Neuropathy – A Review of Natural Treatments and Drug Risk Factors

Natural Medicines and Neuropathy 

Here we discuss a number of natural medicines and their effect on neuropathy. We also speculate that there may be some overlap in useful therapeutics between spinal cord injury (irrespective of whether or not the injury involves neuropathic pain) and neuropathy due to other causes. Hence we discuss the use of natural medicines in both. We also mention a few miscellaneous therapies that don’t technically meet our definition of “natural” medicine.

Gluten Elimination

Gluten sensitivity may be a cause of neuropathy.9,10 One controlled study of 35 patients with idiopathic neuropathy found that a gluten-free diet led to improvements in sural sensory action potentials, whereas the control group experienced deterioration. The difference between the two groups was significant.11 In another study, 17 patients with sensory ganglionopathy were recommended a gluten-free diet. Eleven patients that had good adherence experienced a stabilization of their neuropathy. Four patients that had poor adherence and 2 patients that did not opt for the diet all experienced deterioration.12

Exercise

One small uncontrolled study in 17 patients with diabetic peripheral neuropathy found that 10 weeks of supervised exercise led to significant improvements in pain and neuropathic symptoms, as well as increased intraepidermal nerve fiber branching from a proximal skin biopsy. The authors wrote, “These findings are particularly promising given the short duration of the intervention, but need to be validated by comparison with a control group in future studies.”13 Another follow-up study in 18 patients evaluated the safety of such exercise. There were 57 non-serious adverse events recorded. The authors recommend that physical therapists exercise care in prescribing exercise for patients who have previously been sedentary.14

Gamma-Linolenic Acid (GLA)

A controlled trial in 22 patients with diabetic neuropathy found significant improvements in 6 out of 6 nerve function measurements, wrist and ankle heat threshold values, and overall symptom scores.15 Another controlled trial with 111 diabetic patients of both types 1 and 2 with mild or moderate neuropathy found that 480mg of gamma-linolenic acid caused significant improvements in neuropathy in 13 out of 16 parameters measured at one year.16

Magnesium

A controlled study gave 300mg of magnesium to patients with diabetic polyneuropathy for five years. By the end of the study, staging of polyneuropathy within the magnesium group showed that 39% had improved, 49% stayed the same, and only 12% worsened. Whereas in the control group only 8% improved, 31% stayed the same, and 61% got worse.17 A study presented at a 1994 AIDS conference reported that 68 AIDS patients who had symptoms consistent with peripheral neuropathy all had low levels of magnesium, and that supplementation with magnesium led to improvement in symptoms.18 In an uncontrolled study 12 cancer patients with neuropathic pain due to malignant infiltration of the brachial or lumbosacral plexus were given a single intravenous dose of either 500mg or 1g of magnesium sulfate. In total, 10 out of 12 patients reported either complete or partial relief of pain for roughly four hours.19

Perhaps topical magnesium chloride as either a saturated solution (“magnesium oil”) or as a lotion might be useful for localized applications.

Capsaicin

A review of topical capsaicin for the treatment of postherpetic neuralgia and HIV-neuropathy concluded, “High-concentration topical capsaicin is therefore similar to other therapies for chronic pain. In this case, the high cost of single and repeated applications suggest that high-concentration topical capsaicin is likely to be used when other available therapies have failed, and that it should probably not be used repeatedly without substantial documented pain relief. Even when efficacy is established, there are unknown risks, especially on epidermal innervation, of repeated application of long periods.”20

Ecklonia Cava Extract

A double-blind placebo-controlled study found that ecklonia cava extract improved neuralgia by the end of 4 weeks. However, this study has not been peer-reviewed. We obtained an unpublished manuscript of the study from the manufacturer.21 It’s a brief 5-page document that is dated September 30, 2005. The study was conducted in Korea. The manuscript links to the Mirae Medical Foundation.22 Dosage was the equivalent of 5 capsules of the brand Fibronol twice a day. Nineteen patients were on active treatment, and 15 were controls. The source of the patients neuralgia is not mentioned. Global Assessment forms measured the active groups’ scores to be an average of 2.74 at baseline, and 1.89 at 4 weeks. The improvement was significant. The average placebo groups’ scores were 2.87 at baseline and 2.53 at 4 weeks. The improvement was not significant. 74% of patients in the active group were deemed responders by this measure, compared to 33% in the placebo group. Visual Analogue Scales showed the treatment group went from an average score of 46.1 at baseline to 27.1 at 4 weeks. The improvement was significant. The placebo group went from an average of 51.9 to 43.7, which was not significant. The document states that blinding was not broken during the trial.
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