Diabetic Nerve Pain Treatment Options and Symptoms

23 Jan
Diabetic Nerve Pain, also known as neuropathy or Diabetic Peripheral Neuropathy, is a nerve disorder common in those who have diabetes. Some people with this nerve damage show no symptoms, while others may feel pain, tingling, or numbness in the hands, arms, feet, toes, or legs.
peripheral neuropathy diabetic nerve pain

Courtesy of NIH

Diabetes is not the only cause of neuropathies – they may also result from vitamin deficiencies (B-12 and Folate), chemical exposures, pressure on nerves, or certain medications, especially those used in AIDS therapies and chemotherapy.

Roughly 70% of people with diabetes will develop some form of neuropathy, including Diabetic Nerve Pain. It can appear at any time during the progression of the disease, but the risk increases with age and the duration of the illness. According to the U.S. Department of Health and Human Services,  The highest rates of neuropathy are among people who have had diabetes for at least 25 years. Diabetic neuropathies also appear to be more common in people who have problems controlling their blood glucose, also called blood sugar, as well as those with high levels of blood fat and blood pressure and those who are overweight.

The early symptoms of diabetic nerve pain are a slight tingling or numbness in the extremities. As the disease progresses, and nerves are further damaged, the tingling or numbness becomes painful and may be quite severe. When these symptoms appear in the feet, hands, or legs, it’s known as Peripheral Neuropathy, and when caused by diabetes, Diabetic Peripheral Neuropathy.

Symptoms of Diabetic Peripheral Neuropathy include

  • Numbness or insensitivity to pain or temperature
  • A tingling or burning sensation
  • Pains or cramping
  • Extreme sensitivity to touch
  • Loss of balance or coordination

How are nerves damaged by diabetes?

Vascular and neural diseases are closely related. Blood vessels depend on nerves, and nerves depend on blood vessels. Scientists know that prolonged exposure to high blood sugar damages nerve fibers, but exactly how that happens is still a matter of debate. What they know for sure is that high blood glucose interferes with the ability of nerves to transmit signals, and weakens the walls of capillaries (tiny blood vessels) that supply nerves with nutrients. When nerves don’t receive enough oxygen and nutrients from blood vessels, cells begin to die, and nerves don’t function properly. Other risk factors for nerve damage of this type are smoking, alcohol abuse, and certain genetic factors unrelated to diabetes.

What you can do to avoid DPN

The best way to avoid DPN or to minimize nerve damage once it begins, is to keep your blood sugar under control, exercise regularly, and see your physician on a regular basis to test you for symptoms. According to John Hare, MD, Medical Director of Joslin Diabetes Center’s Affiliated Centers program, “people who keep their blood sugars consistently in [a] healthful range can decrease their risk of nerve damage by more than 50%. Getting diabetes under better control also may help limit the amount of damage caused by neuropathy once it’s developed.” 

In addition to a diabetes specialist, a podiatrist should also be a member of your diabetes health team. Early symptoms of DPN typically appear first in the feet, and may go unnoticed by the patient. Podiatrists are experts at detecting these symptoms, and early intervention can avoid further damage to the blood vessels and nerves.

Treatments for Diabetic Peripheral Neuropathy

Early in its development, the pain and tingling of DPN can be managed with over the counter pain medicine like acetaminophen (tylenol), aspirin, or ibuprofen (advil, motrin). Some also find relief with over the counter pain creams which contain capsaicin, an extract of hot peppers like cayenne and tabasco peppers. It’s believed that these creams block pain signals, but they’re not effective for everyone. As the disease progresses and pain intensifies, your physician may prescribe narcotic pain killers, medicines such as Lyrica, or anti-depressants such as Cymbalta, which are also approved to relieve some types of severe pain.

A highly effective treatment used by the podiatrists at PA Foot and Ankle Associates is MicroVas, originally developed by the U.S. military to treat hypothermia in Navy SEALS. This non-invasive, pain-free therapy uses electronic impulses to cause muscle contraction and relaxation cycles which stimulate circulation. The increased blood flow raises the oxygen level in the tissues, which promotes healing in the nerves and muscles which have been damaged. MicroVas is successful in over 85% of the patients treated, who report reduced pain and improved sensation.


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