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(percussive music) – Peripheral neuropathy relief
in the foot and the ankle. This is one of the most
common problems that we see. And there's a lot of
misconceptions up there. There's 600 articles written
every year that I can find when you type in peripheral neuropathy. There's a lot of misconceptions. What's real, what's a
fraud, what can help, and how do you get real,
meaningful results? We're gonna focus on that in this video and we're starting right now. (breezy music) Guys, thank you so much
for watching this video. We appreciate your likes, your
subscribes, your comments. We really love hearing
if this stuff helps. It really makes a big difference for us. So thank you. There are hundreds of different
causes of nerve damage. This is most commonly called
peripheral neuropathy. The most common causes are
potentially diabetes, aging, thyroid disorders,
drinking alcohol, smoking, aging, chemotherapy, taking
medications for too long, putting too much pressure on your feet, wearing the wrong types of shoes, being too active on your feet. I could keep going on and on.

But if you Google and look up peripheral neuropathy
pain or nerve damage, what this usually affects is the smaller, fine-touch sensation nerves. And what happens generally is as you're walking during the day you don't notice how sore you're getting. And when you lay there at night, your legs swell and get sore. And your nerves throb. Obviously since there's
so many different causes, this can present in different ways, but a lot of simple, easy treatments can make a big difference. Now, there's two different concepts. So one is treating it
and another is curing it. A lot of times, as we get older, trying to cure nerve
pain may be impossible for a lot of people. This is trying to reverse aging. So for example, if you
have wrinkles on your skin, you're not going to look like a baby again by buying a cream. I wanna make that very clear to you. There's a lot of scam
artists out there online selling pills and creams, promising stuff. But with the little asterisk at the bottom they say it doesn't actually work.

And studies show that a lot of this stuff will not reverse and cure it. A lot of these things are treatments that make you feel better. Because at the end of the day, we can't reverse the aging process. And when our skin, when our nerves age, there will be some deterioration. But you can make it
better than it was before even if you don't cure it all the way. At the same time, and there's poor agreement,
even among doctors, even among scientists, nobody even agrees on what exactly defines these types of diseases. Most of the time, here's
how I see symptoms present, numbness, burning,
tingling, radiation pain. These are nerve pain. Sharp, shooting, zapping pain. So you can see all these little nerves, they zap up your ankle or
they come up your ankle, up the sides.

You can see on top of the foot right there how many nerves I have there. What usually happens is, in
most people, in your toes, your toes are the farthest
part from your brain. So the farther you get, the more highway there is
from your brain to your toes. So the more percentage
chance there is of damage. For example, you're less likely to have
nerve pain around your face or your neck. But in your fingertips and your toes, you're more likely to because
those nerves are longer and they get thinner as they go, and they're less protected and
more likely to get damaged. Here's two good rules. If it's at nighttime or you're getting sore
while you're resting, like sitting on the couch, that's more likely to have some
nerve pain component to it. If the pain is worse when
you get up in the morning, that's more likely to
be biomechanical pain. And nerve disease, if
you're just sitting there, can cause nerve pain. But, for example, if I
punched you in the shoulder, that's technically nerve damage because I punched you in
the nerves in your shoulder, and it's gonna ache while
you're sitting on the couch.

Keep that concept in mind. Biomechanical pain, like
someone punching you, can create nerve-like symptoms because that hurts your nerves. And most of the time I
see people have been hurt and that's what causes their nerve pain. They're always sore. Their hips, their backs,
their hamstrings, their knees, and their feet are always sore. So they always have nerve pain. So it's not true nerve pain,
it's biomechanical nerve pain. Nerve pain itself, like in nerve diseases, if you're not sore ever anywhere and you're just having
sharp, shooting, zapping pain in like only one nerve. If it's in both feet equally, that's more likely to be a nerve pain. If it's one foot worse than the other, that's more likely to be biomechanical.

Massage and icing can really help. So let's start with that. Massaging is best performed
with either a cold can or non-cold devices. Sometimes with peripheral neuropathy, cold stuff can irritate your nerves. If it's true peripheral
neuropathy, the cold may be bad. But if it's musculoskeletal,
icing a bottle, and I'd be careful using a can, a plastic bottle might be better so it doesn't explode in your fridge.

But just roll it for like 10 to 15 minutes on the bottom of your arch. There is some fancy ice
ball devices out there. You can use 'em on the
bottom of your foot, but the problem is they
don't really stick around. So thumbs down on that one. Realistically, use a ice bottle. But if it's in your legs,
in your calf muscles, that can work great. These rubber balls, they're like a dollar. They really come with other stuff. You can get these for dirt cheap prices. It doesn't have to be anything expensive. But sitting there or even
standing on this thing, it can really work out your arch if it's your plantar fascia.

And there's harder ones,
there's softer ones, I'm using a harder one right here, that can really stretch out and get rid of a lot of that swelling right there. Once you massage, I always
recommend massaging first. Look at that. It gives me much more flexibility right after I massage my hamstrings and my calf muscles already. But then you stretch. So realistically, if you
can't reach your toes, start with a towel. Just bend up that hamstring,
bend up that calf muscle, get that pulled up, get it in good shape, get that foot feeling really good.

And that does a great job. So you can do your right foot and then you can do your left foot. But getting that fluid out of there, getting that stiffness out of there, especially before you go to bed or when you wake up in the morning, this will really pay dividends in terms of getting that
swelling and eventual nerve pain down the rest of the day. One thing I like is Biofreeze right here. Biofreeze right here is
a topical applicator. So for example, you can take
it and rub it onto your toes. This kind of short circuits your nerves. So when you put this on
the nerves, it feels hot, like icy hot. And then the nerve pressure goes down. This is good for nighttime use.

Put this on your sore areas. Biofreeze is kind of like capsaicin. It can almost burn your nerve pain away. So it makes it very sensitive. And then the pain gradually goes away. So that can feel a little bit better. Nerve injections. Sometimes if it's one nerve, this could be scar tissue or an injured or constricted nerve, I will take an injection. I'll inject that nerve and
see if the pain goes away. Sometimes this is a way
your podiatrist can tell if you actually have nerve pain or not, and where it's really coming from.

So what I like to do is if it's a nerve injury to just one site, I can block the nerve and see
if that nerve pain goes away. That's how you can tell
if it's muscle or nerve. So work with your podiatrist
to figure that out. Walk it off. If you're in bed at night
and your legs swell up, sometimes getting up and moving around can lower your swelling. This is where having your
feet elevated can help. This is where compression
stockings can help. The less swelling you have on your legs, the less likely your nerves
are to be stretched and throb. So same kind of thing. If I punched you in the arm, your arm would swell and that
would stretch your nerves.

Keep that in mind. Technically, walking can
flush some of that fluid out of there. Is that nerve pain or is
it musculoskeletal pain? It's both. Take care of your feet. So as an example, check this out. Inside the orthotic look
at how stable the foot is. But watch this. Look at how much it stretches out. With the orthotic, look
at how stable this is. None of the nerves are being stretched. The foot can move. But watch this. When I stand like this, look
at how the foot flattens out. That stretches all the
nerves through the arch, through the inside of the ankle. So watch this. Stable, nice and stable. Stretches out. That leads to a lot of
nerve pain at night. Think of the nerve kinda like a cord. If I pull the cord and twist it, that's gonna ache later. And nerve can get bruised just
like muscle can get bruised. Skip alcohol drinking. A lot of the times alcohol
drinking can cause nerve pain later at night.

If you have a lot of nerve pain, stop drinking alcohol for a little while and see if you get better. Control your health issues. If you have diabetes, thyroid disorder, go see your primary care doctor. This always goes without saying. But the single biggest cure is getting your blood sugar down, getting your weight down and
your nerve pain gets better. I see this all the time. Get your sugars down,
get your weight down. Is it easy? It's not an easy fix, but it's a real fix that keeps it away. And realistically, you know,
get as healthy as possible. This will really lengthen your lifespan and raise your quality of life. I know it's almost like
a cop-out to say that, but come on, you know it's true.

And maybe this is the wake-up call. We'll help you lose some
weight and get in better shape. Stop smoking. A lot of the times lack of blood flow will cause aching nerves. So if you're smoking, this goes for any type
of smoking or vaping, stopping that stuff can
make a big difference. Get enough sleep. Sometimes seven to nine
hours is what's required. Studies really show getting enough sleep can make your nerves
function a little bit better, there's better chemical
balance in your nerve endings, and there's less nerve pain. Creams and oils. So this really means a lot. Simply having an oil or
moisturizing your skin can make a big difference. I really like thick creams for the foot, lavender oil, different oils.

There's actually studies showing this stuff can lessen nerve pain. Like aloe vera, that kind of stuff. This can help. Try different oils and see if that helps. Especially moisturizing cream. So like Aquaphor or Gold Bond, basic stuff like this really helps. Topical lidocaine. If you're in a ton of pain, sometimes putting some numbing
cream can help obviously. But this is a more expensive and more medically driven answer. Anti-inflammatories: do these help? They do help, but it's
not a long-term solution. That's really a challenge
as these can be dangerous and really hurt your
kidneys and liver long-term. Lyrica and gabapentin. These are nerve depressing medications. This is something you should
talk about with your doctor, but this is kind of the
end-stage treatment.

If you really do have nerve pain and none of these things are helping, sometimes being on these
medications can help. And for a lot of our older patients that are simply too far gone
to fix their health conditions, this is the answer. But don't make this your
first-line treatment. Talk with your doctor
regarding this treatment. On the note of orthotics,
check this out right here. I have a slipper right here
with an orthotic in it. So this has a built-in arch. And what happens is, when
you put these in here, it keeps the arch from flattening out. Whereas without the arch
look at how it flattens out. So same kind of thing. Check this out. A sandal with an arch
support built into it. So you can see how much
of an arch is built there. So same kind of thing. If you don't have anything, even wearing a pair of Crocs
right here will help you. The more support you have
during the day, even in home, the less your nerves get
stretched out during the day. My number one tip is wear good
supportive slippers at home.

Good supportive sandals if
you're outside in warm areas. Good supportive shoes with an orthotic. So as an example, check out the shoe. I can't bend it in the middle,
it's stiff in the back. I have soft mesh in the front so your toes aren't getting squished, and an orthotic. So the orthotic right
here prevents your foot from flattening out. So you can see right here,
it stops the flattening out, and your foot can instantly
start doing better. This stops those nerves from
getting stretched out all day, and you do better when
you're in bed at night, I'm telling you, this stuff
works for almost everybody. Even people with extensive nerve damage. Stretching and exercise. Always getting in better
shape will get you better. This is because your
muscles work less hard, there's less stiffness and less swelling.

Always get checked out by your podiatrist. So nerve damage is very confusing, but you can get tests to see
if you have a nerve blockage. You can get your skin biopsied to see if your nerve endings are dying. You could see a neurologist, but after seeing your podiatrist
if it's your foot problem, and they can really help you with prescription
medications or diagnosis. I would say about 90% of the time when people think they have
nerve damage or a nerve issue, it's not a nerve issue.

I'm gonna be very clear with that. It's usually not a nerve issue, unless you're significantly diagnosed. And even sometimes people
diagnosed with the nerve issue, maybe there's a deeper cause
that can be investigated. So x-rays, MRIs, biopsies, nerve conduction velocity testing. Your podiatrist can work
on all that with you and get the right diagnosis. Be sure, because it's
too easy to just say, "Hey, I'm aching, I have nerve damage." I find, and this is my unscientific claim, like 90% of the time it's not
when patients tell me it is. There's usually a more clear cause that's easily correctable. The key is warm up when you wake up. Do some ankle circles. So move your feet,
stretch out those nerves. As you stretch out those tissues, you get that fluid out of there. So when you wake up in
the middle of the night, moving your feet around, walking, doing a little bit of stretching, this is my morning routine
and nighttime routine that I would do if I had
some neuropathy pain. Just stretch out your calf,
stretch out those muscles.

As you mobilize that
fluid inside your muscles, it gets flowing. It circles out of those compartments, and there's less stretching, like for example, on your plantar fascia. As you massage it, there's less soreness, less fluid, less swelling. Massage that out when you get up. Get that fluid out of there. I love using towels because it
gives you that extra stretch without leaning into your toes. It makes it a little bit softer.

Because especially people have soreness throughout their toes. And there's nerves, just like
carpal tunnel in your wrist, there's nerves that come down your ankle. This is called tarsal tunnel. What you also wanna do is
sciatic nerve through your hip, through your thigh,
through your groin area. You wanna stretch that out. Get your glutes, get your
hamstrings stretched out. I love the stretch board because this is how you can
make measurable progress.

Start on the basic setting,
which is like 15 degrees. Move up to 20 degrees right there. And then after like a couple of weeks, you can work your way up
to now 25, 30 degrees, and then like 35 degrees right there. And then eventually it goes up to like 45 degrees right here. And work your way up. Get that flexibility going. Get gradually more and more flexible. And gradually your muscles
will get less sore, less achy, and you'll develop less of
that soreness and swelling throughout your muscles. So there's these little half-moon devices. Realistically, if you do it barefoot, you're gonna be in some pain and it's gonna make your nerve pain worse.

As I mentioned, get good shoes. Get good inserts that
makes your foot cushioned and it stretches out your
hamstring, your calf muscle. When you get up in the middle
of the night with nerve pain, you can stretch that out and
get that blood flow mobilized. This thing's like 10 to 15 bucks. Realistically, I don't recommend it because you can do that
entire big ankle slant board. That thing's a little
bit better personally.

So see this thing? The ankle slant board, that
works pretty good right there. And then work your way
up to the higher levels. It gives you an even better stretch. I do that while I brush my teeth getting ready for bed at night. And that's it. Just get yourself a
routine where you focus on gettin' your muscles strengthened, gettin' your calf
muscles, your hamstrings. Usin' these different devices can help. Or you don't even need to pay. Guys, thank you so much
for watching our video on peroneal tendonitis.

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