Dr Mailis-Gagnon Answers your questions on Neuropathic Pain

Since I started writing regularly for the CARP newsletter, readers have asked a number of questions. I am responding to a few (please note that this information is not supposed to replace the advice of your doctor):

Q- My wife was diagnosed with diabetic neuropathy and was treated by a chiropractor in Europe with cold lasers with good effect. Is this treatment done here?

A- I asked my colleague, Professor Igor Steiman of the Canadian Memorial Chiropractic College. He looked at the available literature and also asked a number of chiropractors in regards to this treatment. While laser treatment is used to improve inflammation or wound healing, its use in diabetic neuropathy is not known. I also obtained additional information from the American Cancer Society website as follows: The term cold laser refers to the use of low-intensity or low levels of laser light. Proponents claim that cold laser therapy can reduce pain and inflammation.

The US Food and Drug Administration (FDA) considers these laser devices experimental, and allows them to be used in investigational studies based on some evidence that they may provide temporary pain relief. Cold laser treatment is thought to help some types of pain, inflammation, and wound healing, although stronger proof is needed. These lasers are used directly on or over the affected area. Cold lasers are also sometimes used for acupuncture, using laser beams to stimulate the body’s acu-points rather than needles. This treatment regimen appeals to those who want acupuncture but who fear needles.

There is a great deal of variation in the types of lasers that are used and how they are used. Some devices do not have the output that they promise, and others are little more than light-emitting diodes (LED lights). Some advertise that they can help with herpes, high blood pressure, migraine headaches, wrinkles, cerebral palsy, and other conditions, claims for which there is little or no evidence. The FDA forbids statements that a treatment can help or cure diseases if scientific studies have not found it to be true.

Q- In regards to physiotherapy coverage, you indicated we are eligible for OHIP coverage after 65. What about if I live in another province? A-I can’t answer this as I do not know and I am based in Toronto. Provinces have different coverage. Local physicians and therapists would certainly know.

Q- What kind of remedies work for night leg cramps?

This information is derived from the Cleveland Clinic Online resources website. Nocturnal (night) leg cramps (“charley horse”) are cramps that happen commonly during the night while you are sleeping or while you are resting. However, in some people they may happen only during and not significantly at night. The contractions, most often in the calf muscles but also sometimes in the feet, come on suddenly. The cramps are painful and may last up to ten minutes. There might also be soreness after the cramp goes away.

The frequency of cramps generally seems to increase with age (especially after 50 years of age), but they do occur in childhood as well. Both men and women seem to be equally affected. No one really knows what causes these cramps, but some cases have been linked to: sitting for long periods of time, dehydration, over-exertion of the muscles, standing or working on concrete floors and more rarely, to diabetes, peripheral vascular disease, Parkinson’s disease, endocrine disorders, contraceptive pills etc. You might be able to relieve the cramp by walking around, jiggling your leg, or stretching out the calf muscle.