When you have diabetes, high blood sugar levels can injure nerve fibers in your body, leading to diabetic neuropathy. Diabetic neuropathy causes pain and numbness, particularly in your legs and feet.
Although there's no cure for diabetic neuropathy, some treatments can help you control the pain of the condition.
Several medications are used to relieve nerve pain, but they don't work for everyone and most have side effects that must be weighed against the benefits they offer.
Among the pain-relieving treatments to consider are the following:
- Anti-seizure medications. Although certain drugs such as gabapentin (Gralise, Neurontin), pregabalin (Lyrica) and carbamazepine (Carbatrol, Tegretol, others) are used to treat seizure disorders (epilepsy), they're also prescribed for nerve pain. Side effects may include drowsiness, dizziness and swelling.
- Antidepressants. Tricyclic antidepressant medications, such as amitriptyline, nortriptyline (Pamelor), desipramine (Norpramin) and imipramine (Tofranil), may provide relief for mild to moderate symptoms by interfering with chemical processes in your brain that cause you to feel pain, but they also cause a number of side effects, such as dry mouth, sweating, sedation and dizziness. For some people, antidepressants called serotonin and norepinephrine reuptake inhibitors (SNRIs), such as duloxetine (Cymbalta), can relieve pain with fewer side effects. Possible side effects of SNRIs include nausea, sleepiness, dizziness, decreased appetite and constipation.
- Lidocaine patch. This patch contains the topical anesthetic lidocaine. You apply it to the area where your pain is most severe. It has almost no side effects, although it may cause a rash in some people.
- Opioids. Opioid analgesics, such as tramadol (Conzip, Ultram, others) or oxycodone (Oxecta, OxyContin, others), may be used to relieve pain. However, this class of medications may produce serious side effects, including addiction, constipation, drowsiness and headaches, which make long-term use of them undesirable. The Food and Drug Administration has issued a warning about tramadol, which includes the risk of seizure and the risk of suicide for people with histories of emotional disturbances or who are prone to addiction.
A number of alternative therapies, such as capsicum cream (made from chili peppers) and acupuncture, may help with pain relief. Doctors frequently use them in conjunction with medications, but some may be effective on their own. Work with your doctor to find the approach that's best for you.
May 07, 2014
- Diabetic neuropathies: The nerve damage of diabetes. National Institute of Diabetes and Digestive and Kidney Diseases. http://diabetes.niddk.nih.gov/dm/pubs/neuropathies/neuropathies.pdf. Accessed Nov. 10, 2011.
- Feldman EL, et al. Treatment of diabetic neuropathy. http://www.uptodate.com/home/index.html. Accessed Nov. 10, 2011.
- Bril V, et al. Evidence-based guideline: Treatment of painful diabetic neuropathy: Report of the American Academy of Neurology, the American Association of Neuromuscular and Electrodiagnostic Medicine, and the American Academy of Physical Medicine and Rehabilitation. Neurology. 2011;76:1758.
- Ultram (tramadol hydrochloride), Ultracet (tramadol hydrochloride/acetaminophen): Label change. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm213264.htm. Accessed Nov. 20. 2011.