is defined as a functional disturbance or pathological change in the peripheral
nervous system. Symptoms of neuropathy include sensory loss,
muscle weakness and atrophy, and pain. Etiologies of neuropathy include trauma,
infection by micro-organisms, drugs, nutritional deficiency, metabolic
disorders, malignancy, and unknown causes. Due
to the wide range of causes, treatment varies. Herbal treatment of neuropathy
focuses on relieving symptoms (pain) and the cause (such as poor circulation,
increased cellular pressure, trauma, and infection).
According to traditional Chinese
medicine, peripheral neuropathy, polyneuropathy, diabetic neuropathy, distal
polyneuropathy, neuralgia, and fibromyalgia have various etiologies. However, they all share one common factor –
pain due to blood stagnation. Therefore, Flex (NP) is
formulated to treat nerve pain by activating blood circulation and eliminating
Tao Ren (Semen Persicae) and Hong Hua (Flos Carthami) are
often paired together to synergistically invigorate blood circulation and
remove blood stagnation. Ru Xiang (Gummi
Olibanum), Mo Yao (Myrrha), Chuan Niu Xi (Radix Cyathulae), and Yan Hu Suo
(Rhizoma Corydalis) together invigorate blood circulation and relieve
pain. Er Cha (Catechu) and Xue
Jie (Sanguis Draconis) promote the generation of new tissues. Mu Dan Pi (Cortex Moutan) moves blood and clears
heat associated with local inflammation due to blood stagnation. Dang Gui (Radix
Angelicae Sinensis), Dang Gui Wei (Extremitas Radix Angelicae Sinensis),
Chuan Xiong (Rhizoma Chuanxiong), and Lu Lu Tong (Fructus Liquidambaris) open
the channels and collaterals to relieve pain by invigorating blood circulation
to the extremities. Fu Ling (Poria) is
used to strengthen the middle jiao to
promote absorption of the herbs.
Huang (Radix et
Rhizoma Rhei) clears heat, removes blood stasis and helps with blood
circulation. Bai Shao (Radix Paeoniae
Alba) softens the Liver and benefits the tendons and sinews to relieve
tightness, numbness, tingling, and pain. Chuan Mu Xiang (Radix Vladimiriae) invigorates qi
circulation in the channels to assist the overall pain-relieving effects of
Jiao (Radix Gentianae Macrophyllae), Qiang Huo (Rhizoma et Radix Notopterygii), Huang Jin Gui (Caulis Vanieriae), Mo Gu Xiao (Caulis Hyptis
Capitatae), and Liu Zhi Huang (Herba Solidaginis) are used to relieve pain
in the joints and extremities.
Da Zao (Fructus Jujubae) and Gan Cao (Radix et
Rhizoma Glycyrrhizae) are used to harmonize the formula and the middle jiao.
summary, Flex (NP) contains herbs that invigorate blood
circulation and eliminate blood stasis to treat various presentations of nerve
* This formula is contraindicated
during pregnancy and nursing.
herbal formula contains herbs that invigorate blood circulation, such as Dang Gui (Radix Angelicae Sinensis) and Dang Gui Wei (Extremitas
Radix Angelicae Sinensis). Therefore, patients who are on anticoagulant or
antiplatelet therapies, such as Coumadin
(warfarin), should use this formula with caution, or not at all, as
there may be a higher risk of bleeding and bruising.,,
* The following warning statement
is required by the State of California: “This product contains Da
Huang (Radix et Rhizoma Rhei).
Read and follow directions carefully. Do not use if you have or develop
diarrhea, loose stools, or abdominal pain because Da
Huang (Radix et Rhizoma Rhei) may worsen these conditions and
be harmful to your health. Consult your physician if you have frequent diarrhea
or if you are pregnant, nursing, taking medication, or have a medical
is essential to identify and eliminate the cause(s) of neuropathy, especially
if it is induced by drugs or toxic agents. Without elimination of the offending
agent, treatment will offer only symptomatic relief.
due to nutritional deficiency must be identified and treated accordingly.
Adequate intake of vitamin B complex is beneficial. Though it is uncommon in
developed countries, patients with polyneuropathy due to nutritional deficiency
should be put on vitamin B supplementation.
due to metabolic disorders, such as diabetic neuropathy, must be identified,
and the root cause treated accordingly. Blood glucose levels must be monitored
to ensure that the patient’s levels stay within an acceptable range.
is sometimes more effective than herbs in cases of neuropathy. See
Acupuncture Treatment for treatment protocols.
Diagnosis by Dr. Jimmy Wei-Yen Chang:
Yinqiao pulse, a thin, straight, wiry
pulse found on or extends proximally to the chi position. Yinqiao pulse
is one of the eight extra meridian pulses.
neuropathy due to chronic exposure to harmful toxins and chemicals, add Herbal DTX.
* For diabetic neuropathy, use with Equilibrium.
* To potentiate the effect to relieve pain,
add Herbal ANG.
nerve pain in the neck and shoulder area, add Neck & Shoulder (AC)
or Neck & Shoulder (CR).
nerve pain in the arm (shoulder, elbow, and wrist), add Arm Support.
nerve pain in the lower back, add Back Support (AC) or Back Support (CR).
* For nerve pain in the back from herniated
disk, add Back Support (HD).
nerve pain in the knees, add Knee & Ankle (AC) or Knee & Ankle (CR).
nerve pain with chronic
musculoskeletal disorder with damaged soft tissues (muscles, tendons,
ligaments), add Flex (MLT).
With excess heat, add Gardenia Complex.
With severe blood stagnation, add Circulation (SJ).
For lymphedema, add Resolve (AI).
Tou Jia Ji, local ah shi points
* Hegu (LI 4),
Shenshu (BL 23),
Pishu (BL 20),
Sanyinjiao (SP 6),
Taichong (LR 3)
Master Tung's Points:
* Peripheral neuropathy: Erjiaoming (T 11.12), Wanshunyi
(T 22.08), Wanshuner
(T 22.09), Tianhuang (T 77.17), Dihuang (T 77.19), Renhuang (T 77.21), Zhengshi
(T 77.03), Zhengjin (T 77.01), Zhengzong (T 77.02). Bleed Weizhong (BL 40), Sihuashang (T 77.08), Sihuawai
(T 77.14), Sihuazhong (T 77.09), Sihuali (T 77.13), Sihuafu (T 77.10), Sihuaxia
(T 77.11) or dark veins nearby. Bleed before needling for best result.
Tung’s Points by Dr. Chuan-Min Wang:
* Neuropathy: Zhongjiuli (T 88.25), Qili (T 88.51)*, Sizhi (T 77.20),
Renhuang (T 77.21)
Method by Dr. Richard Tan:
area, Adrenal Gland, Lung
magnetic balls and switch ears every five days.
Medicine by Dr. Li-Chun Huang:
* Peripheral neuropathy: Large Auricular
Nerve, Lesser Occipital Nerve, and corresponding points (fingers, toes). Bleed
* Intercostal neuralgia: Intercostal Area,
Large Auricular Nerve, corresponding points (to the area affected)
points: Liver, Gallbladder, Chest, Occiput
* Diabetes mellitus: Diabetes Point, Pancreas, Ear Center, Pituitary, Thalamus, San Jiao, Endocrine
numbness in the extremities, add Lesser Occipital Nerve, Large Auricular Nerve
balance is essential in the treatment and prevention of neuropathy. It is
important to make sure that there is adequate intake of various nutrients in a
well-balanced diet. If necessary, supplement the diet with vitamins and
the intake of foods that contain thiamine (vitamin B1), such as
whole grains and green vegetables, to maintain nerve health. Do not consume
white sugar and white flour products, as they deplete the body of B vitamins.
control over blood glucose levels is essential in patients with diabetic
neuropathy. Diet, exercise, and herbal treatment will be extremely beneficial
in maintaining normal blood glucose levels.
pain can be relieved with light massage using a solution of apple cider vinegar
water, which is made by mixing ˝ cup apple cider vinegar with 2 cups of warm
of hot wraps for half an hour is also effective to relieve pain.
exposure to toxic agents or industrial poisons that cause nerve damage, such as
carbon monoxide, heavy metals (especially lead or mercury), and many chemical
not take harmful drugs that cause nerve damage, such as antibiotics
(sulfonamides, nitrofurantoin, chlorobutanol),
antiseizure drugs (phenytoin), sedatives (barbital, hexobarbital) and
anticancer drugs (vinca alkaloids).
a 44-year-old female marathon runner, presented with a Baker’s cyst on her left
knee, previously diagnosed by an MRI, measuring out to be 4 cm in diameter.
Objective findings were pain and swelling that were limiting her ability to walk
and run. The practitioner diagnosed this condition as stagnation of qi and
blood within the channels, as well as heat toxin and accumulation of phlegm. Resolve (AI) and Flex (NP) were prescribed at 3 grams three times a day at a 2:1
ratio. After one month of taking the herbs, the cyst was almost completely
resolved. The formula was then modified to address the residual inflammation and
stagnation in the channels. Thereafter, the client was able to begin long
distance running again without further problems. Other than that condition, the
patient was in excellent health. She had eliminated coffee from her diet and
started eating anti-inflammatory foods while being treated for the cyst. Submitted
by E.Z., Portland, Oregon.
a 55-year-old female, presented with extreme pain in both heels, radiating up
the calf area. Symptoms of night sweats, problems with staying asleep, low
energy, and depression were also present. Her pulse was weak and thin, and her
tongue was red with thin white coating. The practitioner diagnosed this
condition as Liver qi stagnation and Kidney yin deficiency. Upon diagnosis, the
patient was prescribed Flex (NP) and Circulation (SJ). The
patient reported less pain; however, it was still present especially in the
morning and late in the day after standing a lot. Her sleep improved as well to
waking up only once during the night. The patient continued to improve; however,
effort on her part was necessary to improve more. Submitted by B.L., Fort Myers,
a 55-year-old female, presented with pain located on the right foot, numbness and
tingling along the neck, and pain shooting down the back legs. The patient was
also complaining about hot flashes and night sweating. Objective findings
included pain upon palpation of the joints and red cheeks. The TCM diagnosis
was qi and blood stagnation with yin deficiency; her Western diagnosis was RSD
(reflex sympathetic dystrophy). Flex (NP) was prescribed at 2 to 3
capsules twice a day. After taking the herbs, the patient experienced less pain
in the arm and neck, but pain in the right foot was still present, and she was
experiencing slight stomach discomfort. The patient was directed to take a
higher dosage if tolerable. Submitted by M.P., Muskego, Wisconsin.
a 52-year-old female, presented with body aches over the entire body along with swelling of the legs. Additional symptoms included low grade fever, sore throat,
and low energy. The patient had been previously diagnosed with Lyme disease.
Her pulse was thin and weak and her tongue was pale and dull with thin white
coating. The practitioner diagnosed this condition as general qi and blood
stagnation with Spleen qi deficiency. For treatment, patient was instructed to
take Resolve (AI) and Flex (NP) in conjunction with acupuncture treatment. As a
result, the patient’s energy increased, the pain lessened, and the sore throat
was no longer present. Additional treatment the patient had received was
lymphatic massage which also had helped her improve. Submitted by B.L., Fort
a male patient, suffered from intolerable neuropathy after receiving
chemotherapy and radiation for throat cancer. He conducted an empirical test on
himself in which he took Flex (NP) for one week and did not
take it for another. He reported that the week without the Flex (NP) was nearly
intolerable. But with it, he is “in the zone” and is able to sleep. Flex (NP) has reduced his neuropathic symptoms by a good 50%. Submitted by
C.W., Carpinteria, California.
59-year-old male was stung by a sea urchin while diving in Hawaii four months
prior to coming in for treatment. The spines of the sea urchin went into his
hand. The black marking of the sting are all gone, but he had difficulty moving
his fingers with limited movement of his fingers and hand. His tongue was dusky
and swollen with a sticky coat. His pulses were wiry and slippery. After taking
Flex (NP) and Astringent Complex for 15 days, in conjunction with
acupuncture, the patient was completely healed. Submitted by K.M., Albany,
36-year-old diabetic (Type 1) female presented with severe neuropathy of her
hands along with chronic fungal and bacterial infections, sores all over her
lower limbs, feet numbness, severe fatigue, malaise and weakness. Besides her
diabetes, she also was diagnosed with kidney failure as well as immune
deficiency due to immuno-suppressants. She had a kidney transplant as a result
of her kidney failure. The TCM practitioner diagnosed her condition as severe
Kidney jing (essence) deficiency with underlying Spleen
qi deficiency, damp-heat, and qi and blood stagnation. Her circulation was
severely impaired along with noticeable signs of wasting and thirsting. The
patient prescribed an herbal combination of Flex (NP) (3 to 4
capsules three times daily) and a customized special formula to tonify her
Spleen qi, move the blood, and circulate the qi. The patient experienced relief
from her hand pain within two to three days. Although stinging sensations still
persisted, the pain was less in occurrence and intensity. Her sores and warts
displayed signs of improvement as well as becoming less visible. Submitted by A.R.,
a 57-year-old female, presented with pain in the leg and big toe with pressure,
metallic taste, absence of thirst, heat sensations except in the hands and feet,
and upper body sweating. She had been exposed to toxic chemicals and pesticides
for six months. The TCM diagnosis was yin deficiency with heat, damp-heat and
toxic heat accumulation, and bi zheng (painful obstruction syndrome)
of the legs. After six weeks of taking Liver DTX, Balance (Heat) and Flex (NP), she experienced less leg pain,
decreased sweating, subsiding heat sensations, and warmer hands. The patient
still had a metallic taste in the mouth. The patient was also advised to
increase her intake of carrot juice and cucumbers. Submitted by M.C., Sarasota,
AND CLINICAL RESEARCH
Flex (NP) is formulated specifically to treat nerve pain, such as in various
presentations of neuropathy and neuralgia. The main signs and
symptoms include pain, numbness, sensory loss, and muscle weakness and atrophy.
Optimal treatment of neuropathy and neuralgia requires use of
herbs to alleviate the symptom (pain) and the cause (poor circulation,
increased cellular pressure, trauma, infection, and others).
Pharmacologically, Flex (NP)
utilizes many herbs with excellent analgesic effects to alleviate pain and anti-inflammatory
activity to reduce inflammation. Dang
Angelicae Sinensis), Bai
Paeoniae Alba), Gan
Cao (Radix et
Rhizoma Glycyrrhizae) and Qiang
Huo (Rhizoma et
Radix Notopterygii) all have an analgesic
effect to alleviate pain.,,,,, Mu Dan Pi (Cortex Moutan) and Qin Jiao (Radix
Gentianae Macrophyllae) have an anti-inflammatory
effect to reduce swelling and inflammation.,, More specifically, nerve-related
pain, such as trigeminal pain, responds remarkably to such herbs as Chuan Xiong (Rhizoma Chuanxiong), Bai Shao (Radix Paeoniae Alba), and Gan
Cao (Radix et Rhizoma Glycyrrhizae)., Injury-related pain, such as pain of
the extremities, responds equally well to herbs such as Ru Xiang (Gummi Olibanum), Mo Yao (Myrrha), Yan Hu Suo (Rhizoma Corydalis), Bai Shao (Radix Paeoniae Alba), and Gan
Cao (Radix et Rhizoma Glycyrrhizae).,
Clinically, many herbs in Flex
(NP) have been used successfully to treat various types of nerve pain. The combination of Bai Shao (Radix Paeoniae Alba) and Gan Cao (Radix et Rhizoma Glycyrrhizae)
has a marked analgesic effect, and has been used successfully to treat
trigeminal neuralgia,, and sciatica. Chuan Xiong (Rhizoma
Chuanxiong) exerts an anti-inflammatory
effect via an inhibitory activity on TNF-α production and TNF-α
bioactivity, and is used clinically to
treat trigeminal nerve pain and trigeminal neuralgia., Dang Gui (Radix Angelicae Sinensis)
exerts both analgesic and anti-inflammatory effects through the inhibition of
pro-inflammatory mediators, including nitric oxide and prostaglandin E2 in
In comparison with acetylsalicylic acid, the anti-inflammatory effect of Dang Gui (Radix Angelicae Sinensis)
is approximately 1.1 times stronger, and its analgesic effect is approximately
1.7 times stronger.
Lastly, Yan Hu Suo (Rhizoma Corydalis) is one of the strongest
and most potent herbs for treatment of pain. According to laboratory studies,
the extract of Yan Hu Suo (Rhizoma Corydalis) has been found to be
effective in both acute and chronic phases of pain and inflammation.
Furthermore, with appropriate adjustment of dosage, its analgesic effect is
comparable to that of morphine. Lastly, it has been demonstrated
that the analgesic effect of Yan Hu Suo (Rhizoma Corydalis)
is increased significantly with concurrent treatments with electro-acupuncture.
In addition to relieving the symptoms
(pain), Flex (NP) contains many herbs to treat the causes of
neuropathy and neuralgia (poor circulation,
increased cellular pressure, trauma, infection, and others). Poor circulation
is a significant factor contributing to neuropathy and hindering its recovery. Tao Ren (Semen Persicae), Hong Hua (Flos Carthami), Chuan Xiong (Rhizoma Chuanxiong) and Mu Dan Pi (Cortex Moutan) have
pronounced influence on improving blood circulation, increasing
microcirculation to peripheral parts of the body, eliminating blood stasis, and
facilitating recovery.,,, Increased cellular
pressure is another contributor to neuropathy. Mu Dan Pi
(Cortex Moutan) is used to reduce swelling and pressure in the periphery
of the body by inhibiting prostaglandin synthesis and decreasing permeability
of the blood vessels., Trauma is another common
cause of neuropathy. Ru
Olibanum), Mo Yao (Myrrha) and Yan Hu Suo
(Rhizoma Corydalis) are commonly used in treatment of trauma and sports
injuries. Tao Ren (Semen Persicae) is also
effective to facilitate recovery from injuries. Certain injuries that damage both
nerves and soft tissue, such as frostbite, can be treated with Dang Gui (Radix Angelicae Sinensis),
Gan Cao (Radix et Rhizoma Glycyrrhizae),
and other herbs., Furthermore, infection
and its complications also contribute to neuropathy. There are many herbs with
remarkable antibiotic properties, such as Er Cha
(Catechu), Xue Jie
(Sanguis Draconis), and Mu Dan Pi (Cortex Moutan). Lastly, exposure to drugs and toxic agents are two of the main
causes of neuropathy. While elimination of these offending agents is the best
solution, it is not always possible to discontinue the drugs or completely
eliminate exposure to toxic chemicals. Under these circumstances, the drugs and
the toxic chemicals accumulate in the body and adversely affect the nerves. Gan Cao (Radix et
Rhizoma Glycyrrhizae) is prescribed to remedy these kinds of poisoning.
It is one of the most effective detoxifying herbs for treatment of
physiological insults, including drug poisoning (chloral hydrate, urethane,
cocaine, picrotoxin, caffeine, pilocarpine, nicotine, barbiturates, mercury and
lead), food poisoning (tetrodotoxin, snake, and mushrooms), and others
(enterotoxin, herbicides, pesticides). The exact mechanism of this action is
unclear, but it is thought that it is related to the regulatory effect of Gan Cao (Radix et
Rhizoma Glycyrrhizae) on the endocrine or hepatic systems.
In summary, Flex (NP) is
an effective formula for treatment of neuropathy and neuralgia. It contains herbs
that relieve the symptoms and the cause, and achieves both short- and long-term
basic bodily sensation induced by a noxious stimulus that causes physical
discomfort (such as pricking, throbbing, or aching). Pain may be of acute or chronic state,
and may be of nociceptive, neuropathic, or psychogenic origin. For
neuropathic pain of acute or chronic origins, the drugs of choice include antiseizure
[Dilantin (phenytoin) and
and antidepressant drugs [Elavil
(amitriptyline)]. Though effective, these drugs are associated with
numerous and significant side effects. Antiseizure drugs cause side effects
such as bleeding, burning sensations, clumsiness or unsteadiness, confusion,
irregular eye movements, blurred or double vision, swollen glands in neck or
underarms, slurred speech, delusions, dementia, bone malformations, and many
others. Antidepressant drugs cause blurred vision, confusion or delirium,
hallucinations, constipation (especially in the elderly), problems in urinating,
decreased sexual ability, difficulty in speaking or swallowing, eye pain,
fainting, fast or irregular heartbeat, loss of balance control, mask-like face,
nervousness or restlessness, slowed movements, stiffness of arms and legs, and
shortness of breath or troubled breathing. In short, these drugs should be
prescribed only when benefits significantly outweigh the risks. Furthermore,
use of these drugs must be monitored carefully to avoid developing serious side
effects and complications.
of pain is a sophisticated balance of art and science. Proper treatment of pain
requires a careful evaluation of the type of disharmony (excess or deficiency,
cold or heat, exterior or interior), characteristics (qi and/or blood
stagnations), and location (upper body, lower body, extremities, or internal
organs). Furthermore, optimal treatment requires integrative use of herbs,
acupuncture and tui-na therapies. All these therapies work together to
tonify the underlying deficiencies, strengthen the body, and facilitate
recovery from chronic pain. TCM pain management targets both the symptom and
the cause of pain, and as such, often achieves immediate and long-term success.
Furthermore, TCM pain management is often associated with few or no side
treatment of mild to severe pain due to neuropathic causes, TCM pain management
offers similar treatment effects to those of pharmaceuticals, with significantly
fewer side effects.