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Anodyne Therapy for Peripheral Neuropathy and Pain Relief


Newsletters > Home Health Bulletins for Physicians >

A home health bulletin distributed to our physicians on November 26, 2008

Addressing Circulation to Improve

Peripheral Neuropathy

A 2004 study examining 799 elderly patients concluded that at least 26% of Americans age 65 to 74 live with peripheral sensory deficits.(1)  The percentage increases to 54% or more for those 85 years and older.  Forty-eight percent of those patients reported pain or discomfort.  Twenty-eight percent reported numbness, and forty-four percent reported trouble with walking.  Peripheral neuropathy is connected with the development of non-healing lesions of the feet and with a much higher incidence of fall injuries.14  Problems with circulation have been cited as a contributing factor to peripheral neuropathy.(2,3)

As part of a comprehensive neuropathy care plan, AbleCare Home Health  makes available Anodyne® Therapy to improve circulation and reduce chronic pain.  Anodyne Therapy involves the use of pads placed over a patient’s skin to direct monochromatic, near-infrared energy up to 5cm beneath the skin.  The FDA has approved Anodyne Therapy for use in improving circulation, chronic pain, stiffness, and muscle spasm.  The FDA has not approved Anodyne for treatment of any specific diagnosis, but Anodyne may be used to improve circulation in a localized area when circulation problems seem to be a contributing factor to patient complaints.  Anodyne has been deemed safe to use over wounds, the spine, metal implants, and pacemakers.

Does Improving Circulation Improve Peripheral Neuropathy?  
The vast majority of research on the subject says yes.  One study found that a vasodilating drug, trandolapril, improved symptoms among patients with mild neuropathy.(4)  Anodyne Therapy available through AbleCare Home Health gives practitioners the opportunity to address areas of circulatory compromise directly without causing systemic effects.  Evidence supporting the use of Anodyne Therapy for the relief of pain, especially neuropathic pain, is conclusive.  Multiple, peer-reviewed studies have found Anodyne Therapy to be effective in reversing diabetic peripheral neuropathy as well as sensory impairment from six other causes.(5-11)  One study was a double-blind, placebo controlled study with twenty-seven patients.5  Two of those studies were medical record reviews covering 1,047 patients(11) and 2,239 patients respectively.(10)  Of the eight peer-reviewed studies we found on the subject, we were only able to find one study that failed to show increases in sensation from this sort of monochromatic, infrared therapy.(12)  In this study with 39 participants, researchers shortened therapy sessions by ten minutes, and some authors have suggested that this discrepancy merits further investigation.13  We could find no evidence that refuted Anodyne’s positive results with pain.  Of the studies with positive findings, results included:

  • Patients realized significant decreases in the number of insensate sites after both six and 12 treatments at three treatments per week.(5)  Improvement in 71% of insensate sites has been observed.11  Fifty-three percent of patients deemed to have loss of protective sensation improved enough to no longer meet Medicare criteria after treatment.(10)
  • Pain expressed on a visual analog scale reduced 67%.(10)  This was accomplished despite the fact that several cases previously had proved refractory to a variety of pain-relieving agents.
  • Patient reports of balance impairment improved by 86% after 12 treatments.  At entry, 90% of subjects reported balance impairment.  After treatment, only 17% reported balance problems.(5)

Leonard et al used heat pads without light therapy as the sham treatment.(5)  Their study failed to show any results from the sham heat treatment, suggesting that the effects achieved were the result of factors other than a response to heat. Various authors suggest that red blood cells absorb Anodyne’s photoemissions and release nitric oxide.(5,15,16)

Please offer AbleCare Home Health to your patients with Peripheral Neuropathy.

Peripheral Neuropathy TreatmentA Peripheral Neuropathy care plan can include blood sugar control education, fall injury prevention, foot care education, and therapies that can actually improve sensation. 

 

 

 

References

  1. Mold JW, et al. “The prevalence, predictors, and consequences of peripheral sensory neuropathy in older patients.” J Am Board Fam Pract. September-October 2004; 17: 309-18.
  2. Cameron NE, Eaton SE, Cotter MA, et al. “Vascular factors and metabolic interactions in the pathogenesis of diabetic neuropathy.” Diabetologia 2001; 44: 1973-1988.
  3. Poncelet A. “An Algorithm for the Evaluation of Peripheral Neuropathy.” Am Fam Phys 1998; 57 (4).
  4. Malik RA, Williamson S, Abbott C, et al. “Effect of angiotensin-converting-enzyme (ACE) inhibitor trandolapril on human diabetic neuropathy: randomised double blind placebo controlled trial.” Lancet 1998; 352: 1978-81.
  5. Leonard DR, Farooqi MH, Myers S. Restoration of sensation, reduced pain, and improved balance in subjects with diabetic peripheral neuropathy; A double blind, randomized, placebo controlled study with monochromatic near infrared treatment. Diabetes Care: Jan 2004; 27(1); pp 168-172.
  6. Powell MW, Carnegie DE, Burke TJ. Reversal of diabetic peripheral neuropathy and new wound incidence: the role of MIRE. Adv Skin Wound Care. 2004 Jul-Aug;17(6):295-300.
  7. Kochman AB, Carnegie DH, Burke TJ. Symptomatic reversal of peripheral neuropathy in patients with diabetes. J Am Podiatr Med Assoc. 2002 Mar; 92(3):125-30.
  8. Pendergast JJ, Miranda G, Sanchez M. Improvement of sensory impairment in patients with peripheral neuropathy. Endocr Pract. 2004 Jan-Feb;10(1):24-30.
  9. Kochman AB, et al. Restoration of sensation, improved balance and gait reduction in falls in elderly patients with use of monochromatic infrared photo energy and physical therapy. J Geritr Phys Ther. 2004;27(1):16-19.
  10. Harkless L, DeLellis S, Carnegie D, et al. “Improved foot sensitivity and pain reduction in patients with peripheral neuropathy after treatment with monochromatic infrared photo energy – MIRE.” J Diabetes Complications. 2006 Mar-Apr; 20 (2): 81-7.
  11. DeLellis SL, Carnegie DH, Burke TJ. “Improved sensitivity in patients with peripheral neuropathy: effects of monochromatic infrared photo energy.” J Am Podiatr Med Assoc. 2005 Mar-Apr; 95 (2): 143-7.
  12. Clift J, Kasser R, Newton T, et al. “The effect of monochromatic infrared energy on sensation in patients with diabetic peripheral neuropathy.” Diabetes Care. 2005; 28: 2896-2900.
  13. Clifft J, Kasser R, Newton T, et al. “The effect of monochromatic infrared energy on sensation in subjects with diabetic peripheral neuropathy: a double-blind, placebo-controlled study: response to Burke.” Diabetes Care, May 1, 2006; 29 (5): 1186-87.
  14. Richardson JK. Factors associated with falls in older patients with diffuse polyneuroapthy. J Am Geratr Soc. 2002;50:1767-1773.
  15. Ferreira SH, Duarte ID, Lorenzetti BB. The moleculat mechanism of action of peripheral morphine analgesia: stimulation of the cGMP system via nitric oxide release. Eur J Pharmacol 1991 Aug 16;201:121-122.
  16. Nobel JG, Lowe AS, Baxter GD. Monochromatic infrared irradiation (890 nm): effect of a multisource array upon conduction in the human median nerve. J Clin Laser Med Surg. 2001,19:291-5.