Treating Painful Diabetic Peripheral Neuropathy

The toes burn and tingle and sharp pains shoot into your legs. The bed sheets feel uncomfortable on the feet as you toss and turn, trying to get some rest. Your feet felt numb throughout the day, but now feel like they are on fire. Nothing seems to help as you watch the hours on the clock pass by, hoping to fall asleep.

Burning, numbness, tingling, hot and cold sensations, shooting and electrical pain are common sensations felt at rest in painful peripheral neuropathy. Neuropathy is an abnormality of the nervous system. There are many different types of neuropathy, but the most common neuropathy effecting diabetics is peripheral neuropathy.

Diabetic neuropathy is described as a loss of sensation that starts in the tips of the toes and gradually works its way up the legs, and in severe case into the hands. It is sometimes referred to as a stocking glove neuropathy because it progresses as if one was pulling on a stocking.

Sixty percent of diabetics have some type of neuropathy in their feet. Five percent of diabetics will experience painful diabetic neuropathy and the incidence increases with age. Over 45% of individuals who have had diabetes for over 25 years will experience some symptoms of painful diabetic neuropathy.

The cause of diabetic neuropathy is not clearly understood. Many believe that the damage to the small vessels surrounding the nerves, from the diabetes, causes damage to the nerves. Others believe the increase in blood sugar causes damage to the nerves. Despite the different theories, studies have shown better blood sugar control helps prevent progression of the neuropathy.

There are currently no treatments to help reverse diabetic neuropathy. There are no treatments which help reduce the numbness. But, there are many treatments to help decrease the pain associated with the neuropathy.

Your doctor may prescribe medications to help with the pain. There are many options, but until recently none were FDA approved for the treatment of painful neuropathy. Cymbalta®, duloxetine HCl, was recently approved by the FDA in September of 2004 for use in diabetic peripheral neuropathy at doses of 60 and 120 mg per day. This is the first drug approved for this use. Similar medications, like amitriptyline, desipramine and nortriptyline, have been used to help decrease pain and help with sleep.

Gabapentin, also known as Neurontin®, has been a successful treatment for painful diabetic neuropathy. Neurontin® was originally approved by the FDA for adjunctive use in seizures, but the benefits of this drug for other conditions, like neuropathy, soon became known. The manufacturers of Neurontin® were caught up in a controversy regarding their marketing tactics for this off label use. Many physicians still use this drug despite the controversy. Tegretol and Dilantin, common seizure medications, can be used in more severe cases. New treatments include lidocaine 5% cream, acetyl-L-canitine, nerve growth factor and Annodyne ®, infrared therapy.

To help treat painful peripheral neuropathy without prescription medications, consider the following tips:

1. Keep your blood sugar in control: Studies have shown that when blood sugars remain high, or roller coaster from high to low, peripheral neuropathy will worsen.

2. Exercise. This is probably the last thing you wanted to hear. Exercise helps increase circulation and stimulates the growth of new vessels which help slow the progression of the neuropathy. Exercising also helps to increase your pain threshold and to provide a distraction from the nerve pain in your feet.

3. Eat healthy. Besides helping to control your blood sugar, eating a wide variety of fruits and vegetables will add anti-oxidants to your diet. Anti-oxidants will combat the damaging oxidative effects glucose has on your nerves. In particular, try dark-green, leafy vegetables, yellow, orange, and red fruits and vegetables, citrus fruits and tomatoes.

4. Try red pepper powder. Capsaicin is the active ingredient in chile peppers. When applied to the feet it acts as a counter-irritant and can help decrease neuropathic pain. Capsaicin can be purchased at your local drug store. If you cannot afford capsaicin, try mixing 1 tablespoon of dry chile powder with 2 tablespoons of baby powder. Place the mixture in a sock and use the socks at night.

5. Try alpha lipoic acid. ALA is an effective anti-oxidant that has been shown to relieve pain associated with neuropathy in multiple studies. To help relieve pain, the dose must be at least 600mg a day. It is advisable to start with a lower dose, as higher doses can cause nausea, stomach upset, fatigue, insomnia and can lower blood sugar. In general, ALA is a safe supplement.

6. Try gamma linolenic acid. GLA is an essential fatty acid found in evening primrose oil. Most of the studies have shown modest results, but the possibilities are still encouraging. Take 360mg/day. Many indications require higher dosages, but side effects with long term use at higher doses may include inflammation, thrombosis (blood clots), or decreased immune system functioning.

Treating painful diabetic peripheral neuropathy is very difficult and many of the above mentioned therapies should be tried and combined. Don't expect any "cures" and make sure you give each therapy a chance to work.

Christine Dobrowolski is a podiatrist and the author of Those Aching Feet: Your Guide to Diagnosis and Treatment of Common Foot Problems. To learn more about Dr. Dobrowolski and her book visit http://www.skipublishing.com/ or http://www.northcoastfootcare.com

---

Get More Out Of Life While Managing Your Diabetes

When I was first diagnosed with Type 1 Diabetes at... Read More

Diabetes Awareness: Will They Recognize You?

Imagine how it feels to look younger, feel younger, and... Read More

Diabetes Awareness: The Downside... a New Wardrobe?

Here is some commonsense thinking:I can't understand why anyone who... Read More

Exercise & Diabetes

You are no doubt aware that exercise can help prevent... Read More

Recognizing Early Symptoms Diabetes

Early symptoms diabetesStay alert in recognizing early symptoms of diabetes.... Read More

Benfotiamine And Diabetic Retinopathy

Damage from diabetes can occur in different areas of the... Read More

I Have Diabetes or Another Chronic Condition - Should I Use an HSA?

Health Savings Accounts (HSAs) are becoming quite popular for people... Read More

Becoming a Diabetes Expert

I am a diabetes expert. No I'm not a doctor... Read More

Accu-Check Aviva Glucometer - New for Diabetes Testing

Now you can help make every test strip count as... Read More

Do You Have Diabetes? Symptoms Of Diabetes And How To Address Them

Diabetes mellitus is a condition resulting from the pancreas' inability... Read More

Fanning the Flames of the Diabetes Epidemic

INTRODUCTIONIt is my pleasure to introduce to you, a new... Read More

STAT-LET? Auto Safety Lancets - Makes Diabetes Testing Easy!

Stat Medical Hardware, Inc (SMD) was founded in 1988 and... Read More

Pre-Diabetes - The Calm Before the Storm

Remember when the medical world identified pre-hypertension to better monitor... Read More

Syndrome X - What Is It And Have You Got It?

Syndrome X or the X factor as it is sometimes... Read More

Hyperglycemia, Diabetes, and Managing Blood Sugar

So, after a miserable 10 hours of blood tests it's... Read More

Some Changes Make A Big Difference!

When it comes to diabetes, small changes can make a... Read More

Diabetes

Meal planning includes choosing healthy foods, eating the right amount... Read More

Exercise ? The Only Hope for Diabetes!

Why is it that the smallest paragraph in diabetes prevention... Read More

Diabetes and Fitness

There are two main types of diabetes, type I and... Read More

Improper pH Balance Increases Risk and Damage of Diabetes

THE RISKBlood sugar balance is critical to your body's proper... Read More

Insulin Resistance And Complex Carbohydrates

One of the biggest mistakes that weight loss failures make... Read More

Revolutionary Lancet Device for Diabetic Glucose Testing

Now you can reduce the pain and inconvenience of testing.... Read More

Diabetes - A National Epidemic

Are you a diabetic? If so, you are definitely not... Read More

Diabetes Has Become A Risk in Mens Life

This is true that men with diabetes have an increased... Read More

If You Have Diabetes, You May Be Entitled To No Cost Diabetic Supplies

This article is intended to inform people with diabetes in... Read More

Protein Principles for Diabetes

Dietary considerations can present a Hobson's choice in diabetes. Even... Read More

Raising Happy Diabetic Kids Part II

This is the second article in a series I am... Read More

Favorite Desserts For A Diabetic Husband

It's easier than you think to create delicious desserts for... Read More

Ascensia Breeze Glucometer Rated

Simple Testing Over and Over* simple and easy testing. Simple... Read More

Diabetic Complications - Can Benfotiamine Help Prevent Them?

Diabetic complications contribute too many life threatening diseases globally. The... Read More

Diabetes: African Americans Deadly Foe

Diabetes is having a devastating effect on the African American... Read More

Diabetes Awareness: Wake Up Call

When traveling on out-of-town business, its common to have the... Read More

Type 1 and Type 2 Diabetes

Diabetes affects the manner in which the body handles digested... Read More