Around 50% of people with diabetes develop diabetic peripheral neuropathy during their lifetime. Diabetic neuropathy often interferes with mobility, getting a good night’s sleep, and many everyday activities. It can also reduce sensation, allowing injuries to go unnoticed.
Treatment needs to address both the discomfort you feel and the protective sensation you may lose. At Advanced Pain Management, we help patients understand their nerve pain and explore treatments that support daily function. Here’s what you should know about diabetic neuropathy and how to manage it.
Diabetes causes high blood sugar and elevated blood fats. Over time, these problems can damage your nerves and the blood vessels that supply them with oxygen and nutrients. The result is disruption of the communication channels between your nerves and brain.
Diabetes can affect several types of nerves, including those that control digestion and bladder function. However, peripheral neuropathy — the type that typically affects your feet and legs — is the most common. It can eventually affect your hands and arms, too.
Your risk increases the longer you have diabetes. High blood pressure, high cholesterol, and smoking can also contribute, so protecting nerve health involves more than monitoring blood sugar.
Peripheral neuropathy often starts in the toes and feet. Symptoms include:
Pain may worsen at night and disrupt your sleep. Some people experience numbness without significant pain; this still requires medical attention, because losing sensation could prevent you from noticing a blister, cut, or other injury.
We review your symptoms and medical history, then examine your feet and check sensation, balance, and circulation. We use a thin nylon filament to assess whether you can feel light pressure, and a tuning fork to test vibration sensation.
Having diabetes doesn’t automatically explain every episode of tingling or numbness, so we may also order blood tests to check for other causes of nerve symptoms, such as vitamin B12 deficiency or thyroid disease. Identifying additional causes helps us choose the right treatment for you.
Treatment aims to slow further damage, relieve symptoms, and protect your mobility. However, current treatments don’t reliably reverse established diabetic nerve damage, so the earlier you act, the better.
It’s vital to work with your diabetes care team to reach blood sugar targets that suit your health needs. Managing blood pressure and cholesterol, avoiding smoking, and following a sustainable eating and activity plan also support nerve health.
Regular blood tests and blood sugar management play a particularly strong role in preventing or delaying neuropathy in Type 1 diabetes. In Type 2 diabetes, a broader approach that addresses several risk factors is essential.
We may prescribe medicines like duloxetine, pregabalin, or gabapentin. These drugs act on the nerves to reduce pain signaling. Certain topical medicines can also help localized discomfort. We consider your other medications, health conditions, and possible side effects when choosing treatment.
Common pain relievers like ibuprofen often provide limited relief for nerve pain. If your medication doesn’t help enough or causes troublesome side effects, we can explore other options.
If diabetic nerve pain continues despite other treatments, we may consider spinal cord stimulation. The FDA has approved certain stimulation systems for persistent pain associated with diabetic neuropathy.
We use a device that delivers electrical pulses through thin leads near the spinal cord to change pain signaling. A temporary trial will assess how well the device reduces your pain before you consider a permanent implant.
If surgery is indicated, we review your overall health and suitability for it. Stimulation aims to manage pain; it doesn’t replace diabetes treatment or daily foot care.
Foot care includes checking your feet daily, including the soles and between your toes. Wear properly fitting shoes and socks, avoid walking barefoot, and arrange regular professional foot examinations.
Contact your doctor promptly if you notice a blister, open sore, redness, swelling, or a change in foot color or temperature. Don’t wait for pain to alert you to an injury.
This Diabetes Awareness Month, make nerve health a priority. Schedule an evaluation at one of Advanced Pain Management’s offices in Tucson, Arizona, or the Phoenix, Arizona, area by phone or online to discuss treatment for diabetic nerve pain.
