Is polyneuropathy curable?

Is polyneuropathy curable?

Virtually every patient wonders whether polyneuropathy is curable, i.e. whether the complaints and limitations will eventually disappear. A straightforward answer to this question is not possible in every case. It usually depends on what form of polyneuropathy is present and, in particular, how long the polyneuropathy has existed.

In a nutshell, the following can be said about the chances of curing polyneuropathy: The less severe the polyneuropathy is and the shorter it has been present, the greater the chances of curing it. However, the type of polyneuropathy is crucial. Unfortunately, those who have suffered from severe polyneuropathy for years have relatively poor chances of a complete recovery.

Since it is the type of polyneuropathy that matters, I will discuss different forms of polyneuropathy individually, but not all with be covered in this article. If your individual issues have not been covered, feel free to write me and request some information.

ACUTE INFLAMMATORY DEMYELINATING POLYNEUROPATHY (GUILLAIN-BARRÉ SYNDROME)

Acute inflammatory demyelinating polyneuropathy can nowadays be treated quite well. This is usually done with immunoglobulins. Although the onset of the disease is often frighteningly fast (going from being completely healthy to bedridden in a very short time), a lot of patients can reach a full recovery.

I myself have a close friend who fell ill with this form of polyneuropathy while still in high school. He was completetly healthy before and could not walk anymore after less then a week. Furtunately, he was completely cured within a few months and is now a decent endurance athlete. In about 80% of cases, the disease has a suprisingly mild outcome. However, this should not hide the fact that about 20% of the patients suffer permanent damage and that the disease often (up to 5% of the cases) even leads to death.

POLYNEUROPATHY DUE TO CHEMOTHERAPY

For the last 15-20 years, new drugs have started to be used broadly for chemotherapy that are more effective against cancer, but which also damage the nerves. This is particularly the case with metastatic breast cancer.

Measures against polyneuropathy should be taken as early as possible, because the less pronounced the polyneuropathy is, the sooner it will disappear.

By far the simplest measure is to wear compression or ice gloves while receiving chemotherapy as an infusion. The feet can be protected by compression stockings or cold packs. Compression and cold do nothing more than reduce the blood flow to the hands or feet. As a result, less of the active ingredient in the chemotherapy reaches the hands and therefore cannot damage the nerves. In a Japanese study, an impressive protective effect was found with this method.
(Read the study here: Tsuyuki et al. 2016)

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In this study they used simple latex gloves that can be bought in any pharmacy for very cheap prices. The gloves were one size smaller than what would have usually fit the patients and they wore two pairs at a time to increase compression.

Before trying this, it is important to first clarify whether the chemotherapy you are receiving can actually trigger polyneuropathy at all. 

Another useful measure is balance training. Through training, the nervous system learns to compensate for the damage caused by chemotherapy. Patients who do this training can walk more easily and safely and therefore report less pain and discomfort. Again, it is important to start as early as possible. You can find exercises to do yourself here: Exercises for polyneuropathy.

The benefits of balance training during chemotherapy has been shown in a number of studies. Examples can be read here: Vollmers et al. 2018; Kleckner et al. (2017)

Vibration training is another useful training method in which you stand on a vibrating plate. The vibration provides a very strong stimulus for the nerves. Various studies showed that patients who underwent vibration training during chemotherapy had less severe symptoms of polyneuropathy. (You can find an example study here: Streckmann et al. 2018).

 

Please note that the aim of vibration training is to target the nerves, not the muscles. The training should therefore be different from the vibration training that is common in the fitness industry. The main difference is in the duration. With such a strong stimulus as intense vibration, the nerves tire very quickly and therefore, you should spend no more than 30 seconds on the vibration plate before taking a break of the same length.

Since the training should be done frequently, I personally recommend buying a vibration plate to use at home. Plates are available for about 200 € at sports stores.

Furthermore, classical fitness training also seems to have a certain effect on polyneuropathy during chemotherapy. This effect is not quite as big as that of balance training or vibration training, but it is still significant. This is another reason to stay physically active during cancer treatment. 

NERVES OFTEN RECOVER AFTER CHEMOTHERAPY

Compared to other forms of nerve damage, polyneuropathy caused by chemotherapy has the distinct advantage that the cause of the polyneuropathy eventually disappears. This is because when the chemotherapy is finished, the nerves are no longer being damaged and can therefore recover.

This is why most patients report that their symptoms slowly improve after finishing treatment. However, this is usually only the case during the first year. Unfortunately, symptoms that persist after more than 12 months usually remain.

DIABETIC POLYNEUROPATHY

In diabetic polyneuropathy, the chances for complete recovery are unfortunately relatively poor. Here, too, however, an improvement cannot be ruled out. If diabetes is recognised and treated early, polyneuropathy can usually be prevented. If the polyneuropathy is just beginning and the blood sugar is being well controlled, there is hope for an improvement. However, the symptoms of diabetic polyneuropathy often come so gradually that they are not noticed until it is too late. A significant improvement of the symptoms, therefore, is rare.

However, there are some measures that can slow down or even stop the progress of diabetic polyneuropathy. That is, you can rarely cure polyneuropathy in diabetes, but you can prevent it from getting worse.

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The most important measure is obviously to reduce blood sugar. If the long-term values (HbA1c) are below 7, the nerves are basically safe. In addition to the right medication and a low-sugar diet, proper exercise is also important. 

Exercise should concentrate on two goals: Improving your balance and reducing blood sugar.

 

Balance training has been shown to improve balance and walking ability (here is an example study: Ahmad et al. 2019) exercises can be found here: Exercises for polyneuropathy

Blood sugar can be reduced by classic fitness training, especially high intensity endurance training. Training should focus on burning sugar, not fat and improve blood flow. Both are only improved by relatively high intensity training.

Another important thing is the correct supply of vitamins. Those who suffer from vitamin deficiency and diabetes at the same time are more likely to develop polyneuropathy. This is especially the case for vitamin D. Remember, vitamin D is not a miracle-cure and should only be taken when there is a deficiency. Taking vitamin supplements when you already have enough vitamins in your body does not bring any additional benefit and could be harmful. Therefore do not overdose vitamins and talk to a doctor if you there is any doubt.

IS ALCOHOLIC POLYNEUROPATHY CURABLE?

Alcoholic polyneuropathy has a surprisingly good chance of being cured. If you manage to completely abstain from alcohol, the damage is often reduced. Just as with any other form of polyneuropathy, of course, it depends on how severe the damage is and how long it has existed.

B vitamins may be helpful for alcoholic polyneuropathy. These are taken from the body by the consumption of alcohol resulting in a deficiency. This is especially true for vitamin B1. It is assumed that polyneuropathy can be positively influenced by the administration of B vitamins, if a deficiency has caused the polyneuropathy.

POLYNEUROPATHY OF UNKNOWN CAUSE

There are some factors that can promote polyneuropathy that are generally not well known. If you suffer from polyneuropathy of unknown cause, you should pay special attention to these factors in order to at least slow down the disease, even if it usually cannot be cured.

Very few people know that sleep apnoea, for example, can cause or worsen polyneuropathy. With sleep apnoea, breathing is repeatedly interrupted during sleep. This causes a lack of oxygen, which has a negative effect on the nervous system. In particular, people who snore heavily and suffer from polyneuropathy should have themselves examined for sleep apnoea. You can download a study on this topic here: Lüdemann et al. (2001)

Exposure to lead and other toxins (e.g. solvents) can trigger and promote polyneuropathy. Those who suffer from polyneuropathy should therefore try to avoid contact with such materials as much as possible. However, heavy metals can also accumulate in the body and cause chronic problems. In the event of acute poisoning, however, intravenous medication is given that binds the heavy metals and carries them out of the body. If you suspect that heavy metals have been accumulating in the body for a long time, you can also eat certain foods that are also able to remove toxins from the body. Garlic, broccoli and coriander are particularly suitable for this purpose.

As you can see, even if no cause of polyneuropathy has been found, treatment is certainly possible. For example, if you suffer from sleep apnoea and vitamin deficiency at the same time and drink a lot of alcohol, then there are already several factors that favour the onset of polyneuropathy. However, if you solve the problems by using a breathing mask (cpap) to sleep, supplementing the appropriate vitamins and abstaining from alcohol, the chances of improvement or at least slowing down the effects of the disease are much greater.

Get professional advice

If you need advice with your personal situation, feel free to contact me for a consultation.

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Christian Bitzer, M.A. Sport Science

Bitzer.Sporttherapie@gmail.com

Tel. +49 176 66 86 91 51