Q. I have chronic pain in my feet and legs, and the doctor calls it "peripheral neuropathy." What is it, and will acupuncture help?

A. Peripheral neuropathy is chronic pain, numbness or weakness — most commonly in the feet, legs, hands or arms — caused by nerve damage outside the brain or spinal cord. According to the National Institute of Neurological Disorders and Stroke, peripheral neuropathy can be caused by physical injury to a nerve, tumors, toxins, autoimmune diseases, nutritional deficiencies, alcoholism — and even vascular and metabolic disorders such as diabetes. It is most commonly caused by diabetes and exposure to toxins such as smoke, alcohol, heavy metals and certain medications, particularly those used to treat cancer. It primarily affects the elderly, but can be seen in patients at all ages.

Patients with peripheral neuropathy often complain of numbness, but could also feel the opposite — excessive tingling in their hands and feet. The symptoms spread upward into the legs and arms and can feel like wearing a thin stocking or glove. Patients may also experience muscle weakness, lack of coordination or paralysis if motor nerves are affected. It is important to treat, because untreated peripheral neuropathy may progress to infection, gangrene and eventual amputation.

In many cases, symptoms improve with time — especially if caused by a treatable underlying condition. A number of medications are used to reduce the painful symptoms.

Research supports treating peripheral neuropathy with acupuncture, which in traditional Chinese medicine means improving qi (or chi) motion and cleaning blood stagnation by inserting needles near the patients' affected areas. In most cases the needles will not cause discomfort, and many patients say the sensations are enjoyable. If there is pain or a pinching sensation, the patient must let the acupuncturist know so the needles can be reinserted into a nearby location.

The needles should cause sensations of warmth, tingling, tightness or electric shocks — referred to "getting the qi."

It is theorized more qi to the patient results in more effect from the treatment. After the needle is inserted, it will be turned for a while to increase stimulation. In some cases, electric stimulation may be applied to the needles for 20 to 30 minutes to increase the stimulation.

Each treatment may help to decrease some degree of the pain and improve the sensation on the patient. However, multiple acu-puncture sessions may be needed before one notices improvement.

It is essential to manage peripheral neuropathy through control of the underlying disease, with your doctor's advice. This may require lifestyle changes including careful care of the feet (especially in people with diabetes), exercising, ceasing smoking, eating healthful meals, taking appropriate medication, and massaging and keeping the hands and feet warm.

Dr. Mian Long is a China-trained physician- acu-puncturist and an assistant clinical professor at the University of Hawai'i John A. Burns School of Medicine. Reach her at 692-0908.