By Matthew Nienberg, PA-C
Pain Management, Blanchard Valley Pain Management

Have you felt burning and stinging in your feet that just will not go away? What about tingling, numbness or an inability to feel hot or cold sensations? If these symptoms sound familiar, and you are a patient with type 1 or type 2 diabetes, you may be experiencing symptoms associated with diabetic peripheral neuropathy. 

Diabetic neuropathy is nerve damage, typically starting in the toes and feet, caused by elevated blood sugar levels. While symptoms are most commonly reported in the toes and feet, as the disease progresses, they may be experienced further up the legs and into the hands. While symptoms for some can be mild, others may report severe pain and loss of function. ▶︎

  Diabetic peripheral neuropathy, which affects about 30% of diabetics, can cause numbness, tingling, or burning in the feet. Other symptoms may include sharp pains, cramps, or even an extreme sensitivity to touch. 

Diabetic neuropathy cannot be reversed, so it is of the utmost importance to control blood sugars well to reduce the risk of developing nerve damage. Other risk factors for developing neuropathy include coronary artery disease, high triglyceride levels, being overweight, smoking, and high blood pressure. Lifestyle modifications like diet, exercise, and quitting smoking are vital for mitigating these risk factors.

Beyond lifestyle modifications and keeping good control of your blood sugars, there are treatment options available to reduce the symptoms associated with neuropathy. Medication management is typically the first line of treatment and includes medications that act on the nervous system to try to reduce pain. These medications have been used for years to combat pain and include tricyclic antidepressants, duloxetine, gabapentin, pregabalin, and alpha lipoic acid.    

If these treatments have been utilized and fail to provide adequate relief, it may be time to see a pain management specialist to discuss newer options. These more recently available options include Qutenza patches and spinal cord stimulation. 

Patients who see a pain management specialist have often found relief with Qutenza patches, which are topical prescription strength analgesic patches derived from chili peppers. These patches are applied about every three months in a clinic setting and can reduce the activity of the pain-associated nerve cells in the skin. Patients report receiving up to three months of relief between treatments. 

Pain management specialists can also utilize spinal cord stimulation as a means of treating neuropathy that has not been well controlled with conservative measures. Spinal cord stimulation involves an implanted device that changes the way a person perceives their extremity pain. This is usually done on an outpatient basis with two small incisions. The device is then controlled externally by the patient via a remote.

Understanding the treatment options available for your diabetic neuropathy empowers patients to explore innovative solutions with their care team. If you or someone you know is grappling with the challenges of diabetic peripheral neuropathy, know that advancements in pain management treatments offer new avenues for relief.

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