Diabetes is an ailment that affects millions of lives globally. People who battle the deadly disease and their caregivers face challenges when it comes to managing and overcoming the negative impacts on their lives. Diabetes is detrimental to nerve endings. And because of this, one of the major negative impacts of diabetes include pain, numbness, and a tingling sensation in the fingers, toes, hands, and feet. The pain, however, has been described as a sharp, burning, aching pain. As you can imagine, this is extremely uncomfortable for patients, affecting their mood, sleep, and overall quality of life. Can you imagine being in excruciating pain and feeling an uncomfortable sensation that never goes away?
This condition termed diabetic neuropathy, can be mild to severe, and is usually a lifelong challenge that affects at least half of diabetic patients. And the worst part is? There is no specific medication to treat this unbearable symptom. Currently, there are several prescription medications that might help mitigate a patient’s symptoms. However, studies show that it doesn’t really relieve pain, as patients still feel around 30% to 50% of the pain.
Damaged nerve endings cannot be replaced, but there are ways to halt further damage and relieve pain. This first step includes making some big changes to a diabetic patient’s diet. Physicians will usually set and monitor a diabetic patient’s blood sugar goal, as uncontrolled sugar levels will lead to even severe damages. This can include lowering blood sugar levels to within 70 to 130 mg/dL before meals and below 180 mg/dL after meals. Dietary changes coupled with exercise and prescription medications can keep blood sugar within a healthier range. Lifestyle changes also should be made, as smoking and alcohol will also contribute to further damage.
Along with dietary changes, your doctor will also prescribe physical therapy. Activities like swimming and low impact exercises have been shown to be effective against diabetic neuropathy. Patients should work with a physical therapist specializing in helping diabetic patients, or someone who is at least familiar with diabetic neuropathy. This is because if done wrongly, physical exercise might worsen nerve damage.
As diabetic patients might feel numbness in areas of damaged nerve endings, sores, cuts, swelling, or other wounds might be missed. Therefore, patients should always take good care of areas with nerve damage, as they can get infected and lead to a more serious complication, even resulting in amputation. Patients can do this by washing daily with warm water, ensuring to dry them afterward, and applying lotion to keep them moisturized. Wearing comfortable and flexible shoes is important so a patient’s feet have room to move.
Medications to relieve nerve pain
Over-the-counter pain relievers are also usually prescribed by physicians. These include medications such as ibuprofen, aspirin, or acetaminophen prescribed in low doses over a short period of time. According to clinical assistant professor at NYU Langone Medical Center’s Rusk Rehabilitation Kimberly Sackheim, it is important to consult with a physician if you take these drugs regularly. This is because these temporary pain relievers have long term side effects that can contribute to heart attack, stroke, and kidney failure. And you do not want these other ailments on top of your diabetic neuropathy. Thus, there are other options for long-term pain relief.
Research shows that patients who experience long-term pain are at high risk of developing depression. Antidepressants are usually used to treat depression. Concurrently, research has also shown that antidepressants alleviate nerve pain as the drug interferes with chemicals in the brain that causes one to feel pain. Physicians usually prescribe serotonin and norepinephrine reuptake inhibitors (SNRIs) such as duloxetine and venlafaxine which tend to have lesser side effects. Nevertheless, tricyclic antidepressants imipramine, desipramine, and amitriptyline have also been known to work but comes with side effects such as fatigue, dry mouth, and sweating.
Just like antidepressants, anti-seizure drugs are also known to alleviate nerve pain. Drugs such as gabapentin, pregabalin, can help improve sleep but comes with side effects like dizziness, drowsiness, and swelling.
Opioid pain-relief medications
Opioid medicines are usually a second choice as they are very powerful. These include drugs such as oxycodone (Oxycontin) or tramadol, and they are used to treat much severe pain. The reason this wouldn’t be a physician’s first choice is that they have a high potential for addiction. Lidocaine patches can also be used as they deliver local anesthesia by placing the patch on a specific spot of the skin. These patches aren’t so common, however, as they cause skin irritations in the long term.
Being in constant, excruciating pain can affect a diabetic patient’s life not just physically, but mentally, and emotionally. Although it might not be easy when a patient is newly diagnosed with the terrible disease, the methods above should at least help to alleviate some of the sufferings. These lifestyle changes might seem hard at first, but with the right motivation, and the right perspective, anything is possible.