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How Is Diabetic Nerve Pain Treated?

Over-the-Counter (OTC) Pain Relievers continued...

Lidocaine is an anesthetic that numbs the area it’s applied to. It’s available in gels and creams, both over the counter and by prescription.

Other topical creams. Salicylate is a chemical similar to aspirin. It's found in pain-relieving creams. Cortisone products contain corticosteroids, which are potent anti-inflammatory drugs that can help ease pain. Both are available at drug stores, but there’s no clear evidence that they help relieve nerve pain from peripheral neuropathy.

Prescription Drugs

Many people need to turn to prescription medication to find relief.

NSAIDs are also available by prescription. They may be different doses or different drugs altogether from what’s offered without a prescription.The side effects -- stomach trouble and greater chances of heart disease -- are the same as with other forms.

Antidepressants treat depression but have also become important in relieving chronic pain. They can work whether you're depressed or not. Those used to treat pain include:

  • Tricyclic antidepressants, which affect the levels of the brain chemicals norepinephrine and serotonin. Experts say they’re the most effective of the antidepressants used for pain. But they also cause side effects, like drowsiness, weight gain, dry mouth, and dry eyes. Blood pressure, heart rate problems, and dizziness can also happen with these drugs.
  • Selective serotonin reuptake inhibitors (SSRIs), which work by altering the amount of the brain chemical serotonin. They’re effective for depression but less helpful for pain.
  • Serotonin and norepinephrine reuptake inhibitors (SNRIs), which treat depression by boosting the brain chemicals serotonin and norepinephrine. They may have fewer side effects than the SSRIs or TCAs.

Antiseizure drugs, used to prevent epileptic seizures, can also relieve neuropathy. The drugs control the nerve cells in the brain and other parts of your body, such as legs and arms, that transmit pain. But they can make you dizzy or sleepy, especially at high doses.

Opioid medicines. When your problem is severe, you want immediate relief. That's when you should see a pain specialist. You might need strong medicines that contain a weak opioid (a morphine-like substance). These drugs also affect the brain chemicals serotonin and norepinephrine, similar to antidepressants, and reduce your feeling of pain.

Opioids can provide a better solution for "breakthrough pain" -- a kind that suddenly worsens for no apparent reason -- than OTC drugs.

Neuropathy specialists shy away from strong narcotic opioid medications. They can cause severe constipation, and there’s a chance you could get addicted. There's also a stigma connected with using this type of drug. And depending on the type of work you do, it could be a problem.

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