Massage & Bodywork

July/August 2013

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education classroom to client | Pathology perspectives | body awareness | functional anatomy | somatic research In the treatment of peripheral neuropathy, I've seen my best hopes dashed and my worst fears allayed. I've found that working with the nerve-fascia interface can often provide temporary relief and sometimes (I wish I knew exactly why) results in longer-lasting improvement. Michael Hamm Types of PN One of the challenges of this condition is that it can be the result of dozens of different problems that are not mutually exclusive, so a person's PN may be the result of multiple factors. Different specialists organize this information in slightly different ways, but following is one way to map out types and causes of PN. Peripheral Neuropathy A Panoply of Problems By Ruth Werner An impromptu poll of my Facebook friends suggests that massage therapists are seeing an increasing number of clients with a complicated group of conditions collectively called peripheral neuropathy (PN). This refers to damage in the peripheral nervous system, which can include both spinal and cranial nerves. Not surprisingly, pain— ranging from itching and tingling to severe burning sensations—is a leading feature of PN. PN affects about 10 percent of the general population. Its prevalence rises significantly with age, so this is something that any massage therapist with mature clients needs to be ready to address. 44 massage & bodywork july/august 2013 Inherited PN. This is related to an inborn genetic anomaly. A condition called Charcot-Marie-Tooth disease is the most common cause of inherited PN. Acquired PN. Several different life events may lead to long-term nerve damage, although approximately 25 percent of PN cases show no known cause. • Systemic disease: alcoholism and poorly controlled diabetes are the two leading causes of PN. Autoimmune disease is another contributor; PN can be a consequence of almost any condition that involves low-grade, chronic inflammation. GuillainBarre syndrome is an autoimmune disease with a sudden onset—it may be the only form of acute PN. • Infection: many viruses, including herpes simplex and zoster, HIV, polio, and West Nile virus, can cause nerve damage. Other pathogens, including those that cause diphtheria, Hansen's disease (leprosy), and Lyme disease, are also associated with PN.

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