Diabetic Nerve Pain Overview
Diabetic nerve pain is a condition that occurs as a complication in up to 50% of patients with diabetes. Nerve fibers are delicate and prolonged exposure to high blood sugar (glucose) can damage them. The result is diabetic neuropathy, also known as diabetic nerve damage.
Symptoms of diabetic nerve damage include pain and numbness (especially in the legs and feet) which may be mild, or severe and disabling.
It’s important to note that four in every ten patients do not get treatment for diabetic nerve pain, even though there are many treatment options available. Maintaining tight blood sugar control and a healthy lifestyle may prevent, delay, or slow the progress of diabetic nerve pain.Show All
Doctors Who Treat Diabetic Nerve Pain
As diabetic nerve pain is diagnosed, treated and managed, you may encounter the following team of doctors and specialists. Having a team of doctors or specialists with varied expertise will more accurately help diagnose the possibility of having diabetic nerve pain
Endocrinologist - A medical doctor who specializes in the diagnosis and treatment of conditions affecting the endocrine system. The endocrinologist will help you manage the underlying diabetes, including helping you control your blood glucose (sugar) levels.
Neurologist - A medical doctor who specializes in diagnosing and treating nervous system problems. The neurologist will test how well your nerves conduct electrical signals between them, and recommend a treatment plan based on the severity of your diabetic nerve pain.
Podiatrist - A doctor who specializes in treating people who have painful feet, including those with diabetic nerve pain. The podiatrist will teach you proper foot care techniques, and fit you with special shoes or orthotic inserts for your existing shoes to minimize the pain in your feet.
How to Prepare for Your Doctor Visit for Diabetic Nerve Pain
Now that you have an upcoming appointment with a healthcare provider about your diabetic nerve pain, what can you do to get the most out of it?
- Ask your doctor or the office nurse what you need to do before your appointment. Do you need to fast or avoid eating certain foods? For how long? Do you need to wear a short-sleeved shirt? Do you need to take a pill or drink something the night before?
- Write down any new symptoms you are having since your last appointment.
- Write down your recent blood sugar levels (or download the data from your glucose monitor, if you use one).
- Write down a list of questions that you want to ask your doctor
- Write down any major stresses or life changes that have occurred recently.
- Make a list of all prescription and over-the-counter drugs, vitamins, and supplements you take (with the dosage and how often you take them) and bring the list to your appointment.
- Ask a family member or friend to come with you to take notes so you can concentrate on what the doctor is telling you. That way, you won’t have to worry about remembering everything you are being told.
Questions to Ask Your Doctor About Diabetic Nerve Pain
From your initial diagnosis throughout your treatment and care, you will have questions about diabetic nerve pain. Below is a list of questions to discuss with your doctor so you can make informed decisions about your condition.
Question About My Diagnosis
- Could my pain be caused by something other than diabetes?
- How severe will the pain become?
- What other complications can result from diabetic nerve pain?
- Do I have to do anything special before I get diagnostic tests you have ordered (fast, drink something, etc.)?
Questions About My Treatment
- If I control my blood sugar better, will the pain and tingling go away?
- What side effects might I get from taking the medicine?
- Are there any clinical trials available that I might qualify for?
- I have other conditions. How can I best manage them together?
Questions About My Lifestyle & Family
- Will this pain interfere with any of my daily activities?
- Are there exercises that can ease the pain?
- Do you have a patient education brochure I can read? Or can you recommend an easy-to-understand web site I can visit?
Common Tests or Labs to Diagnose Diabetic Nerve Pain
A diagnosis of diabetic nerve pain is usually based on your medical history (eg, how long you have had diabetes), the symptoms you have, and a physical exam. To pinpoint the diagnosis, your doctor will check your muscle strength and sensitivity to touch, temperature, and vibration.
|Test||Why Test?||What Happens?||Result|
|Quantitative sensory testing||To measure how your nerves respond to vibration and temperature||The neurologist holds a vibrating tuning fork or an ice cube against your foot or hand||If you can’t feel the vibrations or the different temperature, the nerves in your feet or hands have likely been damaged|
|Filament test||To measure sensitivity to touch||The neurologist will brush a soft nylon fiber or filament across the sole of your foot||If you can’t feel the fiber, the nerves in your feet or hands have likely been damaged|
|Nerve conduction studies||To measure how quickly the nerves in your arms and legs conduct electrical signals||The neurologist inserts a needle into your hand or foot and sends a mild electrical shock into your foot or hand||The speed at which the nerve conducts the signal determines whether nerve damage has occurred|
|Electromyography (EMG)||To measure the electrical discharges produced by your muscles at rest and in response to voluntary muscle contraction||The neurologist inserts a needle into various parts of your muscle and observes the lines generated by the muscle signals on a electromyograph||Abnormal electrical activity might indicate that the nerves in your feet or hands have been damaged|
Common Medications and Treatments for Diabetic Nerve Pain
There are many different categories of treatment available to patients with diabetic nerve pain.
|Treatment Type||How it works|
|Anticonvulsants||Anticonvulsants (drugs that are used to treat epilepsy), also decrease diabetic nerve pain by varying degrees. This drug class includes Pregabalin, Gabapentin, and Sodium valproate.|
|Antidepressants||Antidepressants (drugs that are used to treat clinical depression), also decrease diabetic nerve pain by varying degrees. This drug class includes venlafaxine, duloxetine, and amitriptyline.Duloxetine improves quality of life in patients with diabetic nerve pain.|
|Opioids||Decrease pain in patients with diabetic nerve pain.Improve quality of life|
|Percutaneous electrical nerve stimulation||Decreases pain in patients with diabetic nerve pain.Improves sleep|
|Other pharmacologic agents||Capsaicin cream reduces pain in patients with diabetic nerve pain.Isosorbide dinitrate spray reduces pain in patients with diabetic nerve pain.|