It’s Monday Morning—What’s Your Game Plan In Practice?

What likely separates any private practice owner from ultra success is a fully developed game plan!

Traditionally, a lot of Monday morning quarterbacking and speculation goes on surrounding fall sporting events. Why did some coach do this, what if this player did that, and so on.

doctor holding glassesMonday also is the day that pro athletes watch their video performances from the weekend. Literally, they fail their way to success. Yes, that’s right—they are not afraid to make mistakes and continuously learn by them. The more valuable and achieved the player, the more mistakes they make.

Often, you don’t see them, because only their wins are highlighted. The fact of the matter is that winners in any game or business are IN the game more. When you play more, not only do your failures increase, but your wins increase to a greater extent!

This is a numbers game, which great businesses and sports fully realize. The numbers get better with better quality game plans.

Watch the greats in any sport profession, and the rules are basically the same. If you think about championship teams, they’re always working on their game plans.

Any great game plan includes contingencies, training and coaching systems, marketing, fan-based activities, and rules for expansion!

Your private practice really is no different.

But what likely separates any private practice owner from ultra success is a fully developed game plan worked out with coaches who have experience in the game—the ability to work, and move gracefully on the sidelines.

This is one of the most important, often ignored, key tickets of success. And make no mistake it is a ticket, with a price.

In fact, my coaches have a lot more experience and make a lot more money than I do. For the time being, anyways. This is deliberate. It’s part of Living and Practicing by Design™.

You see, I don’t take advice from people who are less successful than I—I go straight to the top.

Napoleon Hill called this gaining “specialized knowledge”.

And it has always served me extraordinarily well as my private practice game plans become more and more elaborate.

How about YOU? Got “Specialized Knowledge”?

Join the conversation on Facebook!

Where are YOUR Patients Getting Their Health Information?

Understand that in private practice one of your biggest jobs is to be a resource.

Like it or not, the vast majority of patients who visit you in private practice expect you to be an authority. They expect you to be an expert on a vast array of topics regarding their health.

In this day and age, this is one of the reasons that patients are willing to pay out-of-pocket for Hands Typing on a Keyboardhealthcare advice and treatment.

This of course, is one of the reasons that some find private practice so difficult and challenging. It is not for the faint of heart because, in private practice, there is no “authority” or board of directors to hide behind. Indeed, for those in health care, like in other segments of society, the barrage of regulatory BS grows every day.

It makes no difference what your chosen profession is. You see, as the third-party system undergoes a literal implosion, society is sicker than ever, and demanding answers. (If you doubt me on this, look at the significant challenges to Obamacare raised by many states.)

But for those in private practice who position themselves properly, this is a grand opportunity. In reality, this is a very pioneering time to be in private practice!

No longer can any private practice owner ignore these facts. So what is the astute practice owner to do?

Well, for starters, understand that in private practice one of your biggest jobs is to be a resource.

More than that, you need to be the patient’s chief healthcare options educator.

The good news, it is not necessary to do this all by yourself.

There are significant resources that are available—including ours—which help you communicate to your patients on a regular basis about a wide variety of health care issues.

This is exactly why our web and social media presence has grown so much. In all our client offices, their patients subscribe to our published health-related materials every day.

This is having a tremendous impact as we now take many calls, emails, and notes every week from these patients.

This is, in fact, one of the biggest reasons that private practice owners employ our services.

Because trying to do this all by yourself can be a nightmare! We are here to help serve you when you are ready.

Join the conversation with clients and patients alike on Beating Neuropathy!

The most important thing you, as a clinician, can do is ask questions…

Some of your patients may complain of pain and tingling when it comes to neuropathy, but it often takes far too long for a patient to admit they are having trouble doing simple tasks like walking.  It’s frustrating to find oneself not able to do things that used to be simple, and a lot of the time, patients resist being open about it until the ir lack of dexterity becomes obvious.

One of the most common symptoms of neuropathy, called motor neuropathy, causes signals not to be delivered properly to the muscles in the arms and legs, resulting in a clumsy gait, as well as a frustrating lack of overall dexterity.  Since your patient’s muscles aren’t being used the way they’re supposed to, they can fall out of use over time, causing the loss of strength many neuropathy sufferers complain about.  Even patients with a significant level of neuropathic pain complain most that the most difficult part about living with neuropathy is the frustration at not being able to do something as simple as walking!

The most important thing you, as a clinician, can do is ask questions. Since many patients are less than forthcoming when it comes to trouble walking or standing, you may have to be proactive.  Once muscle weakness is established as a symptom, we have to remember that there are really two causes to difficulty walking related to neuropathy:  nerves aren’t conducting properly, and muscles are weakening.  There are many approaches to the first problem, ranging from the pharmaceutical remedies you’re probably familiar with ( medicine tends to resort directly to drugs first).

End The Misery of Chronic Pain as a True Specialist

At NeuropathyDR®, we advocate limiting pharmaceutical solutions to very specific cases, as more modern methods tend to produce better, longer-lasting results.  Electric stimulation in several forms, for example, are methods that are still being studied (we conduct studies ourselves), which have been shown to achieve very good results in a large majority of patients.

The second cause, muscle weakness, can be addressed with a regimen of careful eating and exercise.  It’s true that traditional exercise can be difficult for a patient when it’s difficult for them to even walk or stand, but remember: the more muscles move, the less they will break down. Also, the better overall blood circulation, the slower deterioration of nerves will happen!  Develop an exercise routine with your patient that emphasizes low-impact exercise such as swimming, rowing, or cycling.  High-impact exercises are hard on nerves, and are generally more difficult for neuropathy patients.

If you have questions about developing a neuropathy-friendly practice, contact NeuropathyDR®!  We are more than happy to answer your questions.

Our patient, Richard, had been living with his muscle weakness for more than seven years when he came to NeuropathyDR®.  Richard presented with numbness and tingling in his feet, burning in his limbs, and overall weakness in his arms and legs.  Between the pain, stiffness, and weakness, Richard was having a frustrating amount of trouble walking and doing manual tasks.  We decided our priority was to get Richard back to using his limbs the right way, and we developed a five-week regimen for him that combined regular examinations, electro-stimulation, and a customized, low-impact exercise routine that targeted the under-used muscle areas.

Richard’s improvement was dramatic.  After every checkup and every electro-stimulation session, he reported that his symptoms had subsided.  His pain and tingling were less, especially immediately after treatment, and his overall response to the exercise program meant that he was able to complete manual tasks and exhibit a motion range dramatically better than when he started.

Richard was extremely pleased with his NeuropathyDR® experience.  In his post-treatment follow-up, he let us know that he was enjoying a range of motion greater than he had had in seven years!  Six weeks after the treatments were complete, Richard reported that he had continued to implement the method NeuropathyDR® developed for him, and his symptoms were continuing to improve.   Another NeuropathyDR® success!

Contact us if you have patients who have trouble walking, standing, or doing other everyday manual tasks.  Motor neuropathy is one of the biggest problems nerve damage can cause to a patient’s quality of life.  We are here as a resource to help you provide the best care possible.

To Learn More, Go To



The Evolving Specialty Practice of Neuropathy Treatment

It’s hard to believe its already five years since NeuropathyDR® developed some of the most powerful protocols to help end the misery of chronic pain due to peripheral neuropathy and related disorders. Just as we predicted in 2009, those professionals claiming to be able to treat neuropathy have sprung up like weeds.

Some have done a fine job. Others have gotten themselves in hot water. Some have blatantly stolen our work.

And more still have discovered there is a true art and clinical science to really helping these suffering patients regain their quality of life, if not their once vibrant health and the value of being affiliated with only like-minded health care professionals.

Now Dr Michael Beck and myself predicted all of this. Mike remains the premier patient communicator for the chiropractic profession and was instrumental in launching NeuropathyDR®. Now, other medical writers from all disciplines have joined forces to tell the NeuropathyDR Story to the world.

So, here is a recap of where NeuropathyDR Professionals are today!

The book “Beating Neuropathy-Taking Misery to Miracles in Just 5 Weeks!” remains a bestseller and maintains a 4 Star Rating on Amazon! Every day, thousands more around the world learns there are very viable choices to drug-only neuropathy treatment. It’s sequel with patient stories and helpful condition specific care is due out shortly!

The Website NeuropathyDR and its 20+ co-branded sites bring hundreds of new visitors every day, consistently ranking high with local and international search engines.

The First Beat Neuropathy and Chronic Pain App is now in iTunes and the Apple store! This powerful tool connects the world with up to the minute neuropathy information and resources. Download it now HERE

Get Your iPhone/iPad App HERE Now!


The Weekly radio shows Beating Neuropathy and Chronic Pain is broadcast on FM Radio every Sunday night and live streamed around the world!

Our social media presence continues to grow and expand with patients around the world sharing their NeuropathyDR® stories with friends and family.

Within days, iTunes and Beating Neuropathy and Chronic Pain podcasts begin with related articles and patient resources at a brand new website…

And then there is YouTube/Neuropathy Doctor, numerous professional articles published, our work with the American College of Physical Medicine, NeuropathyDoc Twitter feeds…

In short, we built our company to be the best, and it’s an honor to work with professionals just like you every day.

If you’d like to  learn more about these and upcoming opportunities including becoming one of our licensed treatment centers special practice owner financing and BONUSES, go to NeuropathyDR Professionals or call Jes TODAY at 781-754-0599.

Cancer Patients and The Neuropathy and Chronic Pain Specialty Practice

Cancer is one of the most persistent scourges we face as medical professionals.  Not only are the various types of cancer extremely dangerous, but the methods to combat them, including chemotherapy, can be aggressive to the point of heavily impacting a patient’s quality of life.  In short, the side effects are dramatic.  Hundreds of thousands of cancer patients in North America alone receive chemotherapy every year, and many of them experience damage to the peripheral nervous system—chemotherapy-induced peripheral neuropathy, or CIPN.

Like most neuropathy, chemotherapy-caused neuropathy presents in most patients in the form of pain, numbness, tingling, and loss of temperature sensation, most commonly in their extremities.  Other symptoms, while less ubiquitous, are still common: loss of bladder control, constipation, loss of body awareness, and difficulty walking or standing.  Sometimes the condition is chronic, and a patient will have to adjust their lifestyle to living with chronic pain.   In many cases, however, we can manage the pain and discomfort from chemotherapy-caused neuropathy, and help a cancer survivor lead a normal, active life.

The best line of defense we have where patients are concerned is communication.  It’s imperative that patients report any unusual sensations, pain, or numbness to you and their oncologist.  Like any neuropathy, the sooner we identify a problem, the more options we will have when it comes to treatment.  In some cases of complications, it can be prudent to delay or suspend chemotherapy treatments in order to give a patient’s nerves an opportunity to recover.

It is also vital to train patients to protect their peripheral nervous system, which is already under strain from the chemotherapy.  Patients should wear gloves when performing manual labor.  Encourage them to wear well-fitting shoes and clothing, as loose clothing can rub and cause abrasions (which aggravate neuropathy symptoms).  You can help your patients develop a diet and exercise regimen that will contribute to their overall nerve stimulation and health (Contact NeuropathyDR® if you have any questions about proper nutrition and exercise for neuropathy patients, we are happy to answer them).  Of course, managing the underlying condition is the most important factor in treating any kind of neuropathy, so be aware of the specific course of treatment your patient is undergoing for their cancer.

Our patient, Joanne, knows firsthand how hard chemotherapy can be on the nervous system.  Joanne is a cancer survivor who, when she came to us, had been recovering from the effects of her chemotherapy for five years.  Along with most of the common symptoms of peripheral neuropathy, Joanne complained of severe pain in her lumbar back, extreme stiffness in her neck and shoulders, and weakness in her legs.  Joanne’s pain, especially in her feet, was intense to the point of affecting her daily lifestyle.  She was taking medication for pain, but the medicine was marginally effective at best.

One of your biggest challenges will be managing your patient's expectations from treatment.

Our treatment plan for Joanne involved a combination of manual therapy to her spine, as well as topical and oral nutrition, and different forms neurostimulation to her feet and hands in a variety of applications. We treated Joanne three times a week for five weeks; in only four weeks, Joanne was commenting that her symptoms had subsided dramatically. Immediately following each treatment, Joanne noticed a reduction in her pain level.  By her final treatment, the pain and numbness in her feet had subsided 65-70%!

In a thank-you note Joanne wrote us not long after the resolution of her NeuropathyDR® treatment plan, Joanne told us she had been able to stop taking her pain medications and was feeling fine, almost entirely pain-free.  Her strength had begun to return, and her mobility improved as well.

Joanne is a success story we are proud to have to our credit.   To be entirely honest, not all patients show the level of improvement we saw in Joanne in such a short time.  Even so, it goes to show that not only is there hope for cancer survivors who live with neuropathy pain, but in some cases the recovery we promote for patients can be swift and dramatic.  If you work with patients who are receiving or have received chemotherapy, odds are good you encounter neuropathy.  Be equipped to provide them with the best care!  NeuropathyDR® is your resource for healthcare professionals interested in helping neuropathy and chronic pain patients to lead more normal, pain-free lives.  We can provide you with the best support training and materials. Every day we refer patients to our team of trained professionals.

Let us know if you’d like to apply join this extraordinary group of clinicians at



Maximum Patient Benefit and Recovery- Patient Co-Treatment Plans

One of the biggest clinical lessons that has come from our work with peripheral neuropathy patients is just how powerful “Patient Co-Treatment Plans” can be.

Traditionally, we might think of patient components of recovery from illness as a relatively passive home care program such as “just take these twice a day” or “do these exercises”.

Clinical Co-Treatment Plans (CCTxs) involve much more specific, multifaceted approaches to patient care, that not so surprisingly yield often greater results in several areas than just professional advice or professional treatment programs alone.

Some of the keys to CCTxs success lie squarely in getting the patient to accept responsibility for all the components needed to foster maximum results. Commonly observed side benefits may include enhanced family support, approval and greater involvement of other health care providers and especially reduced use of pain and psychotropic drugs.

The More Patients Do To Help Recover, The Smoother Your Clinic Runs

CCTxs typically consist of dietary advice, timed exercise and stretches, massage, oral and topical medications and supplements and in the neuropathy patient, use of the Clinical Co Treatment Kit.

With just a little foresight, the same principles can and should be applied to a vast array of health conditions.

We have found it extraordinarily beneficial to specifically package CCTxs with custom iPhone®/ipad® Apps, DVDs and books, newsletters and exercise books or sheets.

Be sure that any supplementation or medication is always supplied with detailed written instructions. We attach specific, written and sometimes color coded instructions to each bottle or applicator.

But the real key to success is indoctrinating your staff and patient families from the outset that your approach to treatment mandates CCTxs.

You see, when you mandate patient co-operation as part of case acceptance, patient compliance is usually greater. There are also far fewer questions about fees, length and extent of care. The value added benefits of dealing with your office as opposed to a competitors becomes readily apparent. Most of all, your role as teacher with these patients can reduce office stress levels and interrupting phone calls dramatically!

But another less thought of benefit from running your professional health care practice in this way becomes positioning and marketing.

When the community understands the depth of your concern is far greater than making payroll, referrals seem to magically follow. It becomes Disney-sequel- patients can’t resist telling others. New Patient flow tends to come like a freight train with patients and their families who are clamoring for this type of care.

Of course, this is especially true as we move towards a public system of healthcare in which these “touches” have all but vanished forever.

So, how do you actually implement CCTxs in practice?

Obviously, take a look at what’s out there and don’t reinvent he wheel. If you are a neuropathy clinician, we’ve already done all the work for you!

By the same token, if you have an idea, first sketch it out. Be sure to include all the components needed to foster not only patient recovery, but also compliance.

Keep in mind, today, you must build in all the appropriate self-care tools, including books, DVDs, and now especially those that will “push” information in a consistent, replicable manner.  Timed information and self-help content that will also allow for patient (or a family caregiver) self determined interaction. learn way more at


Alternative Therapies for Your Chemotherapy Induced Neuropathy Patients

Alternative Therapies for Your Chemotherapy Induced Neuropathy Patients

One of the more challenging patient populations you can treat is the chemotherapy induced peripheral neuropathy patient.  They’ve already been through the cancer diagnosis and are either in the midst of chemotherapy or they’ve finished their treatment.

Just when they think they’re done with all the side effects of chemotherapy, they’re visited with[1]

–       Shooting pain

–       Burning and numbness

–       Tingling in the hands and feet

–       Inability to sleep because of the pain

Can you imagine the frustration?

Chances are really good that no one told them that chemotherapy induced peripheral neuropathy (CIPN) was a potential side effect of their treatment because, let’s face it, no one can really predict which patients will develop chemotherapy induced peripheral neuropathy.  Why bring it up if you don’t know for certain that it’s going to happen?

For many, their symptoms last well beyond their chemotherapy.

For your CIPN patients, the first option is, of course, drugs to deal with the pain.  But many chemotherapy induced peripheral neuropathy patients are choosing to be more proactive and do everything they can to alleviate their current symptoms and lessen the possibility of permanent nerve damage.  They don’t just want to take a pill to make them feel better. They want to give their bodies the best treatments available.

What Else Can They Do?

More and more CIPN patients are opting for what used to be called “alternative medicine” treatments.  While many think of anything outside of conventional medicine as “alternative”, that’s really not accurate.  Alternative treatments are defined as anything not approved by the Food and Drug Administration.  The treatments we’re talking about here are more complementary or integrative therapies.  In other words, they’re therapies used in addition to and to complement traditional medicine, not taking the place of it.

Because of the growing popularity (and effectiveness) of these complementary and integrative therapies, the medical community has actually named them – Complementary and Alternative Medicine.

Some complementary and alternative therapies providing good results for chemotherapy induced chemotherapy patients are:

–       Cancer treatment specific diets

–       Herbal supplements

–       Non-herbal supplements (like Vitamins B6 and B12, alpha lipoic acid)

–       Acupuncture

–       Massage therapy and Reflexology

–       Exercise

–       Homeopathic and ayurvedic medicine

Any of these therapies, in the hands of skilled practitioner, is a great complement to your chemotherapy and other cancer treatment and can provide substantial relief from chemotherapy induced peripheral neuropathy pain.  Offering these services to your chemotherapy induced peripheral neuropathy patients is an excellent way to treat the whole patient and not just the symptoms.

Involve Their Oncologist

Before you start any Complementary and Alternative Medicine treatments with your chemotherapy induced peripheral neuropathy patients, talk to their oncologists.[2] Make sure that what you’re planning to do will not have an adverse effect on their chemotherapy regimen (some antioxidants do).  Always keep the oncologist in the loop on what you’re doing to complement or following a chemotherapy regimen.

Why These Complementary and Alternative Medicine Treatments Work

Many of the Complementary and Alternative Medicine regimens we mentioned above will help deal with and even alleviate some chemotherapy induced peripheral neuropathy symptoms.

The body is a finely tuned instrument and all the systems work together.  Massage therapy, acupuncture and Reflexology can help with muscle pain and stimulate the systems within the body to fight the cancer.

Certain supplements can help give the body the nutrients and vitamins it needs to repair itself and eliminate the possibility of permanent nerve damage caused by chemotherapy induced peripheral neuropathy.

Treating the Whole Patient By Working With The Whole Team

Everyone On The Patient Team Must Work Together...

None of the medical specialties treating chemotherapy induced peripheral neuropathy patients operates in a vacuum.  You all need to know what the others are doing.

Luckily, most oncologists these days are familiar with the Complementary and Alternative Therapies chemotherapy patients are turning to for relief from the chemotherapy induced peripheral neuropathy symptoms.  Make sure that you involve your patients’ other treaters in your care by communicating with them.  By integrating your Complementary and Alternative Medicine treatments into the overall treatment program, you have a much better chance of giving your patients the optimum results they deserve.

When you are ready, let them know you’re there to help them.

For more tips on growing a successful chiropractic, physical therapy or pain management practice, log on to http://perfectpractice to download a FREE E-Book Copy of my 5 star Amazon  “Living and Practicing by Design” at



Nutrition Planning for Chemotherapy Neuropathy Patients

For better or worse, a rapidly growing patient population is the chemotherapy and post chemotherapy patient.

Patient education and patient compliance are key to success.

While dealing with the emotional issues involved in a cancer diagnosis, they can also be dealing with side effects of chemotherapy like

  • Loss of appetite
  • Nausea and other digestive issues
  • Post chemotherapy peripheral neuropathy
  • Dry mouth

In addition to counseling them on taking their medications properly and physical therapy or massage therapy for muscle, joint and nerve pain, offering nutrition counseling and diet planning is a great way to ensure that your post chemotherapy neuropathy patients are doing everything they possibly can to heal.

Study after study is confirming that proper nutrition is a vital piece in the treatment puzzle for a successful recovery from chemotherapy and other cancer treatments, as well as recovering from the cancer itself.

Just like any other treatment program, patient education and patient compliance are key to success.  Here are some things to think about when designing a chemotherapy or post chemotherapy recovery nutrition program:

Cancer Nutrition Tips[1]

The chemotherapy or post chemotherapy patient’s body needs extra support for the immune system.  Chemotherapy wrecks their immune system and that makes them more likely to catch virtually any bug they come into contact with.  And that makes it even harder for them to heal.

Their best option for immune support is a diet full of whole foods that are easy on their sensitive digestive system.  They need foods that are high in anti-oxidants and protein.  Make sure your diet plan for them includes foods rich in vitamins C, D and E and nutrients like soy isoflavones, amino acids, folic acid, l-glutamine, calcium and carotenoids.

When designing their daily nutrition intake, build in a requirement for drinking plenty of water.  Actually give them a schedule if you have to.  Remaining hydrated is vital for tissue repair.

Rebuilding The Body During and After Chemotherapy

When designing a nutrition plan, take each individual patient’s requirements and tastes into consideration.  Make sure you include foods rich in the following vitamins and minerals but try, wherever possible, to include foods the individual actually likes in their meal plan.

The following list is a really good guide for meal planning:[2]

Vitamin C

  • Red cabbage
  • Kiwi fruit
  • Oranges
  • Red and Green Bell Peppers
  • Potatoes
  • Strawberries and tangerines

Vitamin D

  • Salmon and tuna

Vitamin E

  • Nuts, including almonds and peanuts
  • Avocados
  • Broccoli
  • Mangoes
  • Sunflower seeds


  • Apricots
  • Carrots
  • Greens, especially collard greens and spinach
  • Sweet potatoes
  • Acorn squash

Soy Isoflavones

  • Soybeans
  • Tofu
  • Soy milk – might be easier to digest than regular milk because it’s lactose-free

Folic Acid

  • Asparagus
  • Dried beans
  • Beets
  • Brussels sprouts
  • Garbanzo beans
  • Lentils
  • Turkey

Turning The Food They Need Into The Food They Want

It’s easy to tell your chemotherapy and post-chemotherapy patients what they need to eat.  The tough part, especially if they’re nauseated or just have no appetite, is getting them to eat it.  Make your meal plans more appetizing by liberally using herbs and spices to enhance the flavor of the foods they need. Try recipes that use:

  • Cinnamon
  • Cardamom
  • Basil
  • Coriander
  • Cumin
  • Ginger (natural anti-inflammatory properties)
  • Garlic (natural anti-biotic properties)
  • Mint (great for fighting nausea as well)
  • Fennel
  • Turmeric
  • Parsley

If your’ clinic doesn’t offer diet planning and nutrition counseling to your chemotherapy and post chemotherapy patients, you and your patients are missing out on a vital part of the recovery puzzle.

Use this article as a guide for diet planning.  The combination of your professional expertise and proper nutrition support and counseling is a winning combination for doctor and patient.

When you are ready, let them know you’re there to help them.

For more tips on growing a successful chiropractic, physical therapy or pain management practice, log on to to download a FREE E-Book Copy of my 5 star Amazon rated book “Living and Practicing by Design”.

A Case Study on Patient Compliance and Diabetic Neuropathy

Diabetes is one of the fastest growing diseases in the country.

Nothing builds a powerful specialty practice like incredible results!

With the increase in the number of patients developing diabetes comes an increase in the number of patients developing complications.

One of those complications is diabetic neuropathy.

The good news is that with proper treatment and a compliant patient, diabetic neuropathy can be managed and quality of life vastly improved.

Meet “Evelyn”

Evelyn is a 62 year old woman who presented to our office with progressive and severe diabetic neuropathy.  She suffered from peripheral neuropathy symptoms in her hands and feet, intense cramping in her legs and tingling in both feet.  The range of motion in her back was severely limited from the middle of her back to her hips. She was no longer able to sleep and could not exercise due to the painful neuropathy symptoms in her legs and feet.  Even the easiest exercise, such as walking, was no longer a possibility.  At the time she came to us, she had been suffering with these symptoms for 10 years.  Even after 10 years of medical and podiatric care, she was getting worse instead of better.


After a thorough history & physical and evaluation, we took her into the NeuropathyDR® treatment program.  Her customized treatment program consisted in part of our three pronged approach – manual therapies, in clinic Rebuilder® therapy using both the basin with the feet and the gloves with the hands, daily blood sugar monitoring and charting (four times per day) and metabolic and dietary counseling and treatment. 

With the combined NeuropathyDR® metabolic therapies, Rebuilder® treatment and effective nutritional planning, we were able to drop her blood sugars by 120 points, without changing or increasing her medication.

The drop in her blood sugars led to a decrease in her medication needs. 

In addition to diet planning and counseling, we put her on a combination of nutrients.


As a result of the metabolic and nutritional work we did with Evelyn, her blood sugar was down by 120 points, without any medication changes or additions.  Ultimately, her primary care physician was able to reduce her prescription meds. After 5 weeks of treatment, her numbness and tingling levels on a 0 to 10 scale, with 10 being the highest, went from 10 before treatment down to 5 after treatment. She reported overall improvement of 25 – 30%. The tingling in her feet and hands was significantly reduced.  Her leg cramps were markedly better as was her back pain.

With the improvement in her leg and foot pain, she was able to start significant walking again.

 Every day that she can exercise puts her one more day closer to a normal life.

The success of her treatment is a testament to the patient as well as the treatment protocol. She followed our orders diligently and was extremely compliant with our treatment program.

She purchased from our clinic a special ND/Rebuilder® home care kit, treating herself at home concurrently with the office care, took her prescribed ND supplements, did the prescribed blood sugar monitoring as well as her exercise and metabolic rehab.

While there are no miracle diabetic neuropathy cures, this case illustrates the results that can be achieved with a solid treatment strategy and patient compliance.

 Without a strong partnership between patient and clinician, these results would not have been possible.

As effective specialty practice clinicians, patient success depends upon your ability to convey the message that from the outset of treatment that without your patients full compliance with your treatment regimen, they will not see the results they’re looking for.

And nothing builds a powerful specialty practice like incredible results!

For more tips on growing a successful chiropractic, physical therapy or pain management practice, log on to to download a FREE E-Book Copy of my 5 star Amazon rate book “Living and Practicing by Design”.

Nutritional Supplements for Your Diabetic Neuropathy Patients

Your diabetic neuropathy patients know they need to keep their blood sugar under control…

Your role is to make sure your patients understand exactly what supplements can do for them.

They know they should exercise…

They know they have to watch their diet, especially when it comes to controlling their sugar intake…

When it comes to medication, insulin is probably first and foremost in their minds.

And it should be.  Taking their insulin properly can mean the difference between life and death to a diabetic neuropathy patient.

What they may not realize is that in addition to taking their insulin, watching their diet and a good exercise program, there are nutritional supplements and vitamins that can help control their blood sugar and lessen the effects of diabetic neuropathy.

Granted, these nutritional supplements will not take the place of proper diet, controlling blood sugar and a sound exercise plan, but they can definitely improve the effectiveness of all of these pieces of the diabetic neuropathy puzzle. 

Your role in all this is to make sure they understand what they should take, how much, how often and exactly what those supplements can do for them.

What to Look For in Nutritional Supplements[1]

Diabetic neuropathy patients have different requirements from their nutritional supplements than other patients.  A pill they take once a day is not enough because it’s only going to be really effective for the two hours after they take it.  They need more than that for the symptoms of diabetic neuropathy. 

To get the full effect for treating diabetic neuropathy, they need to maintain a steady therapeutic level of these vitamins and nutrients throughout the day to help keep blood sugar under control.

Your diabetic neuropathy patients should choose supplements they take at last three times a day to keep the levels steady in the blood stream. 

And look for nutritional supplements that come from an FDA approved manufacturer to ensure that what they take is pharmaceutical grade.

Which Vitamin Supplements They Should Take

There is so much information on the market now about nutritional supplements[2] and vitamins.  Your diabetic neuropathy patients need know what they’re buying before they go out and just load up on supplements.  Your job as a NeuropathyDR® clinician is to educate them and make sure they’re taking the right vitamins for their specific diabetic neuropathy symptoms.

Here’s a quick cheat sheet of the Top 12 vitamins and nutrients to provide to your diabetic neuropathy patients to help them identify some of the essential supplements that can help their diabetic neuropathy and exactly what they do:

Thiamin (Vitamin B1) – helps maintain healthy oxygen levels in the blood stream which means that they have less chance of nerve damage due to poor oxygen levels reaching the nerves.  The Recommended Daily Allowance (RDA) of thiamine for the average person is 1.0 to 2.4 mg per day but diabetic neuropathy patients should take in the range of 60 mg per day in equally divided doses. 

Riboflavin (Vitamin B2) – works in combination with Vitamin B6 to help the body use glucose properly. The RDA is 1.2 to 1.6 mg per day but therapeutic levels should be around 60 mg per day.

Vitamin B6 – along with folic acid and B12, it helps prevent nerve damage and heart attacks.  It can also help prevent diabetic blindness and/or vision loss. Therapeutic levels should be at least 60 mg per day but be very careful with your dosage.  Some toxicity has been reported with extremely high levels of B6. 

Vitamin B12 – works with folic acid to help prevent stroke and loss of limbs due to diabetic neuropathy.  It also helps relieve neuropathy pain. 

Biotin – when taken in combination with chromium, biotin (a B vitamin) helps insulin work more effectively, keeps the pancreas working well, and lowers blood sugar levels.

Chromium – when taken with biotin, helps insulin work better, keeps the pancreas working well and lowers blood sugar levels.

Copper –helps protect the cells in the pancreas that make insulin healthy, helps prevent diabetes related damage to blood vessels and nerves and lowers blood sugar levels.

Folic Acid – works with B12 to help prevent strokes and loss of limbs due to diabetic neuropathy.

Magnesium – helps relieve diabetic neuropathy pain and helps insulin work more effectively.

Manganese – helps prevent damage to blood vessels and nerves.

Selenium – sometimes called an insulin imitator, selenium helps take blood sugar into the cells.  Selenium protects against blood vessel and nerve damage from elevated blood sugar levels, two of the contributing factors in diabetic neuropathy.  

Zinc – helps blood sugar get into the cells and insulin work more efficiently.

These supplements, when used properly and under your care and supervision as their NeuropathyDR® clinician, can help improve diabetic neuropathy symptoms and lessen the chances of permanent nerve damage and eventual amputation.

Emphasize to your diabetic neuropathy patients that these supplements will not take the place of eating properly and exercising.   They work in combination with a healthier lifestyle, not in place of it.  By properly taking these supplements, watching their diet, exercising and complying with all of your treatment requirements as their NeuropathyDR® clinician, they greatly improve their chances of living a life free of the pain of diabetic neuropathy.

Let us help you reach this challenging patient population.

For more tips on growing a successful chiropractic, physical therapy or pain management practice, log on to to download a FREE E-Book Copy of my 5 star Amazon  rated book “Living and Practicing by Design”.

Chiropractic Care For Your Diabetic Neuropathy Patients

As a medical professional specializing neuropathy, you probably have a significant number of diabetics as patients.

Chiropractic care for diabetic neuropathy patients usually concentrates on correcting misalignments in the spine.

Diabetes ranks number 5 in the deadly diseases in the United States.

Those numbers are growing at an alarming rate.

One of the more difficult issues in treating diabetic patients is helping them deal with diabetic neuropathy and all it brings with it.

In order to get your diabetic neuropathy patients to make the connection between their diabetes and their diabetic neuropathy, you have to educate them on their diabetic neuropathy and its symptoms and health implications.

You also have to educate them on all their treatment options.

As a NeuropathyDR® clinician, you know how effective chiropractic treatment can be for your diabetic neuropathy patient.  Part of your job as their treating physician is to educate them on the option of chiropractic treatment.

First, make sure they understand why their diabetes has caused diabetic neuropathy.

Why Does Diabetes Cause Neuropathy?

If your patient’s blood glucose levels aren’t controlled and have been high for significant period of time, the blood vessels that carry oxygen to your nerves can be damaged[1].  Elevated blood glucose can also damage the sheath that covers and protects the nerves. That leaves them vulnerable to damage. 

Diabetic neuropathy is just the medical term for the nerve damage caused by elevated blood glucose levels.  That’s the simplest way to explain diabetic neuropathy to your patients.  It will help them to better understand why they’ve developed these new symptoms.

What Happens To The Body Once Those Nerves Are Damaged?

Diabetic neuropathy happens when the nervous system is damaged.  Symptoms change according to which part of the nervous system is damaged.   

If the peripheral nervous system is damaged your patient can experience

  • Numbness in the arms, hands, legs and feet
  • Inability to feel heat, cold or even pain in the arms, hands, legs and feet
  • Burning or tingling or even the “pins and needles” feeling they get when their legs or arms “go to sleep”
  • Changes in the shape of their feet caused by weakened muscles
  • Carpal tunnel syndrome

If their neuropathy affects their autonomic nervous system, they can experience

  • Digestive problems like nausea, vomiting, constipation or diarrhea[2]
  • Erectile dysfunction
  • Irregular heart beat
  • Loss of bladder control
  • Inability to regulate their blood pressure

Why Chiropractic Care Can Help Diabetic Neuropathy Patients

Chiropractic care for diabetic neuropathy patients usually concentrates on correcting misalignments in the spine.  Those misalignments can wreak havoc on the nervous system and internal organs – including the pancreas, a direct link to diabetes.

As a NeuropathyDR® clinician, you have an exclusive treatment protocol with proven results for diabetic neuropathy patients.  An integral part of that treatment protocol is chiropractic adjustment to correct problems with spinal alignment.

As a result of chiropractic adjustment for diabetic neuropathy, the next step in the treatment for diabetic neuropathy is taking steps to reduce their symptoms and help the nerves repair themselves.  This can be done through a combination of topical pain medications, manual manipulation of the bones and joints to properly align the nervous system and nerve stimulation. 

Proper alignment of the bones and muscles and nerve stimulation are all important aspects of successful treatment of diabetic neuropathy. 

Offer your diabetic neuropathy patients an ongoing monitoring and follow up program.  Keep in touch and watch for blisters, sores, torn skin, or inflammation as a sign of new nerve damage. Make sure they’re doing a visual inspection and not just relying on soreness or pain.  Diabetic neuropathy impairs the ability to feel pain in the extremities and they may not notice the problem until it’s too late for successful treatment.  It never hurts to have a fresh pair of eyes (yours) keeping watch over them.

When you’re trained and ready to treat them, let us help you reach them.

For more tips on growing a successful chiropractic, physical therapy or pain management practice, log on to download a FREE E-Book Copy of my 5 star Amazon rated book “Living and Practicing by Design” at

Should Your Peripheral Neuropathy Patients Get a Flu Shot?

It’s that time of year again…

Your patients need to make an informed choice about whether or not to get a flu shot.

Pre-flu season…

And everywhere your peripheral neuropathy patients look they see signs advertising “Flu Shots – Walk Ins Welcome” or “Get Your Flu Shot Today.”

For the average, healthy person getting a flu shot is a no-brainer.

After all, the flu accounts for 200,000 hospitalizations every year and up to 36,000 deaths.  If they can take a shot and avoid that, why wouldn’t they?

But if your patients have peripheral neuropathy caused by

  • Diabetes
  • Cancer (and you’re undergoing chemotherapy)
  • Shingles
  • HIV/AIDS or some other immune system disorder
  • Exposure to toxins
  • Gluten sensitivity (also known as celiac disease)
  • Kidney or liver disease
  • Hereditary neuropathy

They may have concerns about getting a flu shot – especially your peripheral neuropathy patients with underlying immune issues.  HIV patients tend to be especially skeptical about receiving the vaccine. 

If your patients’ peripheral neuropathy is caused by any of these underlying illnesses, they need to make an informed choice about whether or not to get a flu shot.   

They make that informed choice by consulting you as their NeuropathyDR clinician.

This is what they need to know. 

The Flu Vaccine Will Not Actually Make Them Sick

Contrary to urban myth, the flu vaccine will not make your peripheral neuropathy patients sick.  It works by stimulating the immune system to produce antibodies that actually fight the virus. It does not give them the flu.    

Make sure they understand that there is no evidence that the flu shot will make their neuropathy symptoms worse if their neuropathy is caused by any of the underlying illnesses we listed above.  In fact, the Centers for Disease Control strongly recommends that peripheral neuropathy patients with any of these illnesses receive a flu shot every year because they’re more prone to developing serious complications if they get the flu.

Special Concerns for Your Guillain-Barre Syndrome or CIDP Patients

If your patient’s peripheral neuropathy is caused by Guillain-Barre Syndrome or chronic inflammatory demyelinating polyneuropathy (CIDP), they need to exercise some caution before receiving the flu vaccine. 

Because the vaccine keeps them from getting the flu by tricking their immune system into producing antibodies to fight it off,  if they have neuropathy caused by Guillain-Barre Syndrome or CIDP,  this immune stimulation may actually cause a relapse in patients with a history of either of these illnesses.  

If they have had Guillain-Barre Syndrome and the resultant peripheral neuropathy in the past, it might be a good idea to wait at least one year after their symptoms are gone before receiving a flu shot. 

If your patient has CIDP and their symptoms are still present, they might want to avoid the flu vaccine.  Talk to your CIDP patient and consider the chances of complications from the vaccine as opposed to the health risks of actually getting the flu.  Issues to take into consideration are:

  • Advanced age
  • Other chronic medical conditions
  • Possible relapse triggered by getting the flu virus  

Who Should You Advise to Get a Flu Shot?

The Centers for Disease Control recommends that people receive the flu shot every year if they fall into any of these groups:

  • They’re six months to 19 years old
  • They’re 50 years of age or older
  • They have a chronic medical condition (lung, heart, liver or kidney disease, blood disorders, diabetes)
  • They live in a nursing home or other long term care facility
  • They live with or care for someone at high risk for complications from the flu (healthcare workers, people in their household (i.e., children too young to be vaccinated or people with chronic medical conditions)  

Make sure that you ask about all of these issues when you do your physical and history.

In the end, the decision to get the flu shot or take a pass on it is up to the patient.  As their Talk NeuropathyDR clinician, your job is to help them make an informed decision by weighing all the possible issues they may face as a peripheral neuropathy sufferer.

Pre-vaccination counseling is another service you can offer your peripheral neuropathy patients.  Let us help you reach them.  

For more tips on growing a successful chiropractic, physical therapy or pain management practice, log on to download a FREE E-Book Copy of my 5 star Amazon rate book “Living and Practicing by Design” at

Why a Specialty Practice in Todays World?

Make no mistake about it, businesses are being challenged to their core right now.

But, the reality is in a down economy you can OWN your market! Why? Because of how many businesses (practices) pull back, fail to market or maintain contact with people who likely could be customers for life!

I see this as a private practice consultant every day. Those who do all the right things in private health care right now are thriving, pulling together larger market shares all the time as weaker practices fold.

And one factor in our success clearly is the advantages of  developing a true Specialty Practice.

Specialists become experts by advanced training. Specialists get paid more. They especially get more referrals from generalists. Patients know this, then really sense it in the presence of their clinician.

As I watch in our 50 some-odd NeuropathyDR Clinics, those who continue to study, learn new techniques to help those whose lives have been devastated by serious disease and illnesses never want for new patients!

Real Specialty practices in particular have incredible “leverage”.  Staff always are learning newer and better ways of helping patients. Specialty practices have “staying power” when staff is trained properly, each system is perfected,  then marketed to their communities consistently.

And if by chance something is not working, its almost always just one of the above.

So, if you are on track to have an incredible finish to your year, I commend you.

If not, take a hard look at how your practice is positioned in front of your community from every angle. Give patients reasons to ONLY want to see you.

But above all, do this before your nearest competitor does.

It’s not going to be “easier” next year.

NeuropathyDR.The Treatment system Patients and Professionals ask for by name. (TM)











To learn more, click HERE




Diagnosing Peripheral Neuropathy

If a significant percentage of your patient load is made up of patients with

Show your patients how to do a visual inspection of their feet and hands for any problems.

  • Diabetes
  • Cancer (and you’re undergoing chemotherapy)
  • Shingles

You know how to deal with their primary symptoms.  Granted, every patient is different, but to some degree you know what they’re going to experience and their primary care physician has probably (hopefully) given them some idea of what to expect.

But unless that primary care provider is exceptionally thorough, peripheral neuropathy and its symptoms probably didn’t make the top 10 list of what they can expect from their illness.

Suddenly they’re experiencing

  • Swelling in the feet, legs or hands
  • Muscle cramps in the legs
  • Changes in the skin and nails
  • Numbness in the feet and hands
  • Inability of feel heat or cold
  • Sleepless nights due to pain
  • Muscle weakness
  • Painful burning and itching in the hands or feet
  • Feeling like they’re wearing gloves or socks when they’re not

And they didn’t expect any of these symptoms. 

So they do some research and they come to the conclusion that they might have nerve damage and, if you’ve positioned yourself properly as a NeuropathyDR® clinician, they find you.

And now they’re sitting in your waiting room. 

Diagnosing Peripheral Neuropathy in the Hands and Feet[1]

This can be a really difficult diagnosis to make.  The symptoms can vary widely between patients.  And when you’re dealing with patients with such serious illnesses at the root of their problems, it can be hard to pinpoint exactly what the problem is. 

The best course for you to take is to start with a really thorough history and physical followed by an extensive neurological examination.  If your patient is presenting with a known illness, that will make it much easier for you to make the peripheral neuropathy diagnosis because you don’t have to search for the underlying illness. You just have to figure out if the symptoms they’re seeing you for are caused by nerve damage.    

Treatment Options for Peripheral Neuropathy in the Hands and Feet[2]

Once you make the peripheral neuropathy diagnosis, work with your patient’s other doctors to make sure that the underlying medical condition is under control.  Once you understand the treatment regimen they’re undertaking, you can begin to address possible nerve damage and healing the nerves.

Make sure your patient is

  • Getting plenty of rest
  • Pacing themselves
  • Exercising regularly – walking and swimming are good exercises for neuropathy patients
  • Taking care of their feet and hands
  • Not smoking
  • Eating a healthy, well balanced diet

Your patient needs to understand how important it is to pay attention to their feet and hands and to contact you immediately if they notice any blisters, sores, torn skin, or inflammation.  

Show your patients how to do a visual inspection of their feet and hands for any problems.  They need to know not to rely on feeling pain to know that they have sore or blister on their feet.  Their peripheral neuropathy will keep them from feeling pain in their feet and hands.  They may not notice the problem until it’s too late for successful treatment. 

This is a patient population that really needs your help and the NeuropathyDR® treatment protocol is perfect for helping them avoid permanent nerve damage.

Let us help you reach these patients and treat them.

For more tips on growing a successful chiropractic, physical therapy or pain management practice, log on to to download a FREE E-Book Copy of my 5 star Amazon rated book “Living and Practicing by Design.”

Planning to Efficiently Treat Your Peripheral Neuropathy Patients

We become doctors to help people. 

Offer your peripheral neuropathy patients an ongoing monitoring and follow up program.

Unfortunately, the reality of a modern medical practice can sometimes make us rethink our original motives in becoming medical professionals…

So many patients…

Mountains of paperwork…

Not enough time to really get to know our patients as individuals…

Healing can sometimes take a backseat to the “quick fix.” 

Especially in patients with peripheral neuropathy. 

They’re not only dealing with the other symptoms of their underlying illness, now they have[1]

  • Diarrhea, nausea and vomiting
  • Difficulty swallowing
  • Deep pain in the legs and feet
  • Loss of sensation and ability to feel warmth or cold
  • Muscle cramps
  • Numbness, tingling or burning in the arms, hands, legs or feet
  • Weakness
  • Dizziness, especially when they try to stand up
  • Drooping facial muscles
  • Loss of bladder control

They just want to feel better…now…

One of the best ways to get a strong start with treating peripheral neuropathy patients is to make efficient and effective use of every appointment. 

And that means helping the patient help you treat them.

Preparing For That First Appointment

When your new patient calls in for an appointment, have a solid new patient questionnaire ready for them to complete.  Don’t wait until they come in for that first appointment.  Have your scheduling staff email or snail mail it to them a week before their first appointment and follow up with them to ensure they’ve filled it out before they come to your office.

Get as much information as possible.  Other than the very basic questions like age, weight, etc., here are some sample questions you might want to include[2]:

  • What is your occupation?
  • Do you have any underlying medical conditions (i.e., diabetes, shingles, cancer, alcoholism or substance abuse, HIV/AIDS, Guillian-Barre Syndrome)?
  • When did you first notice your symptoms?
  • How often do you experience your symptoms? Do you have problems at specific times of the day or after any specific activity?
  • On a scale of 1 to 10, (1 being mild and 10 being severe), how would you rate your symptoms?
  • Have you noticed anything that makes your symptoms better or worse?
  • How often do you exercise?
  • What does your diet consist of?
  • Have you undergone any significant lifestyle changes recently?

Getting as much information about a day in the life of your new patient before you see them will help you use your appointment time efficiently and really get started with diagnostic testing and treatment.

Once you and your patient have done your homework, you have test results in hand and you know exactly what you’re dealing with, you can formulate a treatment plan specifically for this particular patient.  A plan that will not only alleviate their symptoms but start repairing the nerve damage that’s caused their peripheral neuropathy.

In addition to regular medical treatment, you can offer your patients:

Diet Planning and Nutrition Counseling

The first goal for treatment in peripheral neuropathy is to get the patient’s underlying medical conditions under control and keep them under control to slow the progression of any nerve damage.   That means ensuring that they properly take any prescribed medications and that they’re eating a healthy diet.

A diet that includes:

  • Fresh vegetables
  • Fresh fruit
  • Lean meats
  • High fiber
  • Whole grains
  • No sweets

An integral part of the NeuropathyDR® protocol is sitting down with the patient and planning their meals to include the proper portions of each of these categories on a daily basis.

Pain Reduction and Nerve Repair

Once you know their underlying medical conditions are under control, the next part of the treatment protocol for your peripheral neuropathy patient is taking steps to reduce symptoms and help the nerves repair themselves.  This can be done through a combination of topical pain medications, manual manipulation of the bones and joints to properly align the nervous system and nerve stimulation. 

Diet, proper alignment of the bones and muscles and nerve stimulation are all important aspects of successful treatment of peripheral neuropathy. 

Ongoing Monitoring

A lifetime of bad habits can’t be undone overnight.  You’ll want to provide an ongoing treatment and monitoring program with your peripheral neuropathy patients. 

Once they see how much better they feel after the NeuropathyDR® treatment protocol, it’s incredibly easy for them to slip right back into their old habits.  If you don’t stay in touch and follow up with them regularly, they can undo everything you’ve worked with them to achieve.  And, even worse, they could be facing even more severe nerve damage than they had before. 

Offer your peripheral neuropathy patients an ongoing monitoring and follow up program.  A newsletter with articles about peripheral neuropathy, healthy lifestyle choices and tips for things to watch out for and report to their physician (you as their NeuropathyDR® specialist) will help you make a lasting difference in the lives of patients suffering from peripheral neuropathy. 

When you’re trained and ready to treat them, let us help you reach them.

For more tips on growing a successful chiropractic, physical therapy or pain management practice, log on to download a FREE E-Book Copy of my 5 star Amazon  “Living and Practicing by Design” at

Are Your Peripheral Neuropathy Patients Taking Care Of Their Feet?

As a medical professional treating patients with peripheral neuropathy, you want to have a positive effect on your patients.

More than half the patients admitted that they walked around the house and even outside with no shoes.

You treat them…

You worry about them…

You advise them…

But are they really listening to what you tell them?

If your patients have peripheral neuropathy in their feet, chances are really good they’re not listening to you.  They hear you but they’re not taking what you tell them home.

A recent study that followed 41 patients with type 2 diabetes and peripheral neuropathy found that

  • 90% of the patients had been educated about proper footwear
  • 83% washed and dried their feet properly every day
  • 51% actually perform foot self-exams recommended by their doctors

But more than half the patients admitted that they walked around the house and even outside with no shoes.  And more than two thirds of them were not wearing appropriate footwear.  They were wearing shoes with pointed toes, high heels or flip flops, and even worse.

If you want to really get through to your peripheral neuropathy patients, you need to impress on them how serious they’re condition is and exactly what can happen to them if they don’t follow your instructions.

Step One  – The Thorough Foot Examination[1]

If you have patients with peripheral neuropathy in their feet, even if they don’t present with foot issues, you need to be proactive as their physician and ensure that you see them at least once a year for a complete foot examination. 

When you’re examining their feet, make sure you: 

  • Examine each foot between the toes and from toe to heel.  Make extensive notes in the chart of any problems by drawing or labeling the finding on the foot diagram.  If your patient has skin that is thin, fragile, shiny and hairless, they could have problems with their circulation and that means possible nerve damage. 
  • Ask the patient if they’ve noticed any change in how their feet sweat.  If their feet don’t sweat as they normally would they can develop dry, cracked skin and those cracks can become infected.
  • If your patient is wearing nail polish, take it off.  Check for ingrown toenails, deformed nails or any type of nail fungus. 
  • Make notes on the diagram and in the chart of any areas on the feet that are noticeably dry, red or warm to the touch.

Step Two  – Patient Education

In order to prevent serious problems, your peripheral neuropathy patients need to know how to care for their feet and what to watch for so they can come in to see you before they reach a point  of no return. 

Here’s a good checklist to provide to your patients to remind them of exactly what they need to do to help themselves[2]:

  • Check their feet every day.  Look at their bare feet to make sure they don’t have any sores, blisters, or swelling.  If they can’t see the bottoms of their feet, they should use a mirror or ask someone else to check them.
  • Wash their feet every day and dry them completely to eliminate the possibility of fungus growth.  Make sure they pat their feet dry – don’t rub them.   
  • Use a good lotion on their feet to keep skin smooth and prevent dry, cracked skin.  Don’t use lotion between the toes – it will keep the skin there too moist and that breeds bacteria.
  • Trim their toenails but not too short.  Cut them straight across and file the edges with a nail file to prevent ingrown toenails and cut them right after they bathe while the nail is still soft.
  • Always wear shoes and socks – even inside the house.  If they have neuropathy, it’s just too easy to step on something and injure their feet without even feeling it.
  • Wear comfortable shoes, preferable shoes designed for people with peripheral neuropathy in their feet.  Check their shoes before they put them on and make sure the lining is intact and smooth and that nothing is in their shoes.  Talk to them about Medicare assistance with purchasing special shoes. 
  • Never put their feet in hot water.  Always check the temperature of their bath water with the elbow before stepping into it. 
  • Never use hot water bottles or heating pads on their feet.  Neuropathy makes it harder to sense extreme temperatures and they can burn their feet without even knowing it.
  • When sitting down, they should prop their feet up to keep the blood circulating.  Move the toes and ankles to keep the blood pumping.
  • Never cross their legs when sitting.

Don’t just tell them what they need to do and take it for granted that they understand what you’re telling them.  Ask them to demonstrate the steps to proper foot care so you know they know what you’re saying and that they are physically capable of doing what you’re telling them to do.  Offer clinics on proper foot care for your patients with peripheral neuropathy in their feet. 

And offer your peripheral neuropathy patients an ongoing monitoring and follow up program.  Keep in touch and watch for any of the symptoms of peripheral neuropathy in the feet. 

Peripheral neuropathy in the feet impairs the ability to feel pain and they may not notice the problem until it’s too late for successful treatment.  It never hurts to have a fresh pair of eyes (yours) keeping watch over them.

When you’re trained and ready to treat them, let us help you reach them.

For more tips on growing a successful chiropractic, physical therapy or pain management practice, log on to to download a FREE E-Book Copy of my 5 star Amazon  “Living and Practicing by Design”.

Is Your Patient’s Statin Medication Making Them Sick?

Let’s say you have a new patient who presents with

Prolonged exposure to statins can cause serious damage to the peripheral nerves.

  • Burning pain
  • Sensitivity to touch
  • Tingling
  • Numbness
  • Prickling sensation
  • Weakness
  • Difficulty walking
  • Shooting pain in their muscles

For too long a time, they couldn’t figure out what was wrong with them.  They thought they were just tired or getting older or maybe coming down with something. 

Then they did some research and they think their symptoms may be some sort of neuropathy…

They’re not diabetic, they haven’t been through chemotherapy, they’ve never had shingles…

In fact, the only medical issue they have is high cholesterol and they’re taking statins.  And that can mean they may very well have is one of the fastest growing types of neuropathy…

Statin neuropathy.

And you can both be thankful they landed in your office.  As a NeuropathyDR® clinician, you probably have an excellent chance of recognizing, diagnosing and treating statin neuropathy.

What Is Statin Neuropathy?

Statin neuropathy[1] is nerve damage caused by exposure to cholesterol lowering medication.  By lowering cholesterol, statins also affect the cholesterol rich membranes that surround the nerves.  Prolonged exposure to statins can cause serious damage to the peripheral nerves. While that may not sound like a big deal, it can ultimately affect your patient’s

  • ability to breathe
  • ability of their heart to function properly
  • ability to control many of their bodily functions

The Difficulty of Diagnosing Statin Neuropathy

Patients with statin neuropathy often present with very subtle pain or mild weakness.  Because their initial symptoms are fairly mild, it’s harder to pinpoint a diagnosis.  When symptoms are more pronounced and painful, there may be a lag time between the exposure to the toxin and the onset of significant symptoms.  The symptoms come on so gradually that it’s harder for the patient to give the clinician a clear picture of exactly when they started.

The difficulty in diagnosing statin neuropathy is one of the reasons that it is so important for them to consult a healthcare provider who specializes in treating neuropathy, like a NeuropathyDR® clinician.  Because this is your field of expertise, you are more likely to pick up on subtleties that will allow a faster diagnosis.  Faster diagnosis means faster treatment and that means less chance for permanent nerve damage.

What is the Treatment for Statin Neuropathy?

As a NeuropathyDR® clinician, your initial goal will be to confirm the diagnosis and then help your patient control their underlying medical condition and get off their statin medication[2].   

The next step is to devise a treatment plan.

One of the benefits to the statin neuropathy patient of being treated by a NeuropathyDR® clinician is your hands on approach and specialized training in treating their statin neuropathy.  You can advise them on the necessary safety precautions to avoid falls and potential injury caused by nerve deficits as well as providing nerve stimulation and manual manipulation of their skeletal system to get their body back into alignment and alleviate their nerve pain.

When you’re trained and ready to treat statin neuropathy patients, let us help you reach them.

For more tips on growing a successful chiropractic, physical therapy or pain management practice, and to download a FREE E-Book Copy of my 5 star Amazon “Living and Practicing by Design”, log on to

A Priceless Gift for Your Peripheral Neuropathy Patients – Quality of Life

As a medical professional treating patients with peripheral neuropathy, you know how to deal with their medical issues…

Have your staff provide your peripheral neuropathy patients with some reference materials to help them get the most from their time with you.

Physical therapy…

Nerve stimulation for regeneration and repair…

Prescriptions for pain…

But what might not be as well versed in is helping them maintain or regain their quality of life[1].

Helping your peripheral neuropathy patients recoup some of the intangible things they’ve lost to their illness can be incredibly rewarding, both for you and your patient.

And it can help you build a practice that goes beyond the medical issues and gives your peripheral neuropathy patients a priceless gift…

Giving their lives back.

Helping Your Patients Help Themselves

As part of your new patient intake procedure, have your staff provide your peripheral neuropathy patients with some reference materials and suggestions to help them get the most from their time with you and to help you know what their issues are from the outset[2]:

  • Give your patients some articles and reference materials to read and educate themselves about their condition.  If they know more about their condition, they’ll be more realistic about what they should and shouldn’t expect from treatment. 
  • Ask your patient to write down a list of questions they have about their peripheral neuropathy.  Suggest that they bring someone with them to their first appointment who can write down the answers to their questions for them so they’re not distracted and can really listen to what you tell them.
  • Have your peripheral neuropathy patient provide you with a list of all their medications (both prescription and over the counter – including vitamins, minerals and herbal supplements) so you’ll know how what they’re taking may be affecting their condition and causing some of their issues.
  • Take note if they are having particular issues that might warrant occupational therapy in addition to physical therapy.  Be proactive in making a referral for occupational therapy if you think it’s warranted. 

Listening for Signs of Depression and Other Conditions

No two peripheral neuropathy patients are alike.  Just as their daily lives and routines are different, the effect of peripheral neuropathy on their quality of life is going to be different.  Some patients will require closely monitored pain management therapy.  Others will need to be watched more closely for the signs of depression and withdrawal. 

While you may not be a mental health professional, part of treating the whole patient requires that you pay close attention to their mental state.  Their mental attitude and how they’re adapting to their peripheral neuropathy and the changes it brings to their lives is crucial in a successful course of treatment. 

  • Encourage your peripheral neuropathy patients to share how their feeling, not just physically but emotionally.  Keep a list of support groups available to refer your patients to that can help them deal with their pain and the impact it has on their lives.
  • Encourage your peripheral neuropathy patients to get out and socialize with other people as much as possible.  Joining a support group for neuropathy patients or even for chronic pain sufferers will give them people to talk to who will have a real understanding of what they’re dealing with.
  • Work with your peripheral neuropathy patients on learning to set priorities with their daily routine.  Making a list of tasks to be accomplished and being realistic about them will cut down on frustration and help them fight their depression.

Helping Your Peripheral Neuropathy Patients Adapt

Quality of life is a measure of how a patient adapts to their physical condition.  The pain in their hands and feet can make it difficult to grasp even the smallest object or to keep their balance when they try to walk. 

Imagine how that must disrupt their lives…

In addition to helping them with their medical and emotional issues, there are tips you can share with them that will help them adapt to the practical considerations of dealing with peripheral neuropathy:

  • Using thick, rubber handled utensils in their kitchen will make it more comfortable for them when they prepare meals.
  • Using long-handled “reachers” (like the ones they use in retail stores to get items off top shelves) to reach for objects on shelves or even to pick things up off the floor.
  • Using button hooks to button or unbutton clothing.
  • Using devices that assist with putting on and pulling up socks.
  • Wearing shoes that have closures that make it easy to put them on and take them off.
  • Using devices designed to help pull up zippers.
  • Making sure they never leave anything lying around on the floor that they could trip over.

How You Can Help Your Patients With Nutritional Neuropathy

If you’re treating patients with neuropathy symptoms as a result of[1]

When you’re trained and ready to work with your patients, let them know you’re there.

  • Anemia
  • Gastritis
  • Crohn’s disease
  • Celiac disease
  • Ulcerative colitis

They may well be suffering from nutritional neuropathy in addition to the symptoms for their underlying illness. 

Why Digestive Issues Cause Nutritional Neuropathy[2]

Patients with any of these digestive disorders suffer from a very special set of problems and nutritional neuropathy just makes their physical issues worse.

They have to be careful about everything they eat because they never know exactly what will set off their symptoms.  They have to plan their lives around food and exactly how their underlying illness will disrupt their lives. 

Their illness affects how their body absorbs the vitamins and nutrients from the food they eat.  One of the leading causes of nutritional neuropathy is vitamin deficiency, especially Vitamin B12.  If your patient is limiting their animal protein because of their digestive issues, they could be suffering from a vitamin deficiency in the vitamins they would normally get from those foods. 

Any condition that affects the body’s ability to absorb the nutrients and vitamins from food can lead to nutritional neuropathy. 

Designing the Right Treatment Program for Your Nutritional Neuropathy Patients

To effectively treat your nutritional neuropathy patients, the first thing you need to do is a thorough history and physical.  Your treatment program will need to not only take into account their nutritional neuropathy symptoms; you need to design a diet plan that will work well with their underlying illness.  Digestive issues present a separate set of challenges for you as a clinician.

Your diet plan will not only need to include the vitamins and minerals, but you also need to take into account any digestive problems that will prevent their body from absorbing the good nutrition your diet plan provides.

Make sure your diet plan includes:  

  • Whole grains and legumes to provide B vitamins to promote nerve health.  Whole grains promote the production of serotonin in the brain and will increase feelings of well-being.
  • Fish and eggs for additional vitamins B12 and B1.
  • Green, leafy vegetables (spinach, kale, and other greens) for calcium and magnesium.  Both of these nutrients are vital to healthy nerve endings and health nerve impulse transmission and, as an added bonus, they give the immune system a boost.
  • Yellow and orange fruits and vegetables (such as squash, carrots, yellow and orange bell peppers, apricots, oranges, etc.) for vitamins A and C to help repair skin and boost the immune system.

Advise them to avoid:

  • Coffee and other caffeinated drinks. 
  • Fried foods and all other fatty foods.  Fatty foods suppress the immune system and that’s the last thing they need when fighting nutritional neuropathy and their digestive system disease.
  • Limit high protein foods like animal protein.  High-protein foods elevate the amount of dopamine and norepinephrine which are both tied to high levels of anxiety and stress which will only make them more irritable.
  • Alcoholic beverages.  Alcohol consumption limits the ability of the liver to remove toxins from the body and can make a bad situation worse. 
  • Processed sugar.  They don’t have to eliminate sweets completely, just control them.  Keeping blood sugar levels constant will help control irritability.
  • Control salt intake.  Opt for a salt substitute with potassium instead of sodium and stay away from preserved foods like bacon, ham, pickles, etc.  Reducing salt intake will help ease inflammation and that alone will work wonders in the healing process.

Sit down and discuss your nutritional neuropathy patient’s diet as part of the initial consultation process.  The information gained will help you devise a nutrition plan tailor made for your patient and help to build a rapport between you.

When you’re trained and ready to work with them, let them know you’re there.

For more tips on growing a successful chiropractic, physical therapy or pain management practice, log on to http://perfectpractice to download a FREE E-Book Copy of my 5 star Amazon  “Living and Practicing by Design” at

Help for Your Weekend Warrior Patients with Shoulder Pain

If you specialize in treating patients with nerve damage, you’re probably used to seeing patients with

Don't Forget The Cervical Spine and Shoulder Pain





Any of those illnesses can cause nerve damage and peripheral neuropathy.

But another less chronic patient population you can serve are the weekend warriors…

Those sports enthusiasts who live to play baseball, football, volleyball or even for kayaking.

This patient population is more prone to shoulder injury and the resultant shoulder pain caused by suprascapular neuropathy than the average person.

Patients with suprascapular neuropathy can be especially challenging because

They often wait to come in for treatment until they have a serious problem; and

Part of their treatment will need to be rest and not participating in their favorite pastime

In order to give you a better chance for having a compliant patient, they need understand exactly what they’re dealing with.

They need to understand that they can’t just muscle through the pain and “work it out.”

What is Suprascapular Neuropathy?  Suprascapular neuropathy is nerve damage to the suprascapular nerve – the nerve that runs from the brachial plexus (a group of nerves in the neck and shoulders) to nerves that help the body fully rotate the arms. Suprascapular neuropathy is a common cause of shoulder pain and weakness and can lead to career ending nerve damage for professional athletes or stop weekend warriors from doing what they love. 
Exactly What Causes Suprascapular Neuropathy?
As the suprascapular nerve passes over the shoulder blade, it can be compressed and stretched. When that happens repeatedly over a period of time, the nerve can become damaged and neuropathy develops. The first symptoms are usually pain and weakness when they try to rotate the shoulder.

If you experience any of these issues, contact your doctor or your local NeuropathyDR® clinician immediately to determine if you have nerve damage. You’ll need to start treatment immediately in order to prevent permanent damage.

Devising a Treatment Plan
The treatment for suprascapular neuropathy depends on

What caused the suprascapular neuropathy

How severe the patient’s symptoms are

How long the patient has had symptoms

The result the patient wants to achieve

Your first step will be to limit the patient’s activities. Once they’ve rested the shoulder, you can start them on an exercise program designed to increase their ability to use their shoulder, regain some flexibility in the joint and strengthen the rotator cuff. Once you’ve achieved a degree of relief for your patient, you can modify the exercise program to fit their sport of choice.

The ultimate goal should be to regain their range of motion in the shoulder and strengthen the muscles in order to prevent future nerve damage.

The end game in treating patients with suprascapular neuropathy caused by sports injury should be to repair the damage they’ve already done and prevent them from doing damage in the future. That will require a little more in-depth involvement on your part.

You need to analyze your patient’s technique to see if they are using proper form and see if any changes need to be made to prevent recurrent injury.

The NeuropathyDR® protocol is ideally suited to treating patients with sports related suprascapular neuropathy. Early intervention with a physician well versed in suprascapular neuropathy, like a NeuropathyDR® clinician, is their best course of action.

When you’re trained and ready to work with them, let them know you’re there.

For more tips on growing a successful chiropractic, physical therapy or pain management practice, log on to http://perfectpractice to download a FREE E-Book Copy of my 5 star Amazon “Living and Practicing by Design” at

1 http:// guides/shoulder-problems-and-injuries-topic-overview