Peripheral Neuropathy and Diabetes

From the WebMD Archives

Pain. Tingling. Numbness. If you have a type of nerve damage from diabetes called diabetic peripheral neuropathy, chances are you've experienced these symptoms, especially in your hands and feet. The discomfort can affect your mood, sleep, and overall quality of life.

Prescription medications can help. But research shows that they only ease the pain by about 30% to 50%. How can you bridge the gap? Learn how you can get relief now -- and prevent the condition from getting worse down the road.

Get Your Blood Sugar Under Control

If don't manage your diabetes, your blood glucose levels get too high. Over time, excess blood sugar can damage your peripheral nerves. These connect your brain and spinal cord to the rest of your body. That could set the stage for diabetic neuropathy.

If you bring your blood sugar into the healthy range (a hemoglobin A1C reading of 7% or lower), you'll reduce your risk of nerve damage by 60%, according to research from the National Institute of Diabetes and Digestive and Kidney Diseases. "Healthy blood sugar levels can slow the process and ease the pain of diabetic neuropathy," says Aaron I. Vinik, MD, PhD, the director of the research and neuroendocrine unit at Eastern Virginia Medical School.

How can you keep your blood sugar in check? First, talk to your doctor. "A rapid drop can actually make the pain worse," Vinik says. Your doctor can suggest changes to gently bring your levels down into the healthy zone, like:

  • Eat a diet high that's in fruits, vegetables, low-fat dairy, and whole grains; contains a moderate amount of fish, poultry, nuts, and beans; and has a very low amount of red meat.
  • Maintain a healthy body weight.
  • Manage your stress levels.
  • Exercise for at least 30 minutes, 5 days a week.
  • If your doctor prescribes medication for your blood sugar, take it as recommended.

Take an Over-the-Counter Pain Reliever

Acetaminophen, aspirin, ibuprofen, or naproxen can ease mild to moderate pain caused by diabetic nerve damage, says Kimberly Sackheim, DO, a clinical assistant professor of rehabilitation medicine at NYU Langone Medical Center's Rusk Rehabilitation. "But speak with your physician if you take them regularly," she says. Some of these drugs may raise your risk of heart attack, stroke, or kidney damage.

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Get Your Vitamin D

Your skin produces this nutrient in response to sunlight. It may protect against nerve pain. When researchers from Britain's University of Sheffield studied people with diabetic neuropathy, they found that those who had lower levels of Vitamin D also had more pain.

It's hard to get the recommended 600 to 800 IU of vitamin D from food alone. You may need to take a supplement. In fact, one study found that people with diabetic neuropathy who took a supplement once a week had fewer symptoms after two months.

Kick the Butts

"Smoking causes your blood vessels to constrict, impairing your circulation," Sackheim says. This means your peripheral nerves may get less nutrient-rich blood, which can lead to more pain.

Try a B Vitamin Complex

These play an important role in your nerve health. Not getting enough vitamin B12 can lead to nerve damage. Vitamin B6 is important because it helps the brain produce certain chemicals that send information through our bodies, Sackheim says. Low levels of these chemicals can worsen pain.

Most people get enough B vitamins through food. But ask your doctor if you should take a supplement. Some studies show supplements can help reduce pain and other symptoms.

Soak in a Warm Bath

Not only is the warm water relaxing, but it can also boost circulation throughout your body. "It can provide instant relief," Vinik says. But because diabetic neuropathy can lead to a loss of sensation, make sure the water's not too hot before you get in.

Take an Alpha-Lipoic Acid Supplement

Your body naturally produces small amounts of this antioxidant. When taken in larger doses, it may help regulate blood sugar levels and ease nerve pain. One study found that people who took 600 milligrams daily had a 19% improvement in their diabetic neuropathy symptoms after 5 weeks. "Over the long term, alpha-lipoic damage may protect against further nerve damage," Vinik says.

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Get Moving

Exercise combats pain in a few different ways. It helps keep blood sugar levels in check, which may slow nerve damage. "Exercise also increases blood flow to the arms and legs," Sackheim says. Plus, it boosts your mood and provides stress relief, so you're better able to deal with the discomfort.

One study from the University of Kansas Medical Center found that people with diabetic neuropathy who exercised regularly found that their pain didn't get in the way of daily activities such as work, sleep, and relationships.

So what are you waiting for? Lace up those sneakers! If it hurts to walk or jog, try swimming or the stationary bike.

Use a Capsaicin Cream

Hot peppers may leave your mouth on fire, but their active ingredient -- capsaicin -- might relieve some of the burning and pain of nerve damage. A study published in the journal Pain showed that wearing an 8% capsaicin patch reduced pain levels by 30% after 2 weeks.

Only your doctor can give you a higher-dose patch. But research shows that lower-dose, over-the-counter cream -- about 0.1% capsaicin -- may also help. It could reduce pain intensity by 11% more than a placebo cream.

Give Your Feet Some TLC

Nerve damage in your feet can cause them to lose sensation. "So you may not realize that you scratched or cut your foot until much later," Sackheim says. As a result, you may develop a more serious problem, like an ulcer or infection. To avoid this, Sackheim says you should clean and examine your feet at the end of each day. "Also make sure that you wear comfortable shoes." Pairs that are too tight can pinch your feet and lead to injury.

Learn Relaxation Techniques

"Diabetic neuropathy is associated with anxiety and depression," Vinik says. Both of these conditions can make the pain worse. If you experience them, talk to your doctor. He may suggest medication as well as the following:

  • Biofeedback : In this practice, a machine monitors your heart rate, temperature, and brain waves. This helps you learn how to control your body's response to pain or other symptoms.
  • Relaxation techniques, such as visualizing, breathing exercise, meditation, massage, and yoga

WebMD Feature Reviewed by Michael Dansinger, MD on December 8/, 015

Sources

SOURCES:

Aaron I. Vinik, MD, PhD, director of the research and neuroendocrine unit at Eastern Virginia Medical School; spokesperson for the American Diabetes Association.

Kimberly Sackheim, DO, clinical assistant professor of rehabilitation medicine at NYU Langone Medical Center's Rusk Rehabilitation.

American Diabetes Association: "Peripheral Neuropathy."

Lindsay, T. American Family Physician, published online July 2010.

National Institute of Neurological Disorders and Stroke: "Peripheral Neuropathy Fact Sheet."

National Institutes of Diabetes and Digestive and Kidney Diseases: "DCCT and EDIC: The Diabetes Control and Complications Trial and Follow-Up Study."

Boulton, A. Clinical Diabetes, published online January 2005.

Shillo, P. Study presented at the Academy of Diabetes Association Scientific Sessions, 2015.

Shebab, D. Medical Principals and Practice, published online May 2015.

National Institutes of Health, Office of Dietary Supplements: "Vitamin D."

Ang, C. The Cochrane Library, published online July 2008.

Yoo, M. Pain Medicine, published online August 2015.

Tandan, R. Diabetes Care, published onlineJanuary 1992.

Ziegler, D. Diabetes Medicine, published online September 2011.

Joslin Diabetes Center: "Exercising with Diabetes Complications."

Mou, J. Pain, published onlineSeptember 2013.

Foundation for Peripheral Neuropathy: "Alternative Treatments."

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