NEUROPATHY
IF YOU HAVE NEUROPATHY, OUR CENTER CAN HELP!
We Offer:
- State-of-the-art diagnostic testing to get to the root cause of your problem
- Treatments for numbness and pain, often without medication
- Help for impaired balance
David Saperstein, MD
Nationally known Neuropathy Specialist
I have been taking care of patients with peripheral neuropathy for over 20 years. Unfortunately, rather often the previous care of their neuropathy has not been ideal. Often patients with neuropathy are not given adequate information about their condition and are told not much can be done. Sometimes patients do not have neuropathy or they do not have the type with which they have been diagnosed. Some patients are not treated when they should be and others are treated with therapies that will not help their neuropathy.
In response, I have harnessed my experience in diagnosing, treating, and researching peripheral neuropathy to create the Neuropathy Institute at the Center for Complex Neurology. Here my team and I will employ state-of-the-art techniques to make the most accurate diagnosis and implement the most effective and creative treatments. Better answers. Better solutions.
One of Dr. Saperstein’s personally trained Physician Assistants will speak with you and examine you. The PA will discuss your case with Dr. Saperstein, and he will then personally meet with you. The team will review any previous test results. Further testing may be necessary. However, if you are a potential candidate for the scrambler pain therapy treatment device (see below), a 30-minute trial will be performed at the time of your first visit to the Center. This should be sufficient to determine if this treatment can help you.
This is going to be a comprehensive evaluation and may take up to an hour and a half to complete.
Options for further testing might include:
- Nerve conduction and EMG testing
- Assessment of blood flow
- Autonomic testing
- Nerve ultrasound
- MRI scans
- Nerve or skin biopsy
- Immunologic testing
- Genetic testing
- Spinal tap
After Dr. Saperstein and his team have had the chance to personally review the results, they will discuss your diagnosis as well as treatment options. When possible, the underlying cause of your neuropathy will be treated. Unfortunately, often the neuropathy cannot be corrected and treatment focuses on relieving or decreasing symptoms. Even if this is the case, much can be done to help. This may involve improving balance or easing pain.
Sometimes, standard medications such as gabapentin or Lyrica can help. Many of you may be on these medications or tried them in the past. We find that very often medications are not dosed as optimally as they could be, and this affects the effectiveness and the occurrence of side effects.
The Institute also utilizes options aside from medications, such as natural products, nutritional and dietary changes, as well as cutting-edge neuromodulating therapy, such as the Scrambler pain therapy treatment using the Calmare device. This is a medication-free treatment that can retrain the brain to no longer register neuropathy pain. Dr. Saperstein is the only Neurologist in the state of Arizona to offer this technology.
Treatments available at the Neuropathy Institute include:
- Intravenous immunoglobulin (IVIG) and other biology therapies
- Physical therapy
- Smart sensor shoe inserts to treat unsteadiness
- Calmare Scrambler Pain Therapy Treatment (medication-free treatment for nerve pain)
A Neurologist-Run Neuropathy Center in Arizona!
Dr. Saperstein is a nationally known neuropathy specialist
- Established track record of diagnosing, treating and researching peripheral neuropathy.
- Fellowship trained in neuromuscular medicine and clinical neurophysiology.
- Board-certified in neuromuscular medicine.
- Board-certified in Clinical Neuromuscular Pathology.
- Trained in performance and interpretation of nerve biopsies
- Personally interpreted over 50,000 biopsies of small nerve fibers
What is Neuropathy?
Neuropathy refers to any condition that results from damage to nerves. This can occur from injury, toxins, medications or diseases, such as diabetes. A large percentage of the time the cause for a person’s neuropathy cannot be determined. Neuropathy often causes numbness and pain in the limbs. Sometimes there is weakness or loss of balance.
Other conditions can resemble neuropathy so correct diagnosis is key. Testing options include nerve conduction studies, electromyography (EMG), ultrasound, nerve biopsy and, in some cases, skin biopsy to look at the small nerve fibers in the epidermis.
It is important to determine the cause of someone’s neuropathy so the right treatment can be administered. Unfortunately, many neuropathies cannot be fixed and management involves treating symptoms, such as pain. It is especially important to identify cases were a person’s own immune system is attacking their nerves because there are therapies to treat to this (see CIDP).
For neuropathy treatments, visit The Neuropathy Institute at the Center for Complex Neurology.
Neuropathy Videos
Calmare® Therapy for Neuropathy
A unique pain therapy device
A technologically advanced solution for chronic pain management. This device has been shown to be highly effective in the treatment of chemotherapy-induced peripheral neuropathy (CIPN), drug-resistant chronic neuropathic and cancer pain, having long-lasting effects — an important benefit for both patients and their physicians.
About
The Calmare® device is a U.S. FDA 510(k)-cleared and European CE mark-certified pain therapy medical device for the non-invasive treatment of chronic neuropathic and oncologic pain. Treatment using the Calmare device avoids the harmful, adverse side effects and addictive properties linked to narcotic pain killers.
The Calmare device has been used to successfully treat over 4,000 patients worldwide, where it has been shown to be effective in treating neuropathic and oncologic pain. Conditions treated include:
- Chemotherapy-induced peripheral neuropathy (CIPN)
- Phantom limb syndrome
- Post-surgical neuropathic pain
- Low back pain
- Reflex sympathetic dystrophy
- Sciatica
- Postherpetic neuralgia (PHN)
- Neck pain
The device, with a biophysical rather than a biochemical approach, uses a multi-processor able to simultaneously treat multiple pain areas by applying surface electrodes to the skin. The device creates and sends a no-pain signal which becomes the dominant signal received by the brain, thus overriding the pain signal and providing relief for the patient.
In honor of the technology’s Italian inventors, CTI chose to call this medical device “Calmare”. Translated from Italian, “calmare” means “to soothe or ease.” Treatment utilizing the Calmare device can ease the suffering that patients endure from debilitating pain.
Who's it for?
The Calmare® platform is highly effective in the treatment of pain and has long-lasting effects, an important benefit for both physicians and their patients. Clinical studies have shown that the technology successfully reduces pain in more than 80 percent of treated patients without the adverse side effects commonly associated with drugs, therefore providing patients with a markedly improved quality of life.
Indications
- Chemotherapy-induced Peripheral Neuropathy (CIPN)
- Chronic Cancer Pain
- Failed Back Surgery Syndrome (FBSS)
- Sciatic and Lumbar Pain
- Phantom Limb Syndrome
- Postherpetic Neuralgia (PHN)
- Post-surgical Neuropathic Pain
- Brachial Plexus Neuropathy
- Low Back Pain (LBP)
- Chronic Neuropathic Pain
Contraindications
Due to the manner in which Calmare Pain Therapy Treatment operates, the following should be considered as possible exclusions:
- Pacemaker or automatic defibrillator
- Aneurysm clip, vena cava clips, or skull plates (metal implants for orthopedic repair, e.g. pins, plates, joint replacements are allowed)
- Pregnant and/or breastfeeding
- Prior celiac plexus block, or other neurolytic pain control treatment, within 4 weeks
- Wounds or skin irritation in areas where the electrodes are required to be placed
- History of, or have been treated for myocardial infarction or ischemic heart disease within the past six months
- Severe arrhythmia or any form of equivalent heart disease
- Implanted drug delivery system
- Active withdrawal from drugs and/or alcohol
- Previous intolerance to transcutaneous electronic nerve stimulation
- Latex allergies
Precautions
- Because this device is capable of delivering a charge per pulse of 25 micro coulombs or greater, you should not place electrodes in a trans-thoracic position (may cause cardiac arrhythmia)
- You have an implanted pain stimulator (operating or nonoperational) in which the proposed treatment is in the area of the implanted device (electrical current to area may interfere with the operation of the implanted device)
- You are connected to other electronic monitoring equipment (ECG monitor) – may not operate properly with the medical device in use
How It Works
The Calmare® device uses a biophysical rather than a biochemical approach. A ‘no-pain’ message is transmitted to the nerve via disposable surface electrodes applied to the skin in the region of the patient’s pain. The perception of pain is cancelled when the no-pain message replaces that of pain, by using the same pathway through the surface electrodes in a non-invasive way. Regardless of intensity, a patient’s pain can often be completely removed for immediate relief.
Maximum benefit is achieved through follow-up treatments. The patient may be able to go for extended periods of time between subsequent treatments while experiencing significant pain control and relief. The period of time between treatments depends on the underlying cause and severity of the pain in addition to other factors.
Benefits
- Non-invasive
- Painless
- Immediate pain relief
- Ongoing pain control
- No adverse side effects of opioids and other drugs
Features
- 5 independent channels
- Disposable surface electrodes
- Independent output intensity on each channel
- Dynamic synthesizer processor
- Maximum output current: 5mA RMS
FREQUENTLY ASKED QUESTIONS
(from our social media followers)
Depending on the cause of small fiber neuropathy, nerves can heal. For example, if there is a vitamin deficiency or autoimmune problem, treatment might be able to regenerate nerve fibers.
If MCAS or another condition is causing or contributing to SFN, then treating this condition can improve the SFN.
Small fiber neuropathy typically refers to patients in whom only the small nerve fibers are affected. In CIDP medium and large nerve fibers are affected. Small fibers may be affected as well. Someone with a purely small fiber neuropathy (SFN) does not technically have CIDP, but. some doctors will refer to any SFN that they think is immune-mediated as CIDP. CIDP and an immune-mediated SFN may be treated with similar therapies.
SFN is very common in people with MCAS
Yes. But we do not know how to predict who will improve and who will not.