Private Practice and Social Media: Top 4 Tips for Social Media That Works

Private practice and social media? Here are our Top 4 Tips for Social Media That Works.

Every private practice owner knows (or should!) that social media is a gold mine when it comes to marketing. Ignoring the potential of social media for your private practice growth is almost a recipe for certain failure these days.

Unfortunately, some private practice owners have found out the hard way that social media as a marketing tool needs to be handled appropriately so that it will be effective rather than disastrous.

Social media disasters happen for a lot of reasons. But many social media mistakes can be boiled down into just a few common elements.

Here are our top 4 tips for a social media strategy that works:

Put a policy in place. Before you post a single thing on Facebook, Twitter, Instagram, or any social media site, make decisions about appropriate social media use and put them in writing for your entire team. Then decide which staff will be participating and train them accordingly.

Vet your content. Think carefully about which kinds of articles or memes you’ll share with your followers, and which ones are better left alone. Never share any article you haven’t read based on a headline, which can be misleading. Make half your content original material produced from your office, and the other half information that your patients need and want.

Get out there every day. What makes social media so effective is engagement on a regular basis. You’ll lose your audience very quickly if you’re not able to keep up with the norms for a particular social media site. Learn to use scheduling tools so you’re not personally online all the time!

Have fun with it. One thing patients don’t want to see is boring, didactic, serious content from you day after day. Keep an eye out for things that are relevant but fun—ideally, something that shows the professional but relaxed milieu of your office environment.

Remember that every single post on social media represents you and your private practice.

Having trouble with marketing issues like this? It’s one of the things we address in our program 12 Secrets of Private Practice Mastery.


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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



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

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.”

Designing an Exercise Program for Your Autonomic Neuropathy Patients

As a medical professional treating neuropathy patients, you know how vital it is that your patients remain as physically active as possible. 

Talk with your patients about their expectations and make sure they understand their limitations.

Autonomic neuropathy[1] makes that a little more difficult because this specific type of neuropathy can seriously impact the very systems that are directly affected by exercise.

As a NeuropathyDR® clinician, an exercise program is a vital part of your treatment regimen.  With your autonomic neuropathy patients, you have to be especially careful in both designing and monitoring their exercise program to ensure that they receive the full benefit of the exercise and don’t do more harm than good.

Exercise On A Case By Case Basis

Any exercise program for an autonomic neuropathy[2] patient should be designed for their specific symptoms and circumstances. Talk with your patients about their expectations and make sure they understand their limitations and what their anticipated outcome can be. 

To be most effective, the exercise program you design should include recommendations on:

  • Intensity
  • Type
  • Duration
  • Frequency
  • Controlling when they move to the next level


Most healthy people keep an eye on their heart rate when exercising.  For autonomic neuropathy patients, the heart rate is not a good indicator of the intensity of exercise because their heart rate is already depressed. 


Make sure your autonomic neuropathy patient is interested in the exercise you prescribe.  If you prescribe exercises that they have no interest in or can’t do, the program is doomed to failure.  Some of the best exercises are stationary cycling, semi-recumbent cycling and water exercises. Even sitting in chair and doing light weight exercises is better than doing no exercise at all.


Your autonomic neuropathy patients may have a seriously decreased tolerance for exercise simply because their heart and lungs aren’t functioning properly.  Your exercise program should take this into account and not be too ambitious in the beginning.  Make sure you have a firm grasp of their tolerance for exertion.


If you want your autonomic neuropathy patients to have a successful exercise program, make sure you are both realistic in your expectations.  In order to make it a habit, daily exercise is the most effective.  If at all possible, advise your patients to do some kind of exercise every day.  If they can do it, great but don’t allow them to become discouraged if they can’t.  Just adapt to what they can do.

Moving to the Next Level


This can be one of the more challenging concepts in designing an exercise program for your autonomic neuropathy patients.  You don’t want them to be bored but you don’t want them to overexert themselves. Instead of attempting something more difficult, think about just increasing how often they exercise at first.  Then build to a more intense level of exercise. 

Early intervention with a physician well versed in treating all types of neuropathy, like a NeuropathyDR® clinician, is still the best course of action for an Autonomic Neuropathy patient.  While you can’t reverse your patient’s condition if they have already developed autonomic neuropathy, you can help them achieve a better quality of life and lessen the chance of severe and possibly fatal complications.

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