Diabetic Neuropathy Treatment Options

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Diabetic neuropathy treatment options

Many of our diabetic neuropathy patients are initially disheartened to hear that there is no cure for diabetic neuropathy, and that symptoms tend to get worse over time if left untreated. However, with the right management strategy, it is possible to slow the progression of the disease and relieve pain.

Effective diabetic neuropathy treatment often involves a multi-faceted approach. Blood sugar control, lifestyle modifications, pain medications, and even medical device therapies like spinal cord stimulation may help you find sustainable relief from diabetic nerve pain. There are also steps that you can take to manage life limiting complications of diabetic neuropathy, including urologic and gastrointestinal problems.

The diabetic neuropathy specialists at ProVascularMD put together this quick review of diabetic neuropathy treatments to help you understand your options and the role of different therapies in managing diabetic neuropathy.

Diabetic neuropathy treatment specialist Dr. Michael Lalezarian in Los Angeles, California

Diabetic Neuropathy Specialist

Dr. Michael Lalezarian

Painful diabetic neuropathy? We can help you find relief. Dr. Michael Lalezarian is a double-board certified Vascular Interventional Radiologist specializing in neuromodulation therapy for painful diabetic neuropathy, including spinal cord stimulation. He is a committed partner in the battle against the devastating consequences of diabetes.
5-Star Varithena treatment in Los Angeles

“I was referred to Dr. Lalezarian from my orthopedic surgeon for varicose vein treatment options. From the second I walked into the office, I was at ease and felt very welcomed from Kimberly and the staff. Upon meeting the doctor, he was so kind and fully explained my options after the initial ultrasound on both legs. I decided to go with the sclerotherapy and am so happy that I did. The procedures were quick and virtually painless but the results are life changing for me. The pain suffered for so many years and countless sleepless nights are a thing of the past.”

Vickie W, March 2022

Controlling Blood Sugar Levels

Poor blood sugar management is one of the primary causes of diabetic complications, and diabetic neuropathy is no exception. Keeping your blood sugar within your target range can help prevent further nerve damage, and may even improve some of your current symptoms. If you haven’t already, you should work with your primary care doctor or endocrinologist to figure out your target range. As a diabetic, you should diligently monitor your blood glucose levels and take diabetes medications as prescribed, and follow medical advice from your general practitioner or endocrinologist to keep your blood sugar levels in check.

Lifestyle Modifications

Poor diet, inactive lifestyle, obesity, high blood pressure, and smoking are modifiable lifestyle factors that worsen diabetes and increase the risk of diabetic complications, including diabetic neuropathy. Depending on your health and fitness, healthier lifestyle habits may be an essential step to getting your diabetes under control and relieving diabetic nerve pain.
  • Blood Pressure Control – Uncontrolled blood pressure puts you at higher risk of diabetes complications. Make your blood pressure a priority, and do what you can to keep it in a healthy range as recommended by your doctor.
  • Physical Activity – Being physically active every day is an important part of managing diabetes and its complications. Exercise can help lower blood sugar, improve blood flow, and provide several other health benefits. If you suffer from complicated diabetes, it’s recommended to exercise a significant part of your day, spending around 2.5 hours doing moderate aerobic activity or 1.25 hours of vigorous aerobic activity every day. A doctor or physical therapist can help you determine an appropriate exercise regimen.
  • Maintain a Healthy Weight – Obesity can make diabetes complications much more difficult to live with. It follows that healthy food choices are another important part of diabetes and pain management. If you’re trying to fight back against diabetes, vegetables, fruits, and whole grains should make up a larger portion of your diet, and you should proactively limit portion sizes to maintain a healthy weight.
  • Stop Smoking – Smoking and other tobacco products adversely affect circulation and healing, and can therefore prevent other therapies from work effectively. If you smoke, now is the time to quit.
  • Physical Therapy – A physical therapist can help identify highly effective exercises that are low-impact and easily tolerated, such as swimming. Some physical therapists specialize in diabetes complications and/or neuropathy, and can help you overcome diabetic neuropathy complications that would otherwise affect your ability to exercise.
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Diabetic neuropathy treatment by controlling blood sugar

Foot Care

Diligent foot care is an extremely important part of managing diabetes and treating diabetic neuropathy. Not only can diabetic neuropathy cause numbness in the feet, making it difficult to detect issues, but diabetes can also make it extremely difficult for foot injuries to heal. Routine foot inspection, washing, and wearing proper foot protection are important habits to have when living with diabetic neuropathy because even minor injuries can lead to serious complications. Even minor injuries can lead to serious complications if untreated.
  • Routinely check your feet for sores, bruises, cuts, swelling, infections, and other problems, even if you don’t feel any pain.
  • Wash your feet daily with warm water, and make sure to dry them completely afterward. Apply a lotion after washing and drying to keep them moisturized. Avoid getting lotion in between your toes.
  • Always cover your feet with thick socks, shoes, or slippers to cushion them and prevent injuries.
  • Wear comfortable, flexible shoes that give your feet room to move. Break in new shoes slowly so that they don’t hurt your feet. Ask your doctor about customized shoes (orthopedic shoes) if regular shoes don’t fit well.
  • Seek specialized care if you have a sore that does not heal, as it may indicate a vascular problem or another complication.

Pain Medications

Over-the-counter and prescription pain medications may help relieve diabetic neuropathy pain. The most common are covered below.

Over-the-Counter Medications

Even though over-the-counter drugs can be obtained without the oversight of a physician, we recommend consulting with your doctor before relying on anything new to manage your diabetic neuropathy.

  • NSAIDs – Nonsteroidal anti-inflammatory drugs (NSAIDs) like aspirin, ibuprofen, or naproxen can help reduce inflammation and relieve pain. However, NSAIDs do increase the risk of heart attack, stroke, stomach irritation, and worsening kidney damage if taken in high doses or for an extended duration, and individuals with diabetes are already at a heightened risk of these complications.
  • Acetaminophen – Acetaminophen can relieve pain without reducing inflammation. This medication can lead to liver damage if you take more than the recommended dose.
  • Capsaicin – Capsaicin is found in topical medications that can be rubbed on painful areas, disrupting the nerves that send pain signals to the brain. It can provide pain relief in the short term, but it is unknown whether or not long-term use can cause other complications.
  • Lidocaine – Lidocaine is a numbing agent (an anesthetic). It is available in gels and creams.

Prescription Medications

Be sure to talk to your physician about the benefits and possible side effects of any new medications before you start taking them.
  • Anti-seizure drugs – Pregabalin (Lyrica) and Gabapentin (Gralise, Neurontin) are anti-seizure (epilepsy) drugs that are also prescribed to relieve nerve pain.
  • Tricyclic Antidepressants – Amitriptyline, nortriptyline (Pamelor), and desipramine (Norpramin) are tricyclic antidepressants that may help with mild to moderate nerve pain.
  • SNRI Antidepressants – Duloxetine (Cymbalta) and Venlafaxine (Effexor XR) are serotonin and norepinephrine reuptake inhibitor (SNRI) antidepressants that can help with nerve pain.
  • Lidocaine Patches – In addition to over-the-counter medications, lidocaine may also be prescribed in prescription-strength patches that are placed on the skin to manage localized pain.
  • Local Anesthetic Injections – Anesthetic injections may be prescribed to manage localized pain.
  • Capsaicin Patches – Prescription-strength capsaicin patches (Qutenza) are another method of localized neuropathic pain relief.
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Diabetic neuropathy treatment with spinal cord stimulation device

Alternative Pain Therapies

Some healthcare providers recommend alternative therapies if other methods of pain control are ineffective. Alternative pain therapies for diabetic neuropathy include supplements, external electrical nerve stimulation, and acupuncture, among others. Alternative therapies are largely unproven, and results vary from person to person.

  • Supplements – Alpha-lipoic acid and acetyl-L-carnitine may help relieve nerve pain.
  • Transcutaneous Electrical Nerve Stimulation (TENS) – TENS is a therapy in which tiny electric impulses are delivered to the surface of the skin to disrupt pain signaling.
  • Acupuncture – Acupuncture may help relieve diabetic neuropathy pain, but you may require multiple sessions to experience a benefit.

Spinal Cord Stimulation

A spinal cord stimulator is an implantable medical device that is used to treat painful diabetic neuropathy. A spinal cord stimulator works by creating an electric field near the nerves along the spine. This electric field interferes with the electrical activity of the nerves that are involved with pain signaling to the brain. When the spinal cord stimulator is active, painful sensations are replaced with a mild tingling sensation. An important advantage of a spinal cord stimulator is that it can be personalized to your pain patterns and sensory preferences.

Surgery

Surgery may be the treatment of choice for certain cases of neuropathic pain where destroying specific nerves or relieving nerve compression may provide symptomatic relief.
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Los Angeles Diabetic Neuropathy Specialist Dr. Michael Lalezarian

Diabetic Neuropathy Specialist in Los Angeles

Learn more about Los Angeles Diabetic Neuropathy Specialist Dr. Michael Lalezarian.

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