Q: I have diabetes and have been told I have peripheral neuropathy as a result. What kind of exercising can I do? — J.J. Gruber, Newark, N.J.
A: The Neuropathy Association reports that more than 20 million Americans have peripheral neuropathy, which is defined as a problem with the nerves that carry information to and from the brain and spinal cord to the muscles, skin, joints and internal organs. This causes numbness, pain, weakness and poor coordination. It is important to contact a neurologist for diagnosis and treatment as soon as symptoms are noticed to avoid or slow permanent damage.According to the National Institute of Neurological Disorders and Stroke, peripheral neuropathy can be caused by:
• Physical injury or trauma to a nerve, often from repetitive motion or pressure from a cast or crutches• Tumors• Toxins and/or exposure to poisons• Autoimmune responses such as lupus and rheumatoid arthritis• Nutritional deficiencies, especially of vitamin B• Alcoholism• Vascular and metabolic disorders such as diabetes• Genetics The staff at the Mayo Clinic recommends the following steps to treat this disease:
1. See your physician for medication and pain relievers, including lidocaine patches and possible antidepressants.
2. Eat a healthy diet. Be sure to include B-12 food sources (meats, fish, eggs, low-fat dairy and specially fortified cereals) to get a diet rich in fruits, vegetables and whole grains. B-12 supplements may be required if you are a vegetarian.3. Take care of your hands and feet. Check every day for blisters, cuts and calluses. Do not wear tight shoes or socks.4. Exercise. Consistent and regular exercise can relieve pain and will also keep weight under control, which will relieve pressure on the feet and improves circulation to the extremities.
5. Reduce or eliminate alcohol consumption, which adversely affects circulation.6. Quit smoking. Smoking also adversely affects circulation.
7. Massage hands and feet daily. Massage not only improves circulation but also stimulates the nerves and can temporarily relieve pain.8. Avoid prolonged pressure on hands and feet. Be careful with crossing your legs, standing for great lengths of time or leaning on your elbows too long. This can make your current situation worse and cause new damage to the nerves.
Archived reports at the independent medical research database, the Cochrane Library, suggest that strength training can be effective for those with this disease. Even though most of the research on strength training for neuropathy was tested on people with diabetes, the research results have been consistent: Those who participated in the resistance- training program moderately improved muscle strength. Improvements in being able to perform basic daily activities — such as walking to and from cars — were also reported.Other suggestions are walking a little bit each day (followed by massaging the feet), water exercise classes, yoga or other stretching regimens, tai chi and/or qigong, Pilates and using a stationary bike. Always start slowly and increase speed or intensity of any exercise cautiously. Squeezing a soft ball has been found to be helpful for the hands. Warm baths and acupuncture can help too.
Linda J. Buch is a certified fitness trainer in Denver
http://www.denverpost.com/fitness/ci_18016919
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