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The Best Ways to Manage the Pain of Diabetic Neuropathy

If you have diabetes, you could experience tingling, burning or numbness in your toes and feet or your fingers and hands. This sensation could be caused by diabetic neuropathy, which is a condition that can develop when high blood sugar levels damage your nerves.

Not only is diabetic neuropathy painful, but it can also be dangerous, too. You could grab a hot pan and burn your hand without feeling it. Or tingling and numbness in your feet could make you more likely to trip.

But you can take steps to help minimize this pain and discomfort and help keep yourself safe. We connected with Jennifer Pappalardo, DPM, a podiatrist with Banner – University Medicine, to learn more about how to keep this condition under control.

“Managing your diabetes well is a vital part of minimizing this pain,” she said. “When your blood sugar levels are optimal, you can reduce nerve damage and alleviate neuropathic pain.”

These medications might help diabetic neuropathy pain

A lot of people find pain relief through medication. Be sure to work closely with your health care provider to find the best options for you. They may recommend:

  • Over-the-counter pain relievers. Some people find that OTC non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen (Advil, Motrin) and naproxen (Aleve) work for their pain. Acetaminophen (Tylenol) might also help. Be sure to tell your doctor if you treat your pain with OTC medications.
  • Topical treatments. You can try creams or patches that apply medications such as lidocaine or capsaicin directly to the skin. Topical diclofenac (Voltaren) may also be an excellent option to help with pain.
  • Antidepressants. Some antidepressants can help relieve neuropathic pain because they alter the brain chemicals that transmit pain signals. Tricyclic antidepressants (TCAs) like amitriptyline or nortriptyline and selective serotonin-norepinephrine reuptake inhibitors (SNRIs) like duloxetine may be options.
  • Anticonvulsants. These medications, which are typically used to manage seizures, can help stabilize overactive nerves and reduce pain signals. Your doctor may want you to try gabapentin or pregabalin.
  • Opioids. However, these medications are rarely prescribed for neuropathy pain as they frequently do not work on the same type of receptors for pain. 

Lifestyle modifications to help diabetic neuropathy pain

Keeping yourself healthy overall can help reduce your pain. “A well-balanced diet focused on whole foods such as vegetables, fruits, lean proteins and whole grains can help manage your blood sugar levels and support your overall nerve health,” Dr. Pappalardo said.

And getting regular physical activity can improve blood circulation, alleviate pain and help manage your diabetes effectively. Low-impact exercises like walking, swimming or cycling are good options for many people.

Other pain-relieving treatments to consider

Some people find that alternative or complementary approaches help keep their diabetic neuropathy pain under control. Talk to your health care provider about the pros and cons of:

  • Alpha-lipoic acid (ALA). This antioxidant is available as a supplement and may help reduce neuropathic pain and improve nerve function. 
  • Acupuncture. With acupuncture, a therapist inserts thin needles into points on your body to stimulate natural pain relief methods. 
  • Massage therapy. Massage techniques such as Swedish massage, deep tissue massage or reflexology can help relax muscles, improve circulation and temporarily reduce pain. 
  • Transcutaneous electrical nerve stimulation (TENS). With this therapy, a provider places electrodes on your skin and delivers low-voltage electrical currents. The electrical stimulation may help reduce your pain by interfering with pain signals. “These can be purchased online and offer the same medical quality, regardless of price,” Dr. Pappalardo said.
  • Herbal remedies. Some people find pain relief from treatments such as evening primrose oil or capsaicin cream (derived from chili peppers). “For anti-inflammatory properties, you can add turmeric to your diet, either in supplement form or simply while cooking,” Dr. Pappalardo said. Keep in mind that herbal remedies may interact with other medications or have side effects. 
  • Physical therapy. A physical therapist can help you manage pain, enhance balance and improve strength, flexibility and mobility with specific exercises and stretches.
  • Mind-body techniques. You may want to try relaxation techniques, meditation, guided imagery or biofeedback to help manage stress, improve relaxation and possibly reduce pain perception. 

Be sure to take good care of your feet

With diabetic neuropathy, you could be more likely to injure your feet. Even minor problems could become dangerous because the numbness caused by neuropathy may mean you don't notice the injury, allowing it to become worse.  Treat your feet right by:

  • Wearing shoes that fit well.
  • Avoiding going barefoot.
  • Inspecting your feet frequently for injury or infection.
  • Having regular foot exams.

Take care of your mental health, too

Living with chronic pain can take an emotional toll. Good coping strategies can help you manage stress and maintain your overall well-being. You may want to seek support from loved ones, join support groups or talk to a counselor or therapist. 

The bottom line

Living with diabetes and the chronic pain that can come with it can be challenging. No matter what pain management techniques you choose, be sure to have regular checkups and keep the lines of communication open with your health care provider. That way, you can monitor your progress, discuss any concerns or changes in your symptoms and adjust your treatment plans if needed.

If you would like to connect with a provider who can help you manage your diabetes and keep your pain under control, reach out to Banner Health.

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