Diabetes can result in multiple complications including nerve damage and other side effects. When blood glucose levels are not kept within the proper range, diabetic peripheral neuropathy (DPN) may occur resulting in moderate to severe foot pain, numbness and weakness. Diabetic peripheral neuropathy is a serious side effect of diabetes and affects as many as 50% of diabetic patients. Read further to learn more about foot pain associated with diabetic complications and how it can be treated.
Symptoms of Peripheral Neuropathy
Peripheral neuropathy is the most common type of neuropathy from nerve damage usually presenting in the foot, leg and arms. The most common symptoms including pins and needles, tingling, burning stabbing, or shooting pains in the feet, with many of these symptoms felt at night. It can also present itself as sensitivity or pain to the touch.
For patients experiencing Peripheral Neuropathy due to Diabetes, the following symptoms may also occur:
- No feeling in feet when walking
- Muscles in feet and legs are weak
- Feeling unsteady when walking or standing
- General weakness
- Feeling no pain even with an injury or blisters
- Trouble feeling heat or cold
- Sores or ulcers on feet or legs heal very slowly
Diabetic peripheral neuropathy is a serious side effect of diabetes and as many as 50% of diabetics suffer from it.
Treating Diabetic Peripheral Neuropathy
It is important to contact your health care provider if you are experiencing neuropathic pain symptoms as a result of diabetes. Your physician will help guide you through the diagnosis and treatment options. It is imperative to receive clearance from your physician before beginning a treatment plan.
Diagnosing Diabetic Neuropathy
Along with a physical exam, your health care provider may perform or order specific tests to help diagnose diabetic neuropathy, such as:
- Filament testing: A soft nylon fiber (monofilament) is brushed over areas of your skin to test your sensitivity to touch.
- Sensory testing. This noninvasive test is used to tell how your nerves respond to vibration and changes in temperature.
- Nerve conduction testing. This test measures how quickly the nerves in your arms and legs conduct electrical signals.
Diabetic neuropathy has no known cure. The goals of treatment are to:
- Slow progression
- Relieve pain
- Manage complications and restore function
- Slowing progression of the disease
Consistently keeping your blood sugar within your target range is the key to preventing or delaying nerve damage. Good blood sugar management may even improve some of your current symptoms. Your health care provider will figure out the best target range for you based on factors including your age, how long you’ve had diabetes and your overall health.
Blood sugar levels need to be individualized. But, in general, the American Diabetes Association (ADA) recommends the following target blood sugar levels for most people with diabetes:
Between 80 and 130 mg/dL (4.4 and 7.2 mmol/L) before meals
Less than 180 mg/dL (10.0 mmol/L) two hours after meals
The American Diabetes Association (ADA) generally recommends an glycated hemoglobin (A1C) of 7.0% or lower for most people with diabetes.
Pain Relief Treatments
Many prescription medications are available for diabetes-related nerve pain, but they don’t work for everyone. When considering any medication, talk to your health care provider about the benefits and possible side effects to find what might work best for you.
Pain-relieving prescription treatments may include:
- Anti-seizure drugs. Some medications used to treat seizure disorders (epilepsy) are also used to ease nerve pain. The ADA recommends starting with pregabalin (Lyrica). Gabapentin (Gralise, Neurontin) also is an option. Side effects may include drowsiness, dizziness, and swelling in the hands and feet.
- Antidepressants. Some antidepressants ease nerve pain, even if you aren’t depressed. Tricyclic antidepressants may help with mild to moderate nerve pain. Drugs in this class include amitriptyline, nortriptyline (Pamelor) and desipramine (Norpramin). Side effects can be bothersome and include dry mouth, constipation, drowsiness and difficulty concentrating. These medications may also cause dizziness when changing position, such as from lying down to standing (orthostatic hypotension).
- Sympathetic Nerve Blocks
- Nerve stimulation
Nerve Blocks – Non-steroidal
Lumbar Sympathetic Nerve Blocks are also a great alternative to medication. This procedure is done at Tennessee Valley Pain Consultants in our dedicated procedure suites. The nerve block is performed in the lumbar spine (lower back) and is non-steroidal as not to elevate a patient’s sugars. The procedure blocks the pain transmitters sent through the sympathetic nerve while preserving sensation in the feet.
If you would like a consultation for Diabetic Nerve Pain Treatment, please contact us at (256) 265-7246 to schedule an evaluation and discuss a personalized treatment plan. Or request an appointment online in the upper right hand corner.
This post was written by Tennessee Valley Pain Consultants