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Ways to get neuropathy pain relief?

Question: I have neuropathy pains in my legs and feet. What can I do to get some pain relief?

Answer: Diabetic neuropathy is damage to the nerves caused by diabetes. Peripheral neuropathy--damage to the nerves in your feet--is a common complication of diabetes. This type of neuropathy can occur as the result of poorly controlled diabetes or elevated blood pressure levels. Usually, my patients complain of feeling some numbness and tingling on their feet. Most often, if a person doesn't know they have diabetes one of the last signs to show up is peripheral neuropathy.

In some people, peripheral neuropathy can be so bad they can't feel anything under their feet. Recently, I saw a patient who stubbed her toe, but didn't feel any pain. Hours later she looked at her foot and saw her second toe was black and blue -- yet, she didn't experience any pain. Your medical provider should be testing you at least once a year and make sure you are not developing this problem, or send you to a foot doctor (podiatrist) for further examinations and treatment.

Treatment for neuropathy pain

Diabetic neuropathy has no known cure. Treatment for diabetic neuropathy focuses on the following:

  1. Slowing progression of neuropathy
  2. Relieving pain, managing complications
  3. Restoring function

Consistently keeping blood sugar within a narrow target range can help delay the progression of peripheral neuropathy and may even cause an improvement in symptoms you already have. With intense glucose control you may reduce your overall risk of diabetic neuropathy by as much as 60 percent.

Neuropathy pain medications

[Editor's note: Please consult with your physician before considering or starting any new medication treatments or regimens]

Several medications are used to relieve nerve pain, but they don't work for everyone. Among the pain-relieving treatments that I have tried with my patients

Anti-seizure medications. Although drugs such as gabapentin (Neurontin), pregabalin (Lyrica) and carbamazepine (Carbatrol, Tegretol, others) are used to treat seizure disorders (epilepsy), they're also prescribed for nerve pain.

Antidepressants. I also use antidepressants like amitriptyline and nortriptyline, which may provide relief for mild to moderate symptoms. These type of medications can interfere with chemical processes in your brain that cause you to feel pain. Another type of antidepressant, Cymbalta, a serotonin reuptake inhibitor, can relieve pain as well.

Topical anesthetics. I also use Lidocaine patches, which contains the topical anesthetic lidocaine. You apply it to the area where your pain is most severe. 

There are also a number of alternative therapies that may help with pain relief, such as diabetic foot creams (e.g. capsaicin cream -- made from chili peppers) and acupuncture. I have used them before in conjunction with other medications. Usually I do have to combine many different classes of drugs to control severe neuropathy.

About Catherine Estipona

Catherine Estipona, MSN APN provides family-centered care as a Family Nurse Practitioner. In addition to her day-to-day care of patients, she serves as a Diabetic Educator in the state of Nevada for Lilly USA, LLC, a pharmaceutical company.

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