Diabetes Health Center

Treatment for Diabetes Nerve Pain

Nerve pain caused by diabetes, called diabetic peripheral neuropathy, can be severe, constant, and difficult to treat. It may start as a tingling sensation, followed by numbness and pain. But there are two key points that everyone with diabetes and peripheral neuropathy should know:

• Controlling your blood sugar levels can help prevent worsening nerve pain and improve your overall health at the same time.
• Medications can help relieve nerve pain, make you more comfortable, and improve your quality of life.

"We know that better glucose control is the single most important factor" in preventing neuropathy, slowing its progress once you have it, and relieving many symptoms, says Christopher Gibbons, MD, director of the Neuropathy Clinic at the Joslin Diabetes Center in Boston and instructor of neurology at Harvard Medical School.

If you have diabetes and peripheral neuropathy, talk to your doctor about ways to better control your blood sugar. You may need to take insulin for better control, says Gibbons.

Once you are doing all that you can to keep blood sugar levels under control - including diet, meal planning, exercise, and medication - you should assess with your doctor which pain medication is best to relieve your remaining symptoms.

Fortunately, medications can help relieve nerve pain from peripheral neuropathy so you can function at near-normal levels. You have many pain relief drugs from which to choose. But you may need to try several different types of pain relievers before you find the one that helps you.

Over-the-Counter Pain Relievers for Diabetes Nerve Pain

Some people find relief for mild diabetes nerve pain right on their drug store shelves. Common pain relievers and some topical creams may help, depending on the severity of pain.

"As a first line of treatment, these can be very helpful," Gibbons says.

Anyone with diabetes should talk to their doctor before taking any medication. Even over-the-counter medications can interact with other drugs or cause severe side effects in people with diabetes.

Here are some over-the-counter pain relief options to consider:

NSAIDs (nonsteroidal anti-inflammatory drugs). These medicines reduce inflammation and relieve pain. NSAIDs available without a prescription include aspirin, ibuprofen (Advil, Motrin), and naproxen (Aleve).

But NSAIDs can cause harmful side effects such as stomach irritation and bleeding in some people if taken for weeks or months. When taken long-term they can also lead to kidney and liver damage, which may be more likely in people with diabetes.

However, says Gibbons, "In many cases, especially with younger people who are relatively healthy, the risk is quite low."

Acetaminophen. Acetaminophen and other over-the-counter drugs containing acetaminophen relieve diabetes nerve pain without reducing inflammation. These medications do not cause the stomach irritation that NSAIDs do. However, taking more acetaminophen than recommended can lead to liver damage. It is important to read labels and check with your pharmacist.