofunctional Pain Management, you can manage your pain, decrease inflammation, and regain your foot function without medications or surgery. So, you can return to enjoying your favorite activities and magnify your quality of life.

High-Dose PRP For Spinal Stenosis

Spinal stenosis can be an incredibly debilitating condition as it can cause chronic pain and a lack of mobility in the back, hips, and legs. As a result, the condition can significantly diminish your quality of life if not properly treated. Unfortunately, spinal stenosis can not be cured since it’s caused by degenerative changes in the spine. However, there are ways to treat spinal stenosis so that you can manage the symptoms and improve your quality of life. One of the most effective treatments is high-dose platelet-rich plasma (PRP) injections.

Understanding The Spinal Stenosis Condition 

Spinal stenosis develops when the spinal canal becomes too narrow, thereby compressing the nerves. Nerve compression, in turn, can affect movement and sensation. This narrowing of the spinal canal can be caused by age-related degeneration or injury.

Oftentimes, there is no pain or discomfort until the narrowing worsens and compresses the nerve roots. Patients may experience various symptoms when this happens, including lower back pain, numbness, tingling, and weakness in the extremities. In more severe cases, patients may experience a loss of bladder or bowel control.

Spinal stenosis can cause so many different symptoms because the spine is essentially the highway for the central nervous system. Excessive pressure on the nerves that make up this “highway” can have far-reaching effects throughout the body.

The Difficulty Of Diagnosing Spinal Stenosis

It’s estimated that anywhere between 250,000 to 500,000 Americans are living with symptoms caused by spinal stenosis. It’s a much more common condition in older patients because it’s often caused by age-related degeneration. Studies show that roughly five out of every 1000 persons over 50 are likely to have the condition. However, the exact prevalence is difficult to determine because spinal stenosis can be hard to diagnose. 

One significant difficulty in diagnosing spinal stenosis is that the symptoms can be similar to other conditions, such as herniated discs or scoliosis. Additionally, because spinal stenosis can cause pain in other areas of the body (such as in the leg or hip), the condition can be easily misdiagnosed. Finally, many people with spinal stenosis don’t show any symptoms until the narrowing of the spine is quite severe and is pressing on the nerves. As a result, it can be difficult to identify the condition until it has progressed significantly.

Why Seek Out High-Dose PRP Injections For Spinal Stenosis? 

Conservative treatments for spinal stenosis include anti-inflammatories and epidural cortisone injections. The problem with these types of treatments is that they only provide temporary relief by masking the symptoms and do not address the condition’s underlying cause.

In more severe cases, a traditional doctor might suggest a surgical procedure, such as a laminectomy, which involves cutting away bone and tissue to reduce pressure on the nerves. The problem with such procedures is that not only can they be expensive, but they are incredibly invasive. Because of this, there are potential complications, including infections, allergic reactions, long recovery times, and the potential for nerve damage.

How PRP Injections Work 

Platelet-rich plasma is a concentration of platelets from the patient’s blood. This plasma is rich in growth factors that aid in healing and promote tissue regeneration. When administered directly to the affected area, these growth factors can help stimulate and accelerate tissue repair.

When treating spinal stenosis, injections of high doses of platelet-rich plasma can help reduce swelling and inflammation in the spine by promoting tissue regeneration in the affected area. As a result, PRP injections help alleviate pressure on the nerves, which can help provide long-term relief from pain, numbness, and other symptoms caused by spinal stenosis.

The Basic Procedures Of PRP Treatment

The procedure for treating spinal stenosis with PRP injections is relatively straightforward. First, the doctor will draw the patient’s blood, and the platelet-rich plasma will be extracted from it. The site where the injection will be administered is then treated with a numbing agent. Once this agent takes effect, the PRP is injected with a needle. The doctor administering the injection will use ultrasound imaging as a guide to ensure that the injection is accurate and effective. 

Drawing the blood and processing the platelets will take roughly 30 minutes. Then, it will take another 15 minutes or so for the numbing agent to take effect. Finally, the actual injection shouldn’t take more than 10 to 30 minutes. All in all, you can expect the entire procedure to take an hour to an hour and a half.

Patients may experience some mild discomfort or soreness in the area of the injection, but this should fade quickly. In most cases, patients experience a significant reduction in pain and other symptoms within just a few days. However, several injections may be needed depending on the severity of the condition and individual circumstances. Typically, you’ll need to undergo anywhere from two to six injections one to two weeks apart.

How Safe Are PRP Injections?

PRP injections are generally considered safe, with few risks and side effects. While there is always a risk of infection associated with any injection, the risk is minimal when using a sterile procedure and medical-grade equipment. Additionally, some patients may experience mild discomfort or soreness at the injection site. However, this should resolve quickly. You may experience some swelling and bruising as well, both of which should subside after a few days.

The primary benefit of using PRP injections for treatment is that it is an effective and minimally invasive method of treating spinal stenosis. It also carries fewer risks than surgery, as well as a shorter recovery time and less disruption to the patient’s daily activities. Not to mention, the substance being injected is the patient’s own platelet-rich plasma, so there is no risk of an allergic reaction, nor are there any risks of side effects similar to those presented when using anti-inflammatory drugs or corticosteroid injections.

Results From High-Dose PRP Treatment Of Spinal Stenosis

Recovery time following injections is quick. Any side effects (such as mild pain or bruising) should disappear after 48 hours. However, you should avoid strenuous exercises for a few weeks afterward. Most patients will begin experiencing pain relief within two to three weeks after their first injection, after which results will continue to improve for three to six months.

Studies have shown that PRP injections are highly effective at providing long-term pain relief for patients suffering from chronic back pain in general. For example, one study found that subjects treated with PRP injections experienced a significant decrease in the intensity of their pain after six months.
It’s also worth noting that according to a report published by the Journal of Spine Surgery, PRP injections had the same impact on research subjects dealing with chronic pain caused by disc degeneration (meaning, subjects experienced a significant amount of pain relief after six months). Because of how PRP injections work, their success in managing pain caused by disc degeneration also applies to how they can treat spinal stenosis.

Targeting Spinal Stenosis Pain At The Source

High-dose PRP injections are a safe, minimally-invasive, drug-free alternative for treating spinal stenosis. At Orthagenex, we offer the highest quality and safest PRP treatments to help provide optimal outcomes for our patients. We develop personalized treatment plans tailored to each individual’s condition and needs. We are committed to providing the best possible care for those suffering from chronic spinal stenosis pain. Contact us for more information on how PRP injections can help you find relief from chronic pain and improve your quality of life.