Revolutionizing Neuropathy Care
CLINICAL
The Chiropractic Diabetic Foot Exam (CDFE)
Richard E. Busch
III, DC
OVER THE PAST 27 YEARS, the field of neuropathy evaluation and treatment has witnessed numerous modalities and techniques. For healthcare practitioners committed to helping patients with various neuropathic conditions, staying updated on the latest advancements is essential. Recently, we discovered a game-changing approach to diabetic foot examinations known as the Chiropractic Diabetic Foot Exam (CDFE), originating from podiatrists. This revolutionary method combines evaluation and patient education, making it a valuable addition to neuropathy practices worldwide.
“Over 150000 people undergo amputations of the lower extremity in the United States each year. This incidence is directly proportional to rates of peripheral arterial occlusive disease, neuropathy, and soft tissue sepsis. This correlation is due to the increased incidence of diabetes mellitus, which is present in eighty-two percent of all vascular-related lower extremity amputations in the United States.”
Molina CS, Faulk JB. Lower Extremity Amputation. [Updated 2022 Aug 22], In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/ NBK546594/
A Comprehensive Approach: Our journey in treating neuropathies, spanning 12 to 15 years, has yielded remarkable results using conventional modalities such as lasers, vibration therapy, and nutrition guidance. Additionally, we’ve successfully implemented a modified version of the Toronto Clinical Scoring System for Neuropathy. However, the CDFE has opened new doors for us, introducing a “see, show, touch” examination approach that resonates with patients suffering from diabetic neuropathies and is adaptable to various neuropathy practices.
Key Components of the Chiropractic Diabetic Foot Exam:
1. Vibrate Tip Sensitivity Testing: - Assesses large fiber neuropathy. - Identifies sensitivity to vibration.
2. Pressure Stat Analysis: - Predicts areas prone to diabetic ulcers by analyzing foot pressure and the need for orthotics. - Helps patients understand their likelihood of developing “danger areas.”
3. NeuroPad for Pseudomotor Neuropathies:
Easily visualized color change (from blue to pink) confirms peripheral neuropathy. Provides a visual way for patients to track their progress.
4. TempStat for Home and Office Use:
Uses infrared technology to detect
potential “hot spots,” indicating the likelihood of future injuries.
5. Hydration and Moisture Index Assessment:
Evaluates skin moisture levels; dry skin increases the risk of cracks and infections.
A hydration level below 33% signals potential problems.
6.Circulation Check:
Monitors blood flow through an infrared thermometer.
Detects decreased temperature as an indicator of reduced blood supply.
7.Footwear Assessment:
Ensures proper footwear fit and determines the need for prescription orthotics.
Collaboration for Success: The Chiropractic Diabetic Foot Exam is part of the ARCH LEAP Collaborative, dedicated to Lower Extremity Amputation Prevention. While its primary purpose is evaluating diabetic neuropathy, when combined with other assessments, it becomes an invaluable tool for diagnosing and treating various neuropathies, both small and large fiber.
Patient Empowerment: The program also offers patients a comprehensive guide to diabetic foot care, applicable to a wide range of neuropathies. This empowerment fosters patient compliance and overall well-being.
Enhancing Treatment Success: Whether employing Low-Level Light therapies, electric modalities like the Re-builder, nutritional guidance, or shockwave therapy, the CDFE enhances overall treatment success rates. Moreover, it is a powerful marketing tool to underscore the importance of proper evaluation, prevention, and orthotic support in neuropathy care. In a future article, I would like to address the implementation and treatment aspects of this powerful tool in the chiropractic profession.
The Chiropractic Diabetic Foot Exam represents a significant leap forward in the prevention and treatment of neuropathies. It transcends traditional boundaries and can be seamlessly integrated into various neuropathy practices. By combining evaluation and patient education, this innovative approach promises better patient outcomes and reinforces the importance of neuropathy care in the public consciousness. It’s a giant stride towards a future where neuropathies are not just treated but also prevented, improving the lives of countless individuals.
Dr. Richard E. Busch III has been in private practice in Fort Wayne, IN since 1996. He has built one of the largest spinal decompression and cash practices in the world. Dr. Busch has also trained many chiropractors and medical doctors in prepaid case fee cash practice. For more information go to Cashmasterpractice.com. 5005 Riviera Ct., Fort Wayne, IN. 888-471-4090 or drbusch@buschchiropractic.com.
