As a result of conducting research and reviewing published studies from around the world, new models concerning the causes of neuropathy have been discovered. What is needed is a fuller understanding of the etiology of the condition so that new technology can be brought to bear with both ameliorative and therapeutic benefits. This article offers a description of an ideal type of electronic stimulator that would likely offer significant benefits to the treatment of neuropathy.
As a result of conducting research and reviewing published studies from around the world, new models concerning the causes of neuropathy have been discovered. What is needed is a fuller understanding of the etiology of the condition so that new technology can be brought to bear with both ameliorative and therapeutic benefits. This article offers a description of an ideal type of electronic stimulator that would likely offer significant benefits to the treatment of neuropathy. Neuropathy results when nerve signal propagation is reduced between adjacent nerve cells due to insufficient oxygen being available to support nerve cell metabolism. This is responsible for 90% of all neuropathy cases.
The remaining 10% is caused by physical trauma. Thus, it appears that the main precipitating factor for neuropathy is hypoxia and demineralization of the synaptic fluid, which creates shrinkage of the nerve cells, widening the gap between these cells, making it more difficult for normal sensations to propagate, and causing loss of electrical conductivity in the synaptic fluid itself. A temporary hypoxia of nerve tissue can be traced to most causes of neuropathy. The primary negative effects of this hypoxia are as follows:
- a defensive contraction of the nerve cell resulting in oversized synaptic junctions;
- a loss of electrical conductivity of the synaptic fluid between nerve cells; and
- a defensive change in the electrical potentials of the cell membrane, resulting in a higher resting state of the trigger level, which effectively limits the sensitivity to incoming signals.
For example, when the lumbar area experiences a muscle spasm, blood flow is restricted through that muscle, resulting in reduced oxygen availability to the surrounding tissue, including nerve cells. Because muscles can use either oxygen or glucose metabolic pathways, they can recover quickly from a temporary reduction in the level of available oxygen. Nerve cells, on the other hand, are limited to the Krebs oxidative reductive metabolic system and must take immediate defensive steps to assure survival during this hypo-oxygen state. One of the ways of accomplishing this is to contract along their longitudinal axis like a rubber band, reducing their surface area and thus lowering their need for oxygen. (This also occurs when these cells are attacked by a harsh agent in the blood, such as chemotherapeutic drugs, agent orange, environmental toxins, insecticides, etc.) The synaptic junctions between the axons of one nerve cell and the dendrites of the next nerve cell widen. Normal nerve transmission is now compromised because a nerve signal of normal intensity cannot jump this newly widened gap. The synaptic fluid between the nerve cells must be electrically conductive. Pure water does not conduct electricity, so this conductivity relies on minerals and specific neurotransmitters, such as serotonin in the synaptic fluid, to enable the propagation of the nerve signal. These minerals are delivered via the perfusion of adjacent tissues with fresh blood and kept in suspension by the periodic ionization of successfully transmitted nerve signals across the junction. When nerve signals are reduced because of these larger dimensions of the synaptic junction, necessary minerals are no longer held in place by electrical tension and are slowly leeched out (see Figure 2).This adds to the impairment of effective nerve transmission. When nerve signals can no longer jump the enlarged synaptic gap, the electrical tension that normally holds these minerals in place is absent, causing the synaptic fluid to leach out its mineral content. Electrical conductivity is reduced, thereby inhibiting the transmission of the electrical signals of the normal nerves across this gap.
As a result of hypoxic cellular atrophy, nerve signals must now try to jump a larger gap through a less conductive medium. This loss of nerve transmission is first perceived as tingling, then burning, and finally as pain when the demineralization and gap-widening process progresses. The initial perception associated with atrophied nerves and enlarged synaptic gaps is tingling as some of the normal signals are misdirected to nearby nerves. As the condition progresses, it happens more and more until more signals are misdirected then properly propagated, and the resulting sensation is one of pain. Finally, after the nerve signals can no longer be transmitted at all, numbness is the primary complaint. This secondary effect of neuropathy reduces the strength of the calf muscles, which, in turn, reduces the blood flow to the lower extremities. This condition often results in poor tissue perfusion, insecure gait, balance problems, and other mobility issues.
Electro – stimulation Works on Three Separate but Simultaneous Levels
Electro – stimulation of Nerves
The electrical signal should be a compilation of two signals transmitted simultaneously. One signal is specifically designed to stimulate the nerves themselves and has a very narrow waveform with a small amount of current under the curve and a relatively high transient voltage (characteristically 40–90V alternating current (AC)).The resulting current is miniscule and much below what is commonly found with traditional transcutaneous electrical nerve stimulation (TENS) devices. A larger than normal signal must be used because of the widening gap between the nerve cells (see Figure 1) and the loss of much of the conductivity in the synaptic junction fluid due to demineralization (see Figure 2). The rebuilder’s nerve stimulation signal is many times stronger than the normal afferent and efferent signals; therefore, it can effectively complete the circuit. This stimulates the nerves causing them to re-establish their normal metabolic function. This signal, crossing the synaptic junctions, also re-polarizes the junctions causing them to be receptive to reabsorb minerals, thus improving the conductivity.
Electro – stimulation of Muscles
A second signal that overlays the nerve stimulation signal is designed to stimulate the muscles. This signal has a different, wider waveform with a larger sub-threshold amount of current under the curve and a much smaller voltage (5–20V AC). Muscles are most responsive to this waveform. This signal causes the muscles of the feet, calves, thighs, and buttocks to contract and relax in harmony with the signal. Overcoming any residual inflammatory resistance to blood flow, the signal should also have specific characteristics that cause a complete relaxation of the muscles’ fast and slow twitch cells between each contraction stimulus. In order for the venous pressure to move the blood through the muscles bringing oxygen and nutrients and taking away accumulated lactic acid, the muscle fibers cannot remain in spasm.Adequate blood flow can only occur in a flaccid muscle. This is an important consideration. It is not the contraction but primarily the time interval between the contractions that contribute to the increased perfusion of blood through the oxygen-starved tissue. If the frequency of the muscle stimulation signal is too fast, it does not give the muscle the appropriate time necessary to fully relax. If the signal’s frequency is too slow, the muscle cannot entrain and recruit enough fibers for a sustained contraction. By stimulating the muscles to contract in this manner in response to the signal, the venous muscle pump is used to propel blood, against gravity, back up towards the heart. Blood flow is increased with mineralenriched blood, which results in a flushing of metabolic by-products.This not only offers relief of pain from the build-up of excessive lactic acid, but it triggers the creation of new muscle mass. The synaptic junctions, bathed with this mineral rich blood, are now able to permanently conduct the nerves’ signals more effectively and efficiently.
Combined Electro – stimulation
A combined electro-stimulation at 7.83Hz (one to stimulate the nerve cells and the other to trigger muscle cells) is pulsed on and off at the frequency of 7.83 cycles per second. It has been found that the human body is particularly sensitive to this frequency. One postulation for this sensitivity is that the electrical potential between the earth’s atmosphere and the earth’s surface is also approximately 7.83Hz. Using this signal frequency, it has been found that the body not only responds favorably but the brain is induced to release large amounts of endorphins. Endorphins—internal analgesics as powerful as and chemically related to morphine but without any negative side effects—are created and modulated by the body’s own chemistry.The effect of this endorphin release is a generalized sense of wellbeing, a reduction in pain and anxiety levels elsewhere in the body, and even a reduction in emotional pain.This ensures a very high level of patient compliance, not only because the patient feels good physically during the massage-like treatment period, but because they feel better emotionally afterward, experiencing a reduction in global non-neuropathic (nociceptive) pain for a period of four to six hours.
An additional feature of an ideal stimulator would be its simultaneous weighted direct current (DC) signal. This intentional imbalance to the asymmetric waveform that results in a tiny DC current is designed to stabilize the trigger threshold that regulates the sensitivity of the nerve cell. Like a heart in fibrillation, this normally stable trigger level begins an unregulated oscillation that can result in erratic transmission of incoming nerve signals. Sometimes, small signals are accepted for an attempt at propagation, and sometimes only large signals are accepted. This upsets the homeostasis of the part of the brain assigned to managing these signals and selecting the appropriate response. By sending this constant DC signal, the effect is to hold this resting potential at a fixed voltage long enough for the cell to stabilize itself and regain control.
- stimulating leg muscles to contract and relax thereby increasing blood velocity and volume with fresh blood to the nerves and muscles;
- stimulating all the afferent and efferent nerves in the lower extremities with a signal larger than normal to re-establish the pathways for subsequent normal signals to follow;
- drawing axon and dendrite nerve endings closer together to facilitate proper nerve transmission;
- building residual pain relief each time the system is used;
- causing the brain to release endorphins that reduce global pain and anxiety;
- promoting the healing of non-plantar surface diabetic skin ulcers and sprains;
- increasing muscle strength for safe, pain-free walking;
- promoting better mobility and balance as proprioception returns to the legs and feet;
- reducing edema as muscle contractions encourage lymphatic drainage and movement to the proper nodes; and
- increasing collateral circulation, stimulating vasogenesis.
Safety Considerations
As intermittent electrical signals are received into the nervous system, the resistance, capacity, and impedance changes dramatically on a dynamic basis. This change must be monitored and the voltage, current, and other electrical parameters must be adjusted in realtime. Unless an electrical device incorporates the safety features, the patient can be injured or the instrument will be damaged.Therefore, the clinician should not be tempted to try to stimulate the nerves and muscles simultaneously with a normal TENS or electrical 3 muscle stimulation (EMS) device. â–
