putations may be necessary.
Many treatments are available to relieve the pain and discomfort of PAD and neuropathy. Drug treatment is often the first one offered. For PAD, pain relievers, blood thinners, and other drugs that improve blood flow may be prescribed. Drugs prescribed for peripheral neuropathy include pain relievers, certain antidepressants and anticonvulsants, and, as a last resort, narcotics. However, many medicines have side effects and may not be tolerated. For neuropathy, there are also ointments for topical use and therapies such as transcutaneous electrical nerve stimulation (TENS), which uses electricity to block pain signals, and monochromatic infrared energy therapy, which uses near-infrared energy to increase blood flow and relieve pain. Vascular surgeries such as angioplasty or bypass may be used to treat severe PAD, and surgery to relieve nerve compression can help certain types of neuropathy.
If the immediate problem is limited blood flow, a simple and inexpensive complementary therapy is a guided relaxation and biofeedback method called WarmFeet. This trademarked mind–body technique can increase blood flow to the periphery of the body and relieve pain. Regular practice of the WarmFeet technique also provides side benefits such as lower blood pressure and improved coping skills, both quite useful for people with diabetes.
How relaxation helps
Have you ever wondered why putting your feet up and relaxing after a long day feels so good? There is a physiological explanation. The body’s reactions to stress and relaxation fall at opposite extremes on the continuum of nervous system activity. The nervous system generally maintains a balance between its sympathetic (action oriented) division and its parasympathetic (rest and recovery) division. Stress provokes the “fight or flight” response of the sympathetic division, which increases heart rate, blood pressure and blood glucose levels and increases blood flow to the brain, heart and skeletal muscles. These effects are often prolonged by the release of stress hormones. Relaxation, on the other hand, provokes an increase in parasympathetic activity, which reduces heart rate and blood pressure and routes blood away from the muscles and vital organs and toward the digestive system and the skin. This increased blood flow to the skin warms it and increases the amount of oxygen and nutrients available to the periphery of the body.
When the body relaxes, it also uses carbohydrates more efficiently: Blood glucose levels may decrease 2–4 hours after relaxation. For people who use insulin, it is important to be aware of this possibility. Monitoring blood glucose levels more frequently when starting a formal relaxation program is therefore advisable.
The WarmFeet technique
WarmFeet is a standardized technique designed to take advantage of the body’s natural relaxation response, which widens the peripheral blood vessels and improves circulation in the hands and feet. Inducing relaxation is the first step of the technique: Instructions on a CD or audiotape prompt the user to release tension through conscious muscle relaxation and breath work.
The second step involves visualization, in which a person imagines comfort or warmth around his feet. Visualization, or forming a mental image, is often used in stress reduction and self-healing and has played a successful role in the treatment of various illnesses. It is particularly helpful when the body is in a relaxed state. As a component of the WarmFeet technique, visualization permits the feet to feel even warmer or more at ease. Healthy outcomes or desired healing can also be visualized, and remembering the beauty and strength of the legs and feet at an earlier age is another very encouraging and powerful image. The WarmFeet recording suggests various images that can be used during the visualization portion of the relaxation session.
The third key component of the WarmFeet technique is called assisted thermal biofeedback. Biofeedback is a method in which people use measured information about changes in bodily processes t