Diabetic nerve pain treatment

Diabetic nerve pain has no known cure. The goals of treatment are to:

• Slow the progression of diabetic nerve pain
• Relieve pain
• Manage complications and restore function

Having diabetes already requires you to monitor and manage many signs and symptoms. Diabetic nerve pain might feel like just one more thing to deal with. Daily care, however, is one of the best ways to prevent complications. The best way to delay or prevent nerve damage is by keeping your blood sugar within your target range. Your provider will determine the best target range for your blood sugar based on several factors, such as your age, your overall health, and how long you've had diabetes. The American Diabetes Association recommends the following target blood sugar levels for most people with diabetes:

• Between 80–130 mg/dL (4.4–7.2 mmol/L) before meals
• Less than 180 mg/dL (10.0 mmol/L) two hours after meals

Keep in mind, however, that your provider might adjust these target ranges to meet your specific needs. Different specialists can help you with different complications—for example, a urologist for urinary tract problems and a cardiologist to treat complications in the heart. Here’s what your treatment for diabetic nerve pain might look like depending on the type of complication you have:

• Urinary tract problems: Your provider may recommend changing medications that might interfere with bladder function. They may also recommend a strict urination schedule.
• Digestive problems:To relieve symptoms for nerve damage in the digestive system, your provider might recommend eating smaller, more frequent meals, cutting down on fiber and fat in the diet, and eating soups and pureed foods. Diet changes may help relieve nausea, diarrhea, and constipation.
• Low blood pressure: To prevent swings in blood pressure, your provider might recommend sitting or standing slowly, avoiding alcohol, drinking plenty of water, or sleeping with your head raised 6–10 inches.
• Sexual dysfunction: Certain medications can improve sexual function for people with nerve damage, but they aren't effective for everyone.

You can prevent or delay diabetic nerve pain by keeping your blood sugar in control and taking care of your feet. An at-home blood sugar monitor can help you check your blood sugar and make sure it stays consistently within your target range. Changes in blood sugar levels can speed up nerve damage. According to the American Diabetes Association, people with diabetes should have their A1C measured at least twice a year^[9]. Foot problems are a common complication of diabetic nerve pain. You can prevent many of these problems by having a foot exam at least once a year, having your provider check your feet at each office visit, and taking good care of your feet at home. To protect your foot health:

• Check your feet every day: Look for cracked and peeling skin, redness, blisters, cuts, bruises, and swelling.
• Keep your feet clean: Wash your feet each day with water and soap.
• Moisturize your feet to prevent cracking.
• Trim your toenails.
• Wear clean, dry socks.
• Wear cushioned shoes that fit well: Make sure that your shoes fit properly and allow your toes to move.

Diabetic nerve pain medication

If problems do occur, your provider can help treat them to prevent more serious conditions. Even small sores can quickly turn into severe infections if left untreated.

Diabetic nerve pain relief

Many prescription medications exist for diabetes-related nerve pain, but they don't work for everyone. Side effects are always possible. When considering any medication, talk to your provider about the benefits and drawbacks. Prescription treatments for pain relief may include:

• Anti-seizure drugs: Some medications for seizure disorders are also used to ease nerve pain. The American Diabetes Association recommends^[10] starting with pregabalin (Lyrica) or gabapentin (Gralise, Neurontin), both of which have been found to be effective in managing nerve pain.
• Antidepressants: Some antidepressants can help ease mild to moderate nerve pain.

There are several alternative therapies that may help with pain relief. Health providers frequently use them along with medications, but some may work on their own.

• Capsaicin: A topical cream that has effectively reduced pain for some.
• Alpha-lipoic acid: An antioxidant that may help relieve nerve pain symptoms in some people when delivered intravenously.
• Electrical stimulation: This therapy may help prevent pain signals from reaching your brain. A 2013 review^[11] found 6 out of 8 studies in which patients with diabetic neuropathy found pain relief through electrical stimulation.
• Acupuncture: Acupuncture, which may help relieve the pain of neuropathy, is well tolerated and generally has no noteworthy side effects.^[12] You may not get immediate relief from acupuncture and will likely require more than one session.

It can be difficult to live with diabetic nerve pain. Talk to a counselor or therapist if you need emotional support. You can also ask your provider if there are support groups in your area, or for a referral to a therapist. The American Diabetes Association also offers online support forums on its website^[13].