With me, PN is just one of several comorbid issues, and most exercise exacerbates all kinds of pain. I started Tai Chi late last year; it's very low impact and easily tailored for what ails ya.... One of my resolutions is to do it more seriously/regularly this year; we went through a dozen videos and when we finally found the perfect one for us, we couldn't get a copy that would play on our machine!

Doc

--as I haven't seen any well-designed studies, even correlational ones, addressing it, my sense over the years from many conversations, e-mails, support group meetings, conventions, etc., is that exercise to tolerance tends to improve people who have neuropathy that consists of only or primarily sensory symptoms. These people often have primarily small-fiber syndromes (the small, unmyelinated fibers have only sensory or in some cases autonomic functions) and often ischemic factors, or circulatory factors, are part of the syndrome (as it often is, for example, with diabetics); anything that improves circulation, as exercise certainly does, tends to help move nutrients/oxygen into the nerves and waste products out, and may help symptoms and even healing. I suspect massage and physical therapy may help many such people for similar reasons.

People with motor predominant symptoms, though, tend to to show much less response to exercise--for one thing, when motor potentials are affected, it's much harder to DO voluntary exercise--one may not have the proper pathways to command voluntary muscular action to the complete extent that "normal" people do--and the increased demand on the nerves and muscles is often very fatiguing. For these people, exercise may set up abnormal signalling that results in cramps, spasms, etc.

I understand that many in the MS community report a similar thing--exercise seems to be more symptom relieving/stilling when one has merely sensory symptoms.

This is not to say that exercise might not be having other systemic benefits in even those with compromised motor pathways, but it seems much harder to tolerate exercise in that situation.

You might have noticed that I posted the first reply to this exercise question.Thank you for your interesting and informative reply. I would really like to understand in what way exercise helps PN (in my case small fiber neuropathy in both feet from cancer) so could you please clarify a couple of issues:

1) You say, "exercise to tolerance tends to improve ...". I wholehartedely agree. I assume you mean exercise to tolerance with e.g swimming for people who can't walk etc. I gather you don't mean exercise on your feet to tolerance e.g. running - if your feet get so sore and painful that you're in agony for days after your jog (?)

2) A. You say, "anything that improves circulation, as exercise certainly does, tends to help move nutrients/oxygen into the nerves". I would be very interested to learn how and why this happens. Would you be able to give me a link or reference to a study/paper which explains this? B. Would a TENS machine also improve circulation and move nutrients or is it only fysical exercise that does the trick?

Thank you.

Regards,
Grete Cooper

I believe one of the biological mechanisms of exercise induced circulation benefits is release of nitric oxide at the vascular level. The body signals this when it needs better blood flow.

Chemo damage is mostly at the cellular level...the mitochondria of cells which make energy. If the mitochondria of the blood vessels are damaged, they may not respond to exercise the same way non-chemo patients may.

But the general benefits of moderate regular exercise are well known to improve health, and control blood sugar, and improve circulation.

--about improvements in nerve function from exercise, or from certain supplements, do focus on the nitric oxide connection Mrs. D mentions, in that nitric oxide has a vasodilating effect.

One of the best places to read about this are in the papers of Dr. Aaron Vinik, who is one of the world's leading researchers into diabetic neuropathy, especially small-fiber versions, and who has described the nitric oxide pathways numerous times. I still have one linked in the Useful Website "Stickies" at the top of the board, I believe, and here's a very technical one that talks about it from the viewpoint of skin perfusion:


http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3047977/


Here's another that gets into why increased ischemic flow is important for healing/nutrifying, and why exercise is important for that (and why diabetics have problems with blood flow):

http://care.diabetesjournals.org/content/26/6/1883.full


And here's a HUGE overview associated with Endotext, a series of on-line endocrinology texts:

http://diabetesmanager.pbworks.com/w...20Neuropathies

[QUOTE=glenntaj;842055]--about improvements in nerve function from exercise, or from certain supplements, do focus on the nitric oxide connection Mrs. D mentions, in that nitric oxide has a vasodilating effect.

One of the best places to read about this are in the papers of Dr. Aaron Vinik, who is one of the world's leading researchers into diabetic neuropathy, especially small-fiber versions, and who has described the nitric oxide pathways numerous times. I still have one linked in the Useful Website "Stickies" at the top of the board, I believe, and here's a very technical one that talks about it from the viewpoint of skin perfusion:

Here's another that gets into why increased ischemic flow is important for healing/nutrifying, and why exercise is important for that (and why diabetics have problems with blood flow):

And here's a HUGE overview associated with Endotext, a series of on-line endocrinology texts:


Thank you,

I failed to mention in my posting that my small fiber neuropathy is a result of Waldenstrom lymphoma - a rare leukemia and lymphocyte cancer affecting the immune system. To clarify: my PN is not a result of chemotherapy although I know this to be quite common. Mrs D mentions that "Chemo damage is mostly at the cellular level..." and I know this to be true. Anyway, I am not in that category. My fault not to be more precise.

The links give a good overview of the role of Nitric Oxide (NO) during exercise and its effect as a vasodilator to improve circulation. If I am not mistaken none of this really answers my PN question – it is all about exactly how exercise affects circulation. That is interesting in itself of course!

Did you know you can get NO supplements – some weight trainers and other athletes use them to improve circulation!!

My hope is that I never get so desperate that I go down that route!

Again thank you,

Grete

I believe the drugs used for your type of cancer, kill off cells just like other chemos. The drugs have to destroy the abberent cells that are making the antibodies.

I am sorry if I misunderstood. In your first post, you mention treatment for this macroglobulinemia.


http://annonc.oxfordjournals.org/content/15/4/550.full

Yes, the supplements for increasing NO are arginine and citrulline.

I tried these myself, and found the arginine set off my shingles pain. So I had to stop them.
This year the cold feet issue has not happened for me. I am thinking the new R-lipoic acid is the reason. I was using the old R-lipoic by SourceNaturals that wasn't labeled as stablized, so hence it was not being absorbed like the Doctor's Best brand.
That is my only change this season, from last winter.

Grete,
I'm very new to this all so i'm just trying to figure it all out as I go, I'm not very informed about the TENS machine as of yet, I know lots use them but I"m not sure how well they help . I do have to say I've seem improvement in the burning in my feet/ legs since I started the water areobics. I'm not doing too much on the hard surface of exercising and I"m going to add that back such as the stationary bike, weights jsut to see. I've got snf also and not been diagnosed long but I'm trying to get on top of it early . I've been reading about lots of supplements others take to avoid the high powered pain meds . I"m a work in progress and right now my burning has really gone away it seems from what it use to be so i'm right confused on whether i got the right diagnosis to start with .