Diabetic neuropathy, although the exact cause is not known, researchers believe that it is a process where nerve damage related to high glucose concentrations in our blood causes chemical changes in the nerves. These chemical changes could disrupt the nerves ability to transmit messages throughout the body. It is also possible to have a genetic predisposition to diabetic neuropathy. One of the first symptoms of diabetic neuropathy is a tingling or numbness in hands and feet as high glucose damages the nervous system. Carpal tunnel syndrome is a good example of neuropathy pain. Nerve damage creeps up in type 2 diabetes just as the disease itself does. Individuals can have both diabetes and neuropathy for a few years before it is even diagnosed. In its early stages it can often improve when blood glucose levels are under control but often the damage can be permanent.
Treatment of neuropathy is mainly only focused on the symptoms and trying to improve the triggers that cause neuropathy such as control of blood sugars. Neuropathy often causes permanent damage and for this there is no cure. Some people can experience such severe pain that it will cause sleep deprivation and limit mobility. The best thing that can be done is pain medications and some advances have been made in this field such as topical skin creams such as capsaicin. Even this though cannot be any stronger in dosage than codeine for fear of the risk of addiction if needed and used over a long period of time. One common treatment agent that many have found helpful is called Lyrica but unfortunately is fairly expensive. Some health plans will cover it if prescribed by your physician.
Although there are a wide variety of symptoms for peripheral neuropathy some of the more common ones include but are not limited to: numbness, tingling, burning in limbs (usually feet), Insensitivity to pain, needle-like or a feeling like walking on glass type of pain, sensitivity or extreme sensitivity to touch and loss of coordination or poor balance. Common symptoms of diffuse autonomic neuropathy could include: urination and sexual function problems, bladder infections, gastric or stomach disorders, nausea, vomiting and bloating, light headedness, dizziness or even fainting and little or no appetite. Common symptoms of focal neuropathy include: pain in front of thigh, severe lower back pain, chest or stomach pain, aches behind the eye, double vision and possible paralysis on one side of the face. In severe cases of diabetic neuropathy when the loss of feeling or sensation progresses it could lead to serious injuries or even cuts going unnoticed. This problem could eventually lead to infections, ulcerations, and in the long term amputation.
You and your doctor should sit down and work out a pain management plan to help you live with the pain of neuropathy. He may send you for a consultation with a specialist in neuropathy or you may have a health care team that will work together with you to map out a more complete treatment plan. If your peripheral neuropathy pain becomes chronic narcotics should be avoided as they are in all chronic diseases. Some agents that may be beneficial to the pain include: Amitriptyline, carbamazepine and capsaicin cream. If the neuropathy is severe and starts restricting mobility physical therapy and specialized physician directed or planned exercises may help. Braces, special footwear and other supportive equipment may become necessary and aid in an individual’s ability to keep getting around.