Peripheral Neuropathy
Peripheral neuropathy causes burning, numbness, tingling, or weakness in the hands and feet from nerve damage. MLS laser therapy and spinal decompression address the neurological component at Cobblestone Spine and Joint Institute, which has served Royal Palm Beach patients since 2006.
Peripheral neuropathy is nerve damage outside the brain and spinal cord. The symptoms, which include burning pain, numbness, tingling, electric shock sensations, and weakness in the feet and hands, reflect disrupted signal transmission along the peripheral nerves. It is not a single disease. It is the end result of several different causes, and the right treatment depends on correctly identifying which cause is operative in a given patient.
The most common cause in the western Palm Beach County patient population at Cobblestone is diabetic peripheral neuropathy, which develops from sustained hyperglycemia damaging the nerve's blood supply. The second most common presentation is mechanical neuropathy from spinal stenosis or disc herniation compressing the nerve roots at the lumbar or cervical spine, producing symptoms that travel down the legs or arms along a dermatomal pattern. The third is idiopathic small-fiber neuropathy, which accounts for roughly a third of peripheral neuropathy diagnoses and is confirmed by skin punch biopsy showing reduced intraepidermal nerve fiber density.
What Cobblestone Treats and What Requires Referral
Dr. Dean Mammales, DC evaluates each neuropathy presentation for its mechanical component first. A patient with burning feet and documented diabetic neuropathy may also have lumbar stenosis contributing to the lower extremity symptoms. Treating only the diabetic component while missing the mechanical component leaves half the problem unaddressed. The evaluation distinguishes between length-dependent polyneuropathy (stocking-and-glove distribution, typical of metabolic causes) and radicular patterns that follow specific nerve root distributions, which is mechanical until proven otherwise.
For mechanical neuropathy from lumbar or cervical stenosis and disc pathology, spinal decompression therapy directly reduces the compressive load on the affected nerve roots. Patients who have been told they have neuropathy but have never had spinal imaging may find that the source of their symptoms is correctable.
MLS Laser Therapy for Neuropathic Pain
MLS laser therapy is FDA-cleared for the treatment of neuropathic pain. The 808 nm and 905 nm wavelengths reach the peripheral nerve tissue and stimulate mitochondrial energy production in the nerve cells. For diabetic peripheral neuropathy, laser therapy improves local microcirculation to the nerve endings and produces measurable reductions in burning and numbness in patients who have not responded to medication. A standard protocol runs 12 to 16 sessions over four to six weeks. Results are cumulative rather than immediate.
Peptide Therapy for Neuropathy
Certain peptide protocols have documented neuroprotective and nerve regenerative effects. BPC-157 in particular promotes nerve repair through upregulation of growth hormone receptor expression and improved vascular supply to damaged nerve tissue. For patients with peripheral neuropathy who are not achieving adequate relief through physical interventions, Yuleisy Coto, MSN, APRN, FNP-C evaluates candidacy for peptide-based protocols as an adjunct. See the Peptide Therapy page for detail.