Case report of Acupuncture for PN, CIPN
As I mentioned in the previous article, our own office records indicate that most patients with PN/CIPN reported at least 50% symptom improvement if they receive 8 or 10 treatments. Unlike drug therapy, the benefit of acupuncture is often long-lasting. This is illustrated by the following case history:
A patient from northern Kentucky was referred to me for acupuncture for CIPN. She had completed Taxol-based adjuvant chemo therapy for breast cancer one year earlier. She had persistent pain, numbness and tingling of both feet which responded poorly to medications. After 10 treatments, she only had some residual numbness involving the left 4th and 5th toes, and her pain resolved completely. She came back 6 months later with recurrence of her symptoms but to a lesser degree. She improved significantly again after 5 treatments. One year after the last treatment, a follow-up visit showed no recurrence of PN.
Although the case report is regarding CIPN, I need to point out that I have also treated many patients with peripheral neuropathy of other causes with very positive results.
The following are some safety notes and tips in the management of PN/CIPN;,
- Footwear Avoid heels, proper insoles, grip surface on shoes, loafer style with velcro straps.
- Household environment Use non skid bath mats, remove loose rugs, use night lights, keep rooms well lit.
- Orthosis if necessary and avoid injury from wearing orthosis.
- Avoid or discontinue physical training if physically unfit.
Nutritional supplements are popular among patient. Some have been proven to be effective in the prevention of CIPN, but they have not been adequately researched for management of PN/CIPN. Vitamins E, β-carotene, B6/B12, antioxidants including N-acetylcysteine, α-lipoid acid and acetyl-L-Carnitine have been tried.
- Acupuncture is an effective treatment modality for peripheral neuropathy, including CIPN in my clinical experience over the last decade and it is supported by a few studies.
- Long lasting benefit after discontinuation of acupuncture can be achieved in some patients.
- Some supplements maybe beneficial too. An integrative approach combining acupuncture and nutritional supplements maybe plausible.
- Attention should be paid to comfortable footwear, use of orthosis, and having a save household environment.
- Some medications, such as Opioid Analgesics and anti-epileptics, are helpful if they are well tolerated.