Certain neurological disorders can cause acute episodes of peripheral neuropathy, and for individuals diagnosed with chronic peripheral neuropathy, can physical therapy help improve the ability to move around safely along with medications, procedures, and lifestyle adjustments to help control and manage symptoms?
Peripheral Neuropathy Treatments
Peripheral neuropathy treatment includes symptomatic therapies and medical management to help prevent worsening nerve damage.
For acute types of peripheral neuropathy, medical interventions and therapies can treat the underlying process, improving the condition.
For chronic types of peripheral neuropathy, medical interventions and lifestyle factors can help to prevent the condition’s progression.
Chronic peripheral neuropathy treatment focuses on controlling the pain symptoms and protecting areas of diminished sensation from damage or infection.
Self-Care and Lifestyle Adjustments
For individuals who have been diagnosed with peripheral neuropathy or are at risk of developing the condition, lifestyle factors play a significant role in managing symptoms and preventing nerve damage from worsening and can even prevent the condition from developing. (Jonathan Enders et al., 2023)
Pain Management
Individuals can try these self-care therapies and see if and which help reduce their discomfort and then develop a routine that they can work off of. Self-care for pain symptoms include:
Placing a warm heating pad on painful areas.
Placing a cooling pad (not ice) on painful areas.
Covering the area or leaving it uncovered, depending on comfort levels.
Wear loose-fitting clothes, socks, shoes, and/or gloves not made with material that can cause irritation.
Avoid using lotions or soaps that can cause irritation.
Use soothing creams or lotions.
Keeping the painful areas clean.
Injuries Prevention
Diminished sensation is one of the most common effects that can lead to problems like stumbling, difficulty getting around, and injuries. Preventing and regularly checking for injuries can help avoid complications like infected wounds. (Nadja Klafke et al., 2023) Lifestyle adjustments to manage and prevent injuries include:
Wear well-padded shoes and socks.
Inspect feet, toes, fingers, and hands regularly to look for cuts or bruises that may not have been felt.
Clean and cover cuts to avoid infections.
Use extra caution with sharp utensils like cooking and work or gardening tools.
Disease Management
Lifestyle factors can help prevent disease progression and are closely correlated with the risks and underlying causes. To help prevent peripheral neuropathy or its progression can be done by: (Jonathan Enders et al., 2023)
Maintain healthy glucose levels if you have diabetes.
Avoid alcohol for any peripheral neuropathy.
Maintain a well-balanced diet, which can include vitamin supplements, especially for vegetarians or vegans.
Over-the-Counter Therapies
A few over-the-counter therapies can help with painful symptoms and can be taken as needed. Over-the-counter pain therapies include: (Michael Überall et al., 2022)
Topical lidocaine spray, patch, or creams.
Capsaicin creams or patches.
Topical Icy Hot
Non-steroidal anti-inflammatory medications – Advil/ibuprofen or Aleve/naproxen
Tylenol/acetaminophen
These treatments can help relieve painful symptoms of peripheral neuropathy, but they do not help improve diminished sensation, weakness, or coordination problems. (Jonathan Enders et al., 2023)
Prescription Therapies
Prescription therapies for treating peripheral neuropathy include pain medications and anti-inflammatories. Chronic types of peripheral neuropathy include:
Alcoholic neuropathy
Diabetic neuropathy
Chemotherapy-induced neuropathy
The prescription treatments for chronic types differ from the treatments for acute types of peripheral neuropathy.
Pain Management
Prescription treatments can help manage the pain and discomfort. Medications include (Michael Überall et al., 2022)
Sometimes, a prescription strength supplement or vitamin B12 given through injection can help prevent progression when peripheral neuropathy is associated with a severe vitamin deficiency. Prescription treatment can help treat the underlying process in some types of acute peripheral neuropathy. Treatment for acute peripheral neuropathy, such as Miller-Fisher syndrome or Guillain-Barré syndrome, can include:
Corticosteroids
Immunoglobulins – immune system proteins
Plasmapheresis is a procedure that removes the liquid portion of blood, returning the blood cells, which modifies the overactivity of the immune system. (Sanja Horvat et al., 2022)
Researchers believe there is an association between these conditions and inflammatory nerve damage, and modifying the immune system is beneficial for treating symptoms and the underlying disease.
Surgery
In some cases, surgical procedures can benefit individuals who have certain types of peripheral neuropathy. When another condition is exacerbating the symptoms or process of peripheral neuropathy, surgery may help relieve symptoms and prevent disease progression. This has proved effective when nerve entrapment or vascular insufficiency are factors. (Wenqiang Yang et al., 2016)
Complementary and Alternative Medicine
Some complementary and alternative approaches can help individuals cope with the pain and discomfort. These treatments can serve as an ongoing option for those who have chronic peripheral neuropathy. Options can include: (Nadja Klafke et al., 2023)
Acupuncture involves the placement of needles in specific areas of the body to help reduce pain symptoms.
Acupressure involves applying pressure on specific areas of the body to help reduce pain symptoms.
Massage therapy can help relax muscle tension.
Meditation and relaxation therapies can help manage symptoms.
Physical therapy can also serve as an important component of living with chronic peripheral neuropathy and recovering from acute peripheral neuropathy.
Physical therapy can help strengthen weak muscles, improve coordination, and learn how to adapt to sensory and motor changes to get around safely.
Individuals considering complementary or alternative treatment are encouraged to speak with their primary healthcare provider to determine whether it is safe for their condition. Injury Medical Chiropractic and Functional Medicine Clinic will work with the individual’s healthcare provider and/or specialists to develop an optimal health and wellness treatment solution to provide pain relief and improve quality of life.
Peripheral Neuropathy: A Successful Recovery Story
References
Enders, J., Elliott, D., & Wright, D. E. (2023). Emerging Nonpharmacologic Interventions to Treat Diabetic Peripheral Neuropathy. Antioxidants & redox signaling, 38(13-15), 989–1000. doi.org/10.1089/ars.2022.0158
Klafke, N., Bossert, J., Kröger, B., Neuberger, P., Heyder, U., Layer, M., Winkler, M., Idler, C., Kaschdailewitsch, E., Heine, R., John, H., Zielke, T., Schmeling, B., Joy, S., Mertens, I., Babadag-Savas, B., Kohler, S., Mahler, C., Witt, C. M., Steinmann, D., … Stolz, R. (2023). Prevention and Treatment of Chemotherapy-Induced Peripheral Neuropathy (CIPN) with Non-Pharmacological Interventions: Clinical Recommendations from a Systematic Scoping Review and an Expert Consensus Process. Medical sciences (Basel, Switzerland), 11(1), 15. doi.org/10.3390/medsci11010015
Überall, M., Bösl, I., Hollanders, E., Sabatschus, I., & Eerdekens, M. (2022). Painful diabetic peripheral neuropathy: real-world comparison between topical treatment with lidocaine 700 mg medicated plaster and oral treatments. BMJ open diabetes research & care, 10(6), e003062. doi.org/10.1136/bmjdrc-2022-003062
Horvat, S., Staffhorst, B., & Cobben, J. M. G. (2022). Intravenous Lidocaine for Treatment of Chronic Pain: A Retrospective Cohort Study. Journal of pain research, 15, 3459–3467. doi.org/10.2147/JPR.S379208
Yang, W., Guo, Z., Yu, Y., Xu, J., & Zhang, L. (2016). Pain Relief and Health-Related Quality-of-Life Improvement After Microsurgical Decompression of Entrapped Peripheral Nerves in Patients With Painful Diabetic Peripheral Neuropathy. The Journal of foot and ankle surgery: official publication of the American College of Foot and Ankle Surgeons, 55(6), 1185–1189. doi.org/10.1053/j.jfas.2016.07.004
Spinal stenosis is the term used to describe a narrowing spine. Treatments vary because everybody’s case is different. Some individuals experience mild symptoms, while others experience severe symptoms. Can knowing treatment options help the patient and healthcare team customize and personalize a treatment plan to the individual’s condition?
Spinal Stenosis Treatments
Spaces within the spine can become narrower than they’re supposed to be, which can cause pressure on nerve roots and the spinal cord. Anywhere along the spine can be affected. The narrowing can cause pain, burning, and/or aching in the back and weakness in the legs and feet. Spinal stenosis has several primary treatments. When working through spinal stenosis treatments, a healthcare provider will assess symptoms and start treatment with first-line therapy, such as pain medication and/or physical therapy. These are often the first among individuals with the disease.
Medication
Chronic pain is one of the main symptoms. The first-line treatment often involves using pain-relieving medication/s. Commonly prescribed medications are nonsteroidal anti-inflammatories or NSAIDs. These medications reduce pain and inflammation. However, NSAIDs are not recommended for long-term use, and other medications may need to be used to relieve pain that includes: (Sudhir Diwan et al., 2019)
Tylenol – acetaminophen
Gabapentin
Pregabalin
Opioids for severe cases
Exercise
Exercise can reduce spinal stenosis symptoms by taking pressure off the nerves, which can reduce pain and improve mobility. (Andrée-Anne Marchand et al., 2021) Healthcare providers will recommend the most effective exercises for the individual. Examples include:
Another primary spinal stenosis treatment is physical therapy, which is often used alongside pain medications. Typically, individuals undergo six to eight weeks of physical therapy, with sessions two to three times a week. Utilizing physical therapy has been shown to (Sudhir Diwan et al., 2019)
Reduce pain
Increase mobility
Reduce pain medications.
Reduce mental health symptoms like anger, depression, and mood changes.
For severe cases, physical therapy following surgery can reduce recovery times.
Back Braces
Back braces can help reduce movement and pressure on the spine. This is helpful because even small spinal movements can lead to nerve irritation, pain, and worsening symptoms. Over time, the bracing can lead to a positive increase in mobility. (Carlo Ammendolia et al., 2019)
Injections
Epidural steroid injections may be recommended to relieve severe symptoms. Steroids act as anti-inflammatories to reduce pain and swelling caused by inflammation and irritation of the spinal nerves. They are considered nonsurgical medical procedures. According to research, injections can effectively manage pain for two weeks and up to six months, and some research has found that after a spinal injection, relief can last 24 months. (Sudhir Diwan et al., 2019)
Thickened Ligaments Decompression Procedure
Some individuals may be recommended to undergo a decompression procedure. This procedure involves using a thin needle tool inserted into the back. The thickened ligament tissue is removed to reduce the pressure on the spine and nerves. Research has found that the procedure can reduce symptoms and the need for more invasive surgery. (Nagy Mekhail et al., 2021)
Alternative Treatments
In addition to first-line treatments, individuals may be referred to alternative therapies for symptom management, including:
Acupuncture
This involves the insertion of thin-tipped needles into various acupoints to relieve symptoms.
Some research has found that acupuncture may be more effective at reducing symptoms than physical therapy alone. Both options are viable and can improve mobility and pain. (Hiroyuki Oka et al., 2018)
Chiropractic
This therapy reduces pressure on nerves, maintains spinal alignment, and helps to improve mobility.
Massage
Massage helps to increase circulation, relax the muscles, and reduce pain and stiffness.
New Treatment Options
As spinal stenosis research continues, new therapies are emerging to help relieve and manage symptoms in individuals who don’t respond to traditional medicine or cannot partake in conventional therapies for various reasons. However, some evidence presented is promising; medical insurers may consider them experimental and not offer coverage until their safety has been proven. Some new treatments include:
Acupotomy
Acupotomy is a form of acupuncture that uses thin needles with a small, flat, scalpel-type tip to relieve tension in painful areas. Research on its effects is still limited, but preliminary data shows it could be an effective complementary treatment. (Ji Hoon Han et al., 2021)
Stem Cell Therapy
Stem cells are the cells from which all other cells originate. They act as the raw material for the body to create specialized cells with specific functions. (National Institutes of Health. 2016)
Individuals with spinal stenosis can develop soft tissue damage.
Stem cell therapy uses stem cells to help repair injured or diseased tissues.
Stem cell therapy can help repair or improve the damaged areas and provide symptom relief.
Clinical studies for spinal stenosis report that it could be a viable treatment option for some.
However, more research is needed to confirm whether the therapy is effective enough to be widely used. (Hideki Sudo et al., 2023)
Dynamic Stabilization Devices
LimiFlex is a medical device undergoing research and analysis for its ability to restore mobility and stability in the spine. It is implanted into the back through a surgical procedure. According to research, individuals with spinal stenosis who receive the LimiFlex often experience a higher reduction in pain and symptoms than with other forms of treatment. (T Jansen et al., 2015)
Lumbar Interspinous Distraction Decompression
Lumbar interspinous distraction decompression is another surgical procedure for spinal stenosis. The surgery is performed with an incision above the spine and places a device between two vertebrae to create space. This reduces movement and pressure on the nerves. Preliminary results show positive short-term relief from symptoms; long-term data is not yet available as it is a relatively new spinal stenosis treatment option. (UK National Health Service, 2022)
Surgical Procedures
There are several surgical procedures are available for spinal stenosis. Some include: (NYU Langone Health. 2024) Surgery for spinal stenosis is often reserved for individuals with severe symptoms, like numbness in the arms or legs. When these symptoms develop, it indicates a more notable compression of the spinal nerves and the need for a more invasive treatment. (NYU Langone Health. 2024)
Laminectomy
A laminectomy removes part or all of the lamina, the vertebral bone covering the spinal canal.
The procedure is designed to reduce pressure on nerves and the spinal cord.
Laminotomy and Foraminotomy
Both surgeries are used if an individual’s spinal stenosis negatively affects an opening in the vertebral foramen.
Ligaments, cartilage, or other tissues that constrict the nerves are removed.
Both reduce pressure on the nerves traveling through the foramen.
Laminoplasty
A laminoplasty relieves pressure on the spinal cord by removing parts of the spinal canal’s lamina.
This surgical procedure involves removing herniated or bulging discs that are placing pressure on the spinal cord and nerves.
Spinal fusion
Spinal fusion involves joining two vertebrae using metal pieces like rods and screws.
The vertebrae are more stable because the rods and screws act as a brace.
Which Treatment Is The Right One?
Because all treatment plans differ, determining the most effective is best suited for a healthcare provider. Each approach will be personalized to the individual. To decide what therapy is best, healthcare providers will assess: (National Institute of Arthritis and Musculoskeletal and Skin Diseases. 2023)
The severity of symptoms.
The current level of overall health.
The level of damage that’s occurring in the spine.
The level of disability and how mobility and quality of life are affected.
Injury Medical Chiropractic and Functional Medicine Clinic will work with an individual’s primary healthcare provider and/or specialists to help determine the best treatment options and concerns regarding medications or other forms of treatment.
Unlocking Wellness
References
Diwan, S., Sayed, D., Deer, T. R., Salomons, A., & Liang, K. (2019). An Algorithmic Approach to Treating Lumbar Spinal Stenosis: An Evidenced-Based Approach. Pain medicine (Malden, Mass.), 20(Suppl 2), S23–S31. doi.org/10.1093/pm/pnz133
Marchand, A. A., Houle, M., O’Shaughnessy, J., Châtillon, C. É., Cantin, V., & Descarreaux, M. (2021). Effectiveness of an exercise-based prehabilitation program for patients awaiting surgery for lumbar spinal stenosis: a randomized clinical trial. Scientific reports, 11(1), 11080. doi.org/10.1038/s41598-021-90537-4
Ammendolia, C., Rampersaud, Y. R., Southerst, D., Ahmed, A., Schneider, M., Hawker, G., Bombardier, C., & Côté, P. (2019). Effect of a prototype lumbar spinal stenosis belt versus a lumbar support on walking capacity in lumbar spinal stenosis: a randomized controlled trial. The spine journal : official journal of the North American Spine Society, 19(3), 386–394. doi.org/10.1016/j.spinee.2018.07.012
Mekhail, N., Costandi, S., Nageeb, G., Ekladios, C., & Saied, O. (2021). The durability of minimally invasive lumbar decompression procedure in patients with symptomatic lumbar spinal stenosis: Long-term follow-up. Pain practice : the official journal of World Institute of Pain, 21(8), 826–835. doi.org/10.1111/papr.13020
Oka, H., Matsudaira, K., Takano, Y., Kasuya, D., Niiya, M., Tonosu, J., Fukushima, M., Oshima, Y., Fujii, T., Tanaka, S., & Inanami, H. (2018). A comparative study of three conservative treatments in patients with lumbar spinal stenosis: lumbar spinal stenosis with acupuncture and physical therapy study (LAP study). BMC complementary and alternative medicine, 18(1), 19. doi.org/10.1186/s12906-018-2087-y
Han, J. H., Lee, H. J., Woo, S. H., Park, Y. K., Choi, G. Y., Heo, E. S., Kim, J. S., Lee, J. H., Park, C. A., Lee, W. D., Yang, C. S., Kim, A. R., & Han, C. H. (2021). Effectiveness and safety of acupotomy on lumbar spinal stenosis: A pragmatic randomized, controlled, pilot clinical trial: A study protocol. Medicine, 100(51), e28175. doi.org/10.1097/MD.0000000000028175
Sudo, H., Miyakoshi, T., Watanabe, Y., Ito, Y. M., Kahata, K., Tha, K. K., Yokota, N., Kato, H., Terada, T., Iwasaki, N., Arato, T., Sato, N., & Isoe, T. (2023). Protocol for treating lumbar spinal canal stenosis with a combination of ultrapurified, allogenic bone marrow-derived mesenchymal stem cells and in situ-forming gel: a multicentre, prospective, double-blind randomised controlled trial. BMJ open, 13(2), e065476. doi.org/10.1136/bmjopen-2022-065476
Jansen, T., Bornemann, R., Otten, L., Sander, K., Wirtz, D., & Pflugmacher, R. (2015). Vergleich dorsaler Dekompression nicht stabilisiert und dynamisch stabilisiert mit LimiFlex™ [A Comparison of Dorsal Decompression and Dorsal Decompression Combined with the Dynamic Stabilisation Device LimiFlex™]. Zeitschrift fur Orthopadie und Unfallchirurgie, 153(4), 415–422. doi.org/10.1055/s-0035-1545990
For individuals dealing with digestive issues or bowel disorders, can adding peppermint to a nutrition plan help manage symptoms and digestion?
Peppermint
First grown in England, peppermint’s medicinal properties were soon recognized and are cultivated today in Europe and Northern Africa.
How It Is Used
Peppermint oil can be taken as a tea or in capsule form.
Consult a physician or licensed healthcare professional to determine the proper dosage for the capsule form.
For Irritable Bowel Syndrome
Peppermint is taken as a tea to treat general digestive problems. It is known to reduce the production of gas in the intestine. Today, researchers recognize peppermint as effective for irritable bowel syndrome when used in oil form. (N. Alammar et al., 2019) Peppermint oil has been approved for use by IBS patients in Germany. However, the FDA has not approved peppermint and oil to treat any condition, but it has listed peppermint and the oil as generally safe. (ScienceDirect, 2024)
Peppermint extract may increase serum levels of these medications.
It is recommended to discuss medication interactions with a healthcare provider before starting supplements if taking any of these medications.
Pregnancy
Peppermint is not recommended for use during pregnancy or by nursing individuals.
It is unknown if it could affect a developing fetus.
It is unknown if it can affect a nursing baby.
How To Use The Herb
It is not that common, but some individuals are allergic to peppermint. Peppermint oil should never be applied to the face or around mucous membranes (National Center for Complementary and Integrative Health. 2020). Using more than one form, such as tea and oil, is not recommended because it could lead to side effects.
Because the FDA does not regulate supplements like peppermint and others, their contents may be varied.
Supplements may contain harmful ingredients or not contain the active ingredient at all.
This is why seeking reputable brands and informing an individual’s healthcare team of what is being taken is highly recommended.
It has the potential to worsen certain conditions and should not be used by:
Peppermint was used to treat colic in infants but is not recommended today.
The menthol in the tea may cause infants and small children to choke.
Chamomile could be a possible alternative. Consult a healthcare provider to see if it is safe.
Beyond Adjustments: Chiropractic and Integrative Healthcare
References
Alammar, N., Wang, L., Saberi, B., Nanavati, J., Holtmann, G., Shinohara, R. T., & Mullin, G. E. (2019). The impact of peppermint oil on the irritable bowel syndrome: a meta-analysis of the pooled clinical data. BMC complementary and alternative medicine, 19(1), 21. doi.org/10.1186/s12906-018-2409-0
Agbabiaka, T. B., Spencer, N. H., Khanom, S., & Goodman, C. (2018). Prevalence of drug-herb and drug-supplement interactions in older adults: a cross-sectional survey. The British journal of general practice : the journal of the Royal College of General Practitioners, 68(675), e711–e717. doi.org/10.3399/bjgp18X699101
Kligler, B., & Chaudhary, S. (2007). Peppermint oil. American family physician, 75(7), 1027–1030.
Cash, B. D., Epstein, M. S., & Shah, S. M. (2016). A Novel Delivery System of Peppermint Oil Is an Effective Therapy for Irritable Bowel Syndrome Symptoms. Digestive diseases and sciences, 61(2), 560–571. doi.org/10.1007/s10620-015-3858-7
Khanna, R., MacDonald, J. K., & Levesque, B. G. (2014). Peppermint oil for the treatment of irritable bowel syndrome: a systematic review and meta-analysis. Journal of clinical gastroenterology, 48(6), 505–512. doi.org/10.1097/MCG.0b013e3182a88357
For individuals dealing with eczema, can incorporating acupuncture into a treatment plan help manage and reduce symptoms?
Acupuncture for Eczema
Eczema is a chronic skin disorder that causes intense itching, dry skin, and rashes. Common treatment options for eczema include:
Moisturizers
Topical steroids
Prescription medications
Some research suggests that acupuncture may also help individuals with eczema. In recent years, researchers have looked at acupuncture as a possible treatment option and found that it can reduce symptoms.
Acupuncture
Acupuncture involves inserting thin metallic needles in specific acupoints in the body. It is believed that by stimulating specific points, the body’s central nervous system activates and releases certain chemicals designed to enable healing. Ailments that are treated using acupuncture include: (Johns Hopkins Medicine. 2024)
Headaches
Back pain
Nausea
Asthma
Osteoarthritis
Fibromyalgia
Treatment
Studies have found that acupuncture could be a treatment option depending on the severity of the condition and the intensity of the itching sensations. (Ruimin Jiao et al., 2020) The needles are placed at various points associated with relieving the condition. These points include: (Zhiwen Zeng et al., 2021)
LI4
Located at the base of the thumb and index finger.
It has been shown to help reduce inflammation and irritation.
LI11
This point is located within the elbow to reduce itchiness and dryness.
LV3
Located on the top of the foot, this point reduces stress on the nervous system.
SP6
The SP6 is on the lower calf above the ankle and can help reduce inflammation, redness, and skin irritation.
SP10
This point is located adjacent to the knee and reduces itchiness and inflammation.
ST36
This point is located below the knee on the back of the leg and is used to improve overall well-being.
Eczema flare-ups are also linked to stress and anxiety. Acupuncture has been shown to reduce anxiety and stress, which can also help relieve eczema symptoms (Beate Wild et al., 2020).
Acupuncture helps repair skin barrier damage or the outer part of the skin designed to protect the body. (Rezan Akpinar, Saliha Karatay, 2018)
Individuals with eczema tend to have a weakened skin barrier; this benefit can also improve symptoms. (National Eczema Association. 2023)
Individuals with eczema often have an overactive immune system contributing to the disorder.
According to research, acupuncture can also help in regulating the immune system. (Zhiwen Zeng et al., 2021)
Risks
Acupuncture is generally considered safe, but there are some risks to be aware of. These risks include: (Ruimin Jiao et al., 2020)
Swelling where the needles are inserted.
Red spots on the skin.
Increased itchiness.
A rash known as erythema – occurs when small blood vessels are injured.
Most studies on acupuncture for eczema show positive results that prove it can aid in relieving symptoms. (SeHyun Kang et al., 2018) (Ruimin Jiao et al., 2020) However, individuals should talk to their healthcare provider to see if it’s a safe option.
Jiao, R., Yang, Z., Wang, Y., Zhou, J., Zeng, Y., & Liu, Z. (2020). The effectiveness and safety of acupuncture for patients with atopic eczema: a systematic review and meta-analysis. Acupuncture in medicine : journal of the British Medical Acupuncture Society, 38(1), 3–14. doi.org/10.1177/0964528419871058
Zeng, Z., Li, M., Zeng, Y., Zhang, J., Zhao, Y., Lin, Y., Qiu, R., Zhang, D. S., & Shang, H. C. (2021). Potential Acupoint Prescriptions and Outcome Reporting for Acupuncture in Atopic Eczema: A Scoping Review. Evidence-based complementary and alternative medicine : eCAM, 2021, 9994824. doi.org/10.1155/2021/9994824
Wild, B., Brenner, J., Joos, S., Samstag, Y., Buckert, M., & Valentini, J. (2020). Acupuncture in persons with an increased stress level-Results from a randomized-controlled pilot trial. PloS one, 15(7), e0236004. doi.org/10.1371/journal.pone.0236004
Akpinar R, Karatay S. (2018). Positive Effects of Acupuncture on Atopic Dermatitis. International Journal of Allergy Medications 4:030. doi.org/10.23937/2572-3308.1510030
Kang, S., Kim, Y. K., Yeom, M., Lee, H., Jang, H., Park, H. J., & Kim, K. (2018). Acupuncture improves symptoms in patients with mild-to-moderate atopic dermatitis: A randomized, sham-controlled preliminary trial. Complementary therapies in medicine, 41, 90–98. doi.org/10.1016/j.ctim.2018.08.013
Can incorporating nopal or prickly pear cactus into one’s diet help individuals trying to lower blood glucose, inflammation, and risk factors associated with heart and metabolic diseases?
Nopal
Nopal, also known as prickly pear cactus, is a versatile vegetable that can be added to nutrition plans to increase fiber intake, vitamins, minerals, and plant-based compounds. It grows in the U.S. Southwest, Latin America, and the Mediterranean. The pads, or the nopales or cactus paddles, have a texture like okra and slight tartness. The prickly pear cactus fruit, referred to as tuna in Spanish, is also consumed. (University of Arizona Cooperative Extension, 2019) It is often used in fruit salsas, salads, and desserts and is available as a supplement in tablet and powder form.
Nopal is highly nutritious, low in calories, free of fat, sodium, or cholesterol, and full of fiber, vitamins, minerals, and betalains. (Parisa Rahimi et al., 2019) Betalains are pigments with anti-inflammatory properties. The variety of fibers creates a low glycemic index (measures how much a specific food raises blood sugar levels after consumption) of about 32, a recommended addition to a diabetes-friendly diet. (Patricia López-Romero et al., 2014)
Compounds
Nopal contains a variety of beneficial carbohydrates, vitamins, and minerals.
Nopal has soluble and insoluble fiber, which benefits blood sugar.
It also contains vitamin A, carotenoids, vitamin C, calcium, and plant-based compounds like phenols and betalains. (Karina Corona-Cervantes et al., 2022)
Blood Sugar Regulation
Research has evaluated regular nopal consumption and supplementation for blood sugar control. A study on blood sugar evaluated adding nopal to a high-carbohydrate breakfast or a breakfast high in soy protein in Mexican individuals with type 2 diabetes. The study found that consuming nopales, about 300 grams or 1.75 to 2 cups before a meal, could reduce after-meal/postprandial blood sugars. (Patricia López-Romero et al., 2014) An older study had similar results. (Montserrat Bacardi-Gascon et al., 2007) Individuals were randomly assigned to consume 85 grams of nopal with three different breakfast options:
Chilaquiles – a casserole made with corn tortilla, vegetable oil, and pinto beans.
Burritos – made with eggs, vegetable oil, and pinto beans.
Quesadillas – made with flour tortillas, low-fat cheese, avocado, and pinto beans.
The groups assigned to eat nopales had reductions in blood sugar. There was a:
30% reduction in the chilaquiles group.
20% decrease in the burrito group.
48% reduction in the quesadilla group.
However, the studies were small, and the population was not diverse. so further research is needed.
Increased Fiber
The combination of soluble and insoluble fiber benefits the gut in various ways. Soluble fiber can act as a prebiotic, feeding beneficial bacteria in the gut and assisting in removing low-density lipoprotein (LDL) cholesterol from the body. Insoluble fiber increases transit time, or how quickly food moves through the digestive system and promotes bowel regularity. (Centers for Disease Control and Prevention, 2022) In a short-term randomized clinical control trial, researchers found an improvement in irritable bowel syndrome symptoms in individuals supplemented with 20 and 30 grams of nopal fiber. (Jose M Remes-Troche et al., 2021) For individuals not used to consuming fibrous foods, it may cause mild diarrhea, so it is recommended to increase intake slowly and with adequate water to prevent gas and bloating.
Plant Based Calcium
One cup of nopal provides 244 milligrams or 24% of daily calcium needs. Calcium is a mineral that optimizes bone and teeth health. It also assists in blood vessel contraction and dilation, muscle function, blood clotting, nerve transmission, and hormonal secretion. (National Institutes of Health. Office of Dietary Supplements 2024) Individuals who follow diets that exclude dairy products can benefit from plant-based calcium sources. This includes cruciferous vegetables like kale, collards, and arugula.
Other Benefits
Studies done in animals and test tubes suggest that fresh nopal and extracts may assist in reducing triglycerides and cholesterol in metabolic dysfunction-associated steatotic liver disease or when unhealthy amounts of fat accumulate in the liver. (Karym El-Mostafa et al., 2014) Other potential benefits with limited evidence include:
Unless individuals are allergic to it, most can eat whole nopal without a problem. However, supplementing is different because it provides a concentrated source. Individuals taking medication to manage diabetes and consuming nopal regularly may contribute to an increased risk of developing hypoglycemia or low blood sugar. Dermatitis has also been reported from contact with the cactus spines. (U.S. Department of Agriculture, FoodData Central, 2018) There have been rare reports of bowel obstruction in individuals who consume large amounts of the seeds found in the fruit. (Karym El-Mostafa et al., 2014) Ask a registered dietitian or primary healthcare provider if nopal can provide safe benefits.
Rahimi, P., Abedimanesh, S., Mesbah-Namin, S. A., & Ostadrahimi, A. (2019). Betalains, the nature-inspired pigments, in health and diseases. Critical reviews in food science and nutrition, 59(18), 2949–2978. doi.org/10.1080/10408398.2018.1479830
López-Romero, P., Pichardo-Ontiveros, E., Avila-Nava, A., Vázquez-Manjarrez, N., Tovar, A. R., Pedraza-Chaverri, J., & Torres, N. (2014). The effect of nopal (Opuntia ficus indica) on postprandial blood glucose, incretins, and antioxidant activity in Mexican patients with type 2 diabetes after consumption of two different composition breakfasts. Journal of the Academy of Nutrition and Dietetics, 114(11), 1811–1818. doi.org/10.1016/j.jand.2014.06.352
Corona-Cervantes, K., Parra-Carriedo, A., Hernández-Quiroz, F., Martínez-Castro, N., Vélez-Ixta, J. M., Guajardo-López, D., García-Mena, J., & Hernández-Guerrero, C. (2022). Physical and Dietary Intervention with Opuntia ficus-indica (Nopal) in Women with Obesity Improves Health Condition through Gut Microbiota Adjustment. Nutrients, 14(5), 1008. doi.org/10.3390/nu14051008
Bacardi-Gascon, M., Dueñas-Mena, D., & Jimenez-Cruz, A. (2007). Lowering effect on postprandial glycemic response of nopales added to Mexican breakfasts. Diabetes care, 30(5), 1264–1265. doi.org/10.2337/dc06-2506
Remes-Troche, J. M., Taboada-Liceaga, H., Gill, S., Amieva-Balmori, M., Rossi, M., Hernández-Ramírez, G., García-Mazcorro, J. F., & Whelan, K. (2021). Nopal fiber (Opuntia ficus-indica) improves symptoms in irritable bowel syndrome in the short term: a randomized controlled trial. Neurogastroenterology and motility, 33(2), e13986. doi.org/10.1111/nmo.13986
El-Mostafa, K., El Kharrassi, Y., Badreddine, A., Andreoletti, P., Vamecq, J., El Kebbaj, M. S., Latruffe, N., Lizard, G., Nasser, B., & Cherkaoui-Malki, M. (2014). Nopal cactus (Opuntia ficus-indica) as a source of bioactive compounds for nutrition, health and disease. Molecules (Basel, Switzerland), 19(9), 14879–14901. doi.org/10.3390/molecules190914879
Onakpoya, I. J., O’Sullivan, J., & Heneghan, C. J. (2015). The effect of cactus pear (Opuntia ficus-indica) on body weight and cardiovascular risk factors: a systematic review and meta-analysis of randomized clinical trials. Nutrition (Burbank, Los Angeles County, Calif.), 31(5), 640–646. doi.org/10.1016/j.nut.2014.11.015
Corona-Cervantes, K., Parra-Carriedo, A., Hernández-Quiroz, F., Martínez-Castro, N., Vélez-Ixta, J. M., Guajardo-López, D., García-Mena, J., & Hernández-Guerrero, C. (2022). Physical and Dietary Intervention with Opuntia ficus-indica (Nopal) in Women with Obesity Improves Health Condition through Gut Microbiota Adjustment. Nutrients, 14(5), 1008. doi.org/10.3390/nu14051008
For individuals living with cyclical or chronic endometriosis symptoms, can incorporating support therapies help in disease management?
Support Therapies
Endometriosis is a disorder in which tissue similar to the uterine lining begins to grow outside the uterus where it does not belong. Endometriosis support therapies involve a comprehensive approach to treatment. It involves non-invasive treatments to help manage symptoms that can include:
A physical therapist uses various pressures, stretching, and/or trigger point release. This helps: (Sylvia Mechsner, 2022)
Release muscle tension
Lower cortisol – stress hormone
Improve circulation
Release endorphins – the body’s natural painkillers
Medications
Nonsteroidal anti-inflammatory drugs or NSAIDs and hormonal contraceptives – birth control are the first line of treatment. Advil and Motrin are over-the-counter NSAIDs. If those don’t manage pain effectively, a healthcare provider may recommend prescription NSAIDs. (Sylvia Mechsner, 2022) Hormonal suppression agents or estrogen modulators are a second line of treatment for endometriosis and can include: (Christian M. Becker et al., 2022)
Hormonal contraceptives suppress or regulate periods. They are effective for management, but not everyone can take them because of medical history, side effects, or fertility disorders and conditions. (Mert Ilhan et al., 2019) A healthcare provider can recommend alternative support therapies.
Transcutaneous Electrical Nerve Stimulation
A transcutaneous electrical nerve stimulation utilizes a battery-operated device that delivers low-voltage electrical stimulation to nerve fibers through electrodes placed on the skin.
Sessions are usually 15 to 30 minutes and work by disrupting pain signals. (Sylvia Mechsner, 2022)
Acupuncture
Acupuncture is a therapy in which a practitioner inserts thin needles into specific acupoints on the body to promote the flow of energy and alleviate pain. (Nora Giese et al., 2023)
Chiropractic
Chiropractic care focuses on spinal adjustments and alignment to enhance nervous system function, help alleviate pelvic discomfort and nerve pain – sciatica – and improve overall well-being. (Robert J. Trager et al., 2021)
Non-surgical decompression could be recommended to gently stretch the spine, relieve pressure, and flood the spine with added nutrients.
Movement Medicine: Chiropractic Care
References
Mansfield, C., Lenobel, D., McCracken, K., Hewitt, G., & Appiah, L. C. (2022). Impact of Pelvic Floor Physical Therapy on Function in Adolescents and Young Adults with Biopsy-Confirmed Endometriosis at a Tertiary Children’s Hospital: A Case Series. Journal of pediatric and adolescent gynecology, 35(6), 722–727. doi.org/10.1016/j.jpag.2022.07.004
Mechsner S. (2022). Endometriosis, an Ongoing Pain-Step-by-Step Treatment. Journal of clinical medicine, 11(2), 467. doi.org/10.3390/jcm11020467
Ilhan, M., Gürağaç Dereli, F. T., & Akkol, E. K. (2019). Novel Drug Targets with Traditional Herbal Medicines for Overcoming Endometriosis. Current drug delivery, 16(5), 386–399. doi.org/10.2174/1567201816666181227112421
Becker, C. M., Bokor, A., Heikinheimo, O., Horne, A., Jansen, F., Kiesel, L., King, K., Kvaskoff, M., Nap, A., Petersen, K., Saridogan, E., Tomassetti, C., van Hanegem, N., Vulliemoz, N., Vermeulen, N., & ESHRE Endometriosis Guideline Group (2022). ESHRE guideline: endometriosis. Human reproduction open, 2022(2), hoac009. doi.org/10.1093/hropen/hoac009
Pereira, A., Herrero-Trujillano, M., Vaquero, G., Fuentes, L., Gonzalez, S., Mendiola, A., & Perez-Medina, T. (2022). Clinical Management of Chronic Pelvic Pain in Endometriosis Unresponsive to Conventional Therapy. Journal of personalized medicine, 12(1), 101. doi.org/10.3390/jpm12010101
Giese, N., Kwon, K. K., & Armour, M. (2023). Acupuncture for endometriosis: A systematic review and meta-analysis. Integrative medicine research, 12(4), 101003. doi.org/10.1016/j.imr.2023.101003
Trager, R.J., Prosak, S.E., Leonard, K.A. et al. (2021). Diagnosis and management of sciatic endometriosis at the greater sciatic foramen: a case report. SN Comprehensive Clinical Medicine, 3. doi.org/doi:10.1007/s42399-021-00941-0
Can using egg substitutes or replacements be safe for individuals with an egg allergy?
Substitutes and Replacements
Individuals should not assume either is safe unless they carefully read the label.
Egg substitutes may contain eggs.
Egg replacement products may be egg-free.
Look for alternatives labeled vegan or egg-free to ensure there are none.
Substitutes May Contain Eggs
Liquid egg substitutes in grocery store dairy aisles are made from eggs. The following all contain eggs and are not safe for individuals with egg allergies:
Generic liquid egg substitutes in cartons
Egg Beaters
Powdered egg white products
Replacements Are Safe Alternatives
Special replacement products that do not contain eggs are available.
They are labeled vegan egg substitutes.
They are usually sold in powdered form.
They are useful for baking.
They cannot be used as a replacement for eggs in foods like a quiche.
Always check the ingredients on the label before purchasing a product sold as a substitute or replacement to ensure it is completely free.
These products may also contain soy, dairy, or other food allergens.
Vegan – contains no animal products, which includes eggs and dairy.
Vegetarian – may contain eggs as they are not meat but an animal product.
Unaware of Foods With Eggs
Stay aware of eggs hidden in other food products, such as cakes, breads, pastries, noodles, crackers, and cereals.
The federal Food Allergen Labeling and Consumer Protection Act requires that all packaged food products that contain eggs as an ingredient must list the word egg on the label. (U.S. Food & Drug Administration. 2022)
Other ingredients that indicate eggs are in the product include:
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