Do you have diabetes? Then sometimes you may feel a slight tingling, burning, or pricking pain in your hands and feet, especially in the toes. For some, this is so severe that they can't sleep at night. This is what we call diabetic peripheral neuropathy, or diabetic neuropathy in medical terms. This is a serious, common, and difficult-to-treat condition. But don't worry. You don't have to live with this pain. There are many things we can do to control this condition. Let's find out more about it today.
First and most important: blood sugar control!
When it comes to treating this nerve pain, the most important thing we all need to understand is to control our blood sugar levels. If your blood sugar levels are consistently high, it gradually damages the delicate nerves in your body. This damage is what you feel as numbness, tingling, and pain.
Don't forget, even the best painkillers in the world will be of little use if you don't control your blood sugar levels. Sugar control is the foundation of this treatment.
So, talk to your doctor and discuss how to manage your diabetes again.
- Plan your meals properly.
- Exercise regularly.
- Take the diabetes medication prescribed by your doctor on time and exactly as prescribed.
If you've done all of this correctly and still have pain, the next thing we need to think about is pain-relieving medication.
Pain relief medications
There are many medications used to control this nerve pain. You may need to work with your doctor to try several medications to find the right one. That's normal. Let's take a look at what these medications are.
| Drug type | Examples | Important things to know |
|---|---|---|
| Medicines that can be purchased at the pharmacy without a doctor's prescription (Over-the-Counter - OTC) | ||
| NSAIDs (Nonsteroidal anti-inflammatory drugs) | Ibuprofen, Naproxen, Aspirin | These reduce pain and swelling. However, long-term use can cause stomach ulcers, bleeding, heart disease, and kidney damage. Since the kidneys of a person with diabetes are already at risk, do not use these without consulting a doctor. |
| Acetaminophen | Paracetamol | This does not reduce swelling, but only reduces pain. It reduces inflammation in the stomach. However, if taken in excess, it can cause serious liver damage. |
| Capsaicin cream | A cream to apply to the painful area | These contain a compound found in chili peppers. It works on the nerve cells in the skin that carry pain signals to the brain. It's good in the short term. |
| Lidocaine gel/cream | Apply gel or cream to the painful area. | It causes a numbing sensation where it is applied, reducing pain. |
| Prescription Drugs | ||
| Antidepressants | Tricyclic antidepressants, SNRIs | Although these are medications for depression, they are also very effective for nerve pain. They work for pain whether you have depression or not. Side effects such as drowsiness, weight gain, and dry mouth can occur. |
| Antiseizure drugs | Pregabalin, Gabapentin | These medications control the nerve cells that transmit pain. Therefore, the sensation of pain is reduced. However, dizziness and drowsiness may occur. |
| Opioid drugs | Tramadol | These are strong painkillers for very severe pain. They are good for breakthrough pain. But there is a risk of addiction . And there are more side effects like constipation. These should only be used under the close supervision of a doctor. |
| Qutenza patch | Prescription capsaicin patch | This is a plaster containing highly concentrated capsaicin, prescribed by a doctor. It should be applied to the skin about once every 3 months. |
Talk to your doctor.
After reading about these medications, your doctor should decide which medication is best for you and what dosage you should take. Never start using these medications based on what someone else says or how you feel. Not every medication works for everyone.
Other treatments besides medication
Sometimes it can be difficult to control pain with medication alone. In such cases, your doctor may recommend other treatments.
- Lidocaine injection or patch: Numbs the painful area by injecting it under the skin or applying a patch.
- Electrical nerve stimulation: A small electrical current blocks the transmission of pain signals. However, there are varying opinions about its effectiveness.
- Surgery: Sometimes, if the pain is caused by a pinched nerve, surgery can relieve the pinched nerve. This is not something that is done for everyone.
- Pain management devices: Pain management through small devices implanted into the body.
Things that help make life easier
When living with this pain, there are a few simple things that can help you maintain your quality of life.
- Hand or foot braces: These support muscle weakness and help reduce nerve compression.
- Orthopedic shoes: Diabetics are at higher risk of foot injuries. Because numbness can make even a small injury go unnoticed, it is important to use special shoes that reduce walking discomfort, fit your feet well, and prevent injuries.
Take-Home Message
- The best and first treatment for nerve pain caused by diabetes is to control blood sugar levels well.
- Even if you can get painkillers from the pharmacy, don't use them without consulting your doctor. Diabetes can have other risks.
- There are many treatments for this pain, so don't give up hope. Talk to your doctor to find the treatment that works best for you.
- Always take care of your feet. Check them daily for any cuts, cracks, or redness.
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