Medical contributions and review by Brian Block, MD, PhD.
The CDC reports that more than 34 million Americans have diabetes. This is almost 11% of the population. And approximately 20% of people with diabetes will develop peripheral diabetic neuropathy symptoms over time.
What Is Peripheral Diabetic Neuropathy?
Diabetes is a common metabolic disorder characterized by elevated blood glucose levels. High blood sugar over a span of years damages the body’s nerves along with other tissues. Those nerves send signals or sensations from the feet to the head, like pain, hot and cold. Over the years, people can end up with nerve problems that usually start with pain and burning sensations in their feet and later in the hands – this is peripheral neuropathy. The pain is not activity-related, so these individuals experience burning in their feet at all times.
Many people complain that the pain is worse at night. This may be because there is less other stimulation happening while lying quietly in bed, so the sensations feel stronger.
Eventually, as nerves are further damaged, pain can give way to a loss of sensation; for example, if a person cuts their foot, they may not feel it. This becomes a problem if the wound doesn’t get addressed. An open wound can become infected without the person’s knowledge. In the worst-case scenario, an unaddressed wound can lead to amputation.
Treatment Options for Peripheral Diabetic Neuropathy
The best way to manage diabetes is with diet, exercise and medications. Some prescription drugs, like pregabalin, gabapentin and duloxetine, are often used to treat the pain of peripheral neuropathy. However, although they can help reduce pain, none of them improve sensation.
An emerging treatment option for relief is spinal cord stimulation. This treatment has been used routinely for treating pain for many years, especially for pain after spine surgery. It has recently been found to be helpful for patients with diabetic foot pain.
For this treatment, patients undergo a procedure that implants a small wire into the back and a computer sends small electrical pulses to interrupt the pain signal that goes from the feet to the brain. The wire insertion is an outpatient procedure. Patients can try it out before deciding whether they want a permanent implant.
Several research studies have found that patients experienced significantly reduced pain without medication side effects. An unexpected result was that the spinal cord stimulation also improved sensation. Advancements in this treatment and research will continue. Patients may achieve greater improvements in peripheral neuropathy symptoms.
Practicing Good Diabetic Care
Fortunately, not every person with diabetes will develop peripheral neuropathy. Yet, it’s still crucial they practice good diabetic care. Along with diet, exercise and medication adherence, foot care is also important. Patients with severe diabetes need someone to look at their feet daily to ensure no wounds exist.
Individuals living with diabetes also need to keep up with their doctors’ appointments. This includes their primary care physician, endocrinologist and podiatrist.
Listen to a Podcast
Peripheral diabetic neuropathy, caused by nerve damage in people with diabetes, can cause pain and numbness in the feet and legs and sometimes the hands and arms. In this podcast, we talk with pain management specialist Dr. Brian Block about how to combat the pain caused by peripheral diabetic neuropathy and what treatments are available. Download the podcast or listen on your favorite podcast platform:
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