Treatment of Painful Diabetic Neuropathy

Finding an effective treatment of painful diabetic neuropathy can be extremely frustrating, both for the individual in pain and for their loved ones desperately trying to find a solution.

Diabetic neuropathy is a nerve disorder caused by high blood glucose and other complications associated with having diabetes for a long time. The resulting nerve damage can be felt as numbness or pain in feet, lower legs, hands or arms. If you have painful diabetic neuropathy (PDN), you may experience that pain as tingling, burning, stabbing, deep aching or greater at the touch—especially at night. Sometimes the pain can come on fast and be severe.

According to the National Institute of Diabetes, most people with diabetes develop some form of neuropathy. It is more common if you have had diabetes for more than 25 years and have problems controlling your blood sugar, have high levels of blood fat and blood pressure, or are overweight.


Doctors diagnose diabetic neuropathy based on symptoms and a physical exam. They may check your blood pressure, heart rate, muscle strength, reflexes and sensitivity to position changes, vibration, temperature or light touch. Once diagnosed, treatment can involve:

  1. Control of blood glucose levels

First, blood glucose levels must be brought within the normal range to help prevent further nerve damage. According to a Diabetes Control and Complications Trial, tight control of glucose levels can reduce the incidence of neuropathy by 60%.

  1. Prescribed oral medications

Diabetic-NeuropathyBefore you reach for the usual painkillers, it might be worth getting a diagnosis from your doctor. Over-the-counter pain medicines are not recommended: they may not work well for treating nerve pain and can have serious side effects.

You do not have to be depressed for an antidepressant to help relieve your nerve pain; antidepressants are the most common form of treatment. According to the National Institute of Diabetes, drug options include tricyclic antidepressants (e.g. Norpramin, Pertofrane), other antidepressants such as duloxetine (Cymbalta), anticonvulsants such as pregabalin (Lyrica), and various opiods and opioid like drugs. Duloxetine and pregabalin are approved by the U.S. Food and Drug Administration specifically for treating PDN.

  1. Topical medications

Some people experience pain relief with treatments applied to the skin. According to the National Institute of Diabetes, these can include nitrate sprays, capsaicin cream and lidocaine patches (Lidoderm, Lidopain) for the feet, alpha-lipoic acid (an antioxidant) or evening primrose oil.

  1. Therapies and more

Others find that acupuncture, biofeedback or physical therapy help relieve their pain. Less studied options may include electrical nerve stimulation, magnetic therapy and laser or light therapy. However, new clinical trials of therapies happen all the time. Also, if your feet and legs are very sensitive to the touch, then a device called a bed cradle can help keep sheets and blankets away from the skin.

Treatment of painful diabetic neuropathy is complex and may involve a combination of medications or treatments. Patient suitability, benefits and potentially adverse side effects need to be considered for any treatment, but there is hope.

Get help by contacting us at the Capitol Pain Institute in Texas. Doctors here are pain management specialists, equipped to diagnose your specific condition and to find the most effective pain relief treatment to help relieve your pain. Instead of sitting there in pain, start to reclaim your life by booking an appointment now!

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