Pain Management Techniques for Diabetic NeuropathyJanuary 19, 2021 10:23 pm Comments Off on Pain Management Techniques for Diabetic Neuropathy
Diabetes, a metabolic disorder that occurs when the body cannot properly process glucose, is a condition that’s on the rise in the Western world. A small percentage of the diabetic population is born with diabetes, which in this case is a genetic failure of the pancreas to produce sufficient insulin. However, the vast majority of people with diabetes are not born with the condition. Poor dietary options in conjunction with the increasing prevalence of a sedentary lifestyle have made type II, or adult-onset, diabetes increasingly and alarmingly common. In the United States, a lack of access to health care in much of the population also means that precursors to diabetes, such as elevated blood sugar levels, go unidentified until it’s too late.
Diabetes can cause many complications and conditions over time. One of these conditions is diabetic neuropathy, a specific kind of nerve pain that comes as a result of blood with elevated glucose levels damaging nerves. Diabetic neuropathy most often affects nerves in the extremities, and pain or lack of sensation in the fingers, toes, and legs is common. In the most severe cases under a lack of diabetes management, nerve damage in the extremities can even lead to amputations.
There is no cure for diabetic neuropathy—that is to say, the root cause of the pain cannot be eliminated. However, several pain management techniques for diabetic neuropathy exist, allowing you to maintain some quality of life while you manage the rest of your condition.
Topical treatments are usually the first line of attack against diabetic neuropathy. Some of the most popular over-the-counter topical analgesics are those that contain capsaicin, a natural compound with pain-relieving properties. If you’re familiar with food science, this may surprise you— after all, capsaicin is the compound found in chili peppers that gives them their characteristic piquancy. Additionally, aerosolized capsaicin puts the pepper in pepper spray, which can be damaging to the eyes. But while the burning sensations that capsaicin causes in mucous membranes can be painful, they can relieve pain in other parts of the body when used in low concentrations. Capsaicin creams exist in low-dosage over-the-counter form, or they can be applied under a doctor’s care in higher doses.
However, capsaicin can also cause irritation. Plus, as anyone who has eaten a bowl of hot chili knows, heat can intensify capsaicin, meaning that even warm weather can cause the heat it generates to be a little too strong.
Another popular topical treatment for nerve pain is a lidocaine patch. Lidocaine is a local anesthetic with a number of common uses, one of the most familiar being the local anesthetic of choice in the dentist’s office. Unlike capsaicin, lidocaine works by preventing nerves from sending and receiving signals. However, lidocaine also blocks all other signals, causing a numbness that the neuropathy sufferer may find just as uncomfortable as the pain itself. Lidocaine is available both over the counter and by prescription in gels, creams, or transdermal patches. Patches are the most popular delivery method for treating neuropathy in the feet and toes.
When diabetic neuropathy is too widespread to adequately treat topically, other medications may do a better job at treating all the instances of pain. One such drug is pregabalin, an anticonvulsant related to gabapentin. Pregabalin is most commonly prescribed as a treatment for epilepsy and generalized anxiety disorder, and pharmaceutical companies heavily market it under its brand name (Lyrica) as a treatment for fibromyalgia. However, the FDA has also approved it to treat diabetic neuropathy, meaning that sufferers who approach their doctors about pregabalin should not feel apprehensive about pursuing “off-label” treatment.
Like gabapentin, pregabalin blocks calcium channels, which are found in muscles and nerves. The ability to block these receptors is what gives pregabalin its anticonvulsant properties. Pregabalin can be effective in reducing pain associated with diabetes, but—as many drugs do—it comes with a long list of possible side effects. These range from the ever-common dry mouth and dizziness to kidney stones, depressed heartbeat, and even suicidal ideation. Even the possibility of such side effects may dissuade sufferers of diabetic neuropathy from taking a pharmaceutical approach to pain relief.
Serotonin-norepinephrine reuptake inhibitors, or SNRIs, are a class of antidepressants that may also be useful in the treatment of diabetic neuropathy. SNRIs are closely related to the more familiar SSRIs (selective serotonin reuptake inhibitors), which were an improvement upon the tricyclics and monoamine oxidase inhibitors whose side effects and dietary restrictions made them challenging to prescribe. SNRIs work by blocking reabsorption of neurotransmitter proteins, acting upon both serotonin and norepinephrine. This change in brain chemistry is believed to improve mood and cognition in the user. Additionally, this change in neurotransmitter reuptake can improve chronic pain, such as that of diabetic neuropathy. However, like both pregabalin and SSRIs, SNRIs carry many possible side effects, with sexual dysfunction being perhaps the most notorious accompaniment to SSRI and SNRI use.
If topical preparations and pharmaceuticals are unappealing pain management techniques for diabetic neuropathy, you may be able to find relief in targeted ultrasound. For example, the NanoVibronix PainShield uses ultrasonic waves—not to be mistaken for radiation—to treat pain in soft tissue. The PainShield has a wealth of applications, harnessing the healing power of ultrasound for trigeminal neuralgia, joint pain, arthritic pain, pain from tendon and ligament injuries, carpal tunnel syndrome, and even diabetic neuropathy. The localized energy that the ultrasound transducer delivers to the site of pain stimulates soft tissue and relieves pain in the area, whether that pain is acute or chronic. Best of all, with this handheld device, you can deliver relief when you need it most, all without a doctor’s supervision. The FDA has approved the PainShield to treat these varieties of pain, giving sufferers of diabetic neuropathy an alternative path to pain relief that doesn’t carry frustrating or harmful side effects. While there’s no cure for diabetic neuropathy, with the NanoVibronix PainShield, pain management has never been simpler or safer.
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This post was written by Elyse