What are the treatment options for diabetic nerve pain?
· A randomized, sham-controlled, crossover study of 50 adults with type 2 diabetes evaluated the effectiveness of Percutaneous Nerve Stimulation (PENS) therapy in the treatment of neuropathic pain. PENS is a modern adaptation of acupuncture that uses percutaneously placed acupuncture needles to stimulate peripheral sensory and motor nerves innervating the …
What is the best medicine for nerve pain?
· Clinically, a unique treatment method is used to treat diabetic peripheral neuropathy, and the traditional Chinese medicine fumigation treatment is 1 of the representatives. TCMF can directly act on the diseased part of the patient, accelerate the blood circulation of the diseased part, and promote the improvement of the nerve function of the foot and the clinical …
How do you get rid of diabetic neuropathy?
Meditation to Relieve Diabetes Nerve Pain Meditation is a therapy offered in many pain treatment centers for diabetes and other painful disorders. Research …
Can you treat diabetic nerve pain with capsaicin?
Various forms of electrical stimulation have been used to manage pain in diabetic neuropathy, including transcutaneous electrical nerve stimulation, percutaneous electrical nerve stimulation and frequency-modulated electromagnetic neural stimulation [Bril et al. 2011]. A recent review analysed eight studies that evaluated the use of electrical stimulation in PDN.
How do you recover from diabetic nerve pain?
For diabetic neuropathy, you may want to try:Capsaicin. Capsaicin cream, applied to the skin, can reduce pain sensations in some people. ... Alpha-lipoic acid. ... Acetyl-L-carnitine. ... Transcutaneous electrical nerve stimulation (TENS). ... Acupuncture.
Can Chinese medicine help with neuropathy?
Acupuncture and TCM offer a safe alternative for treating neuropathy symptoms stemming from diabetes, chemotherapy, inflammatory and other conditions.
Can diabetic nerve pain be cured?
There is no cure for diabetic neuropathy. You can manage diabetic nerve pain with medication, exercise and proper nutrition.
What do the Chinese use for neuropathy?
Wu-Tou decoction (WTD) has been characterized by the anti-inflammatory functions and clinically applied for chronic pain for thousands of years in China. The prescription of WTD is composed of Radix Aconiti, Herba, Ephedrae, Radix Astragali, Raidix Paeoniae Alba and Radix Glycytthizae.
How many acupuncture sessions are needed for neuropathy?
A typical treatment course consists of weekly sessions for 6 to 10 weeks, followed by maintenance sessions beginning every other week and extending to once every month.
Is acupuncture good for diabetic neuropathy?
All studies reported that acupuncture significantly relieved diabetic neuropathy. ST36, BL13, BL20, SP6, and SP9 were the most widely used acupoints. Five studies used electro-acupuncture, whereas other studies used manual acupuncture.
How do you treat diabetic nerve pain naturally?
Normal blood sugar levels are the best possible treatment for diabetic nerve pain. Walk it off. Exercise releases natural painkillers called endorphins. Exercise also promotes blood flow to the nerves in the legs and feet.
What is the latest treatment for diabetic neuropathy?
What is the latest treatment for diabetic neuropathy? Cymbalta (duloxetine), Neurontin (gabapentin), and Lyrica (pregabalin) are the latest and only FDA-approved treatments for diabetic neuropathy.
How do you repair nerve damage naturally?
Green and leafy vegetables. Broccoli, spinach and asparagus all contain vitamin B, a nutrient important for nerve regeneration and nerve function. Spinach, broccoli and kale also contain a micronutrient called alpha-lipoic acid that prevents nerve damage and improves nerve function.
What do Chinese people take for pain?
Herbal Medicine Treatments Corydalis (Yu Jin) is a tuber that has been used in Chinese medicine for thousands of years. It is dug up, ground, and boiled with hot vinegar for the treatment of chronic pain. It contains a pain-relieving compound called dehydrocorybulbine (DHCB).
Do Chinese herbal patches work?
Skin-patches of Chinese herbal medicine are commonly used in China as supplementary therapy for patients with acute gouty arthritis; many clinical studies have reported promising effects. There is evidence to support the efficacy of this treatment, but confirmatory evidence is necessary.
What is in Chinese herbal medicine?
In this Chinese folk medicine, herbs are used more simply, somewhat in the manner of Western herbal medicine. Herbs most commonly used in this manner include astragalus , dong quai , ginger , kudzu ( Pueraria lobata ), licorice , lycium , Panax ginseng , and schizandra .
How to treat neuropathy pain?
Another home treatment for pain involves limiting your alcohol intake. Alcohol can increase nerve damage, and is sometimes the cause of neuropathy.
What is acupuncture for neuropathy?
Acupuncture for neuropathy. Acupuncture is a technique used to treat pain and relieve discomfort. The needles used in acupuncture are inserted into your body’s pressure points to stimulate the nervous system. This releases endorphins, your body’s natural painkillers, in the muscles, spine, and brain. This technique changes your body’s response ...
Do acupuncture needles need to be sterilized?
Infection. Acupuncture needles are required to be sterile. If a practitioner uses unsterilized needles or reuses old needles, you could be exposed to life-threatening diseases. Not all people are qualified candidates for acupuncture.
Can acupuncture cause pain?
Pain and bruising. You may experience minor pain or discomfort at needle sites after an acupuncture treatment. You may also have light bleeding.
What is the best treatment for back pain?
This helps boost the body’s response to pain, and improves blood circulation. Acupuncture is commonly used to treat headaches, back pain and joint pain.
What is acupuncture in Chinese medicine?
What is acupuncture? Acupuncture is a component of traditional Chinese medicine. During acupuncture, tiny needles are inserted into the skin at various pressure points across the body. According to Chinese tradition, acupuncture helps balance the flow of energy, or qi (pronounced “chee”), within your body.
Does alcohol cause neuropathy?
Alcohol can increase nerve damage, and is sometimes the cause of neuropathy. Taking a warm bath is also thought to soothe neuropathic pain. Warm water stimulates the body and increase blood circulation. As a result, pain symptoms decrease.
How to reduce pain in diabetic nerves?
It is possible, through biofeedback, to train the body to decrease the severity of diabetes nerve pain. This involves consciously controlling a body function that is normally regulated by the body -- like skin temperature, heart rate, or blood pressure.
How to help diabetics with nerve pain?
Try to block out worries and distracting thoughts. Relaxation techniques to help with diabetes nerve pain include: Rhythmic breathing: Take long, slow breaths. Inhale slowly, and then exhale slowly. Count slowly to five as you inhale. Then count slowly to five as you exhale.
What is the practice of acupuncture?
It is a practice in which fine needles are inserted into the skin to stimulate specific points in the body. Traditional Chinese medicine is based on the theory that energy flows through the body along certain pathways, called ‘chi’. Illness or pain results when that energy is blocked or out of balance.
What is acupuncture in Chinese medicine?
What is acupuncture? It is a practice in which fine needles are inserted into the skin to stimulate specific points in the body. Traditional Chinese medicine is based on the theory that energy flows through the body along certain pathways, called ‘chi’. Illness or pain results when that energy is blocked or out of balance. The Chinese theory holds that acupuncture unblocks or balances that flow of energy.
Does hypnosis help with pain?
The mind has learned to control the body. Scientists say hypnosis seems to block nerve pain receptors in the brain. Those receptors control sensations of pain, anxiety, and discomfort. Studies have shown that pain related to cancer, surgery, back injuries, and migraines responds well to hypnosis.
How to help neuropathy pain?
Relaxation Techniques to Relieve Neuropathy Pain. Stress can make neuropathy pain worse, so it is important to learn to relax. Your breathing pattern is often affected by changes in emotions. That's why managing your breathing is an important tool for relaxation.
How does meditation help with diabetes?
Meditation is a therapy offered in many pain treatment centers for diabetes and other painful disorders. Research shows that meditation can lower blood pressure and improve heart rate , breathing, and brain waves. Tension and tightness seep from muscles as the body receives a quiet message to relax.
What is the treatment for diabetic neuropathy?
No single treatment exists to prevent or reverse neuropathic changes or to provide total pain relief. Treatment of PDN is based on three major approaches: intensive glycaemic control and risk factor management, treatments based on pathogenetic mechanisms , and symptomatic pain management. Clinical guidelines recommend pain relief in PDN through the use of antidepressants such as amitriptyline and duloxetine, the γ-aminobutyric acid analogues gabapentin and pregabalin, opioids and topical agents such as capsaicin. Of these medications, duloxetine and pregabalin were approved by the US Food and Drug Administration (FDA) in 2004 and tapentadol extended release was approved in 2012 for the treatment of PDN. Proposed pathogenetic treatments include α-lipoic acid (stems reactive oxygen species formation), benfotiamine (prevents vascular damage in diabetes) and aldose-reductase inhibitors (reduces flux through the polyol pathway). There is a growing need for studies to evaluate the most potent drugs or combinations for the management of PDN to maximize pain relief and improve quality of life. A number of agents are potential candidates for future use in PDN therapy, including Nav 1.7 antagonists, N-type calcium channel blockers, NGF antibodies and angiotensin II type 2 receptor antagonists.
What is peripheral neuropathy?
Peripheral neuropathy is characterized by diffuse damage to the peripheral nerve fibres. The commonest cause of peripheral neuropathy is diabetes, and 30–90% of patients with diabetes have peripheral neuropathy [Callaghan et al.2012a]. Diabetic sensorimotor polyneuropathy (DSPN), the most common type of diabetic neuropathy, is associated with an impaired quality of life, significant morbidity and increased healthcare costs. Additionally, 16–34% of patients with diabetes report painful neuropathic symptoms and the prevalence is greater in type 2 diabetes, women and South Asians [Ziegler et al.2009; Abbott et al.2011]. The symptoms of painful diabetic neuropathy (PDN) can be debilitating and can cause sleep disturbances, anxiety and interfere with physical functioning [Galer et al.2000].
Does trandolapril help with neuropathy?
In a placebo-controlled study, the angiotensin-converting enzyme (ACE) inhibitor trandolapril has been reported to improve the neurophysiological indices of neuropathy at 12 months, even in patients who are normotensive with mild diabetic neuropathy [Malik et al.1998]. Furthermore, in a larger randomized trial (DEMAND study) the calcium channel blocker manidipine and ACE inhibitor delapril in combination, or Delapril on its own significantly reduced the progression of neuropathy compared with placebo. Hyperlipidaemia has been implicated in the pathogenesis of diabetic neuropathy and it has been suggested that adequate control of blood lipid levels through lipid-lowering agents may prevent or ameliorate the effects of DSPN [Fried et al.2001]. Additionally, HMG-coenzyme A reductase inhibitors (statins) have been suggested to have additional neuroprotective effects [Leiter, 2005]. Elevated triglycerides have been shown to correlate with the loss of myelinated fibre density, independent of diabetes duration and glycaemic control [Wiggin et al.2009] and are also an independent risk factor for amputation in patients with diabetes [Callaghan et al.2011]. An improvement in diet and exercise with an improvement in triglycerides has been shown to result in an increase in IENFD in subjects with IGT [Smith et al.2006] and fenofibrate has been shown to significantly reduce amputations in the FIELD study [Malik et al.2013; Rajamani et al.2009].
Does glycaemic control help with DSPN?
In patients with type 2 diabetes, the role of intensified glycaemic control in preventing and managing DSPN is less clear with studies offering contradictory conclusions. A recent meta-analysis of randomized control trials found no significant benefit of intensive glycaemic control in reducing the incidence of DSPN in patients with type 2 diabetes [Boussageon et al.2011]. This conclusion was supported by a Cochrane review which demonstrated no significant improvement in markers of neuropathy in patients with type 2 diabetes managed through intensive glycaemic control [Callaghan et al.2012b]. However, most studies conducted in patients with type 2 diabetes were not specifically designed to investigate the effect of intensive glycaemic control on DSPN and thus only incorporated a rudimentary assessment of neuropathy.
What are the two therapeutic approaches for PDN?
Once the diagnosis of PDN is established, there are two therapeutic approaches: pathogenetic treatments target the underlying pathophysiological processes to prevent nerve fibre loss, and symptomatic treatments aim to alleviate the painful symptoms of PDN to normalize physical and psychological functioning.
Can a QST be used to diagnose neuropathy?
Due to the subjective nature of the symptoms reported by patients, these scales may not produce consistent results and may lack the sensitivity to track any objective changes in neuropathy status, partly because these scales assess pain status and are thus subjective, measuring largely positive symptoms [Dyck et al.2007]. In comparison, measures of the severity of neuropathy typically focus on negative signs and symptoms. Quantitative sensory testing (QST) has been used in clinical trials to measure progression of neuropathy. However, PDN is principally caused by small-nerve fibres, which are not assessed using the standard QST of vibration perception [Shy et al.2003; Tavakoli et al.2008]. Recent guidance has clearly stipulated that QSTs should not be used as standalone tests for the diagnosis of neuropathic pain [Backonja et al.2013]. Although, skin biopsies which measure intraepidermal nerve fibre density have been used to diagnose and assess neuropathy [Bakkers et al.2014] and corneal confocal microscopy has been proposed as a reliable, noninvasive marker of neuropathy that may be used to objectively assess neuropathy in PDN [Shy et al.2003].
Is amitriptyline safe for PDN?
A crossover study of desipramine in 20 subjects favoured active treatment over placebo [Max et al.1991]. Additionally, three randomized controlled trials of imipramine have all favoured treatment over placebo for the management of PDN [Kvinesdal et al.1984; Sindrup et al.1989, 1990]. However, TCAs are associated with a high side-effect burden which may limit their use in patients with diabetes. In a meta-analysis of the efficacy and safety of six antidepressants and GABA analogues for the management of PDN, amitriptyline was found to be the least safe agent for this indication [Rudroju et al.2013]. In clinical practice, the high doses used in the clinical trials are rarely used due to side effects and therefore lower doses are prescribed.
How to treat diabetic neuropathy?
Physical therapy. Some physical therapy treatments, such as swimming, can help treat diabetic neuropathy. Low-impact exercises are the most effective, as high-impact exercises can quickly cause nerves to go numb.
How to avoid nerve pain?
Keeping your blood sugar under control to prevent nerve damage is the best way to avoid nerve pain. Follow your doctor’s advice for diet, exercise, and treatments if you already experience diabetic nerve pain. Diabetic neuropathy doesn’t have any known cures. However, many treatments can help lessen the discomfort and pain caused by diabetic nerve ...
What is the best pain reliever?
Powerful drugs like oxycodone (Oxycontin) and the opioid-like medicine tramadol (Conzip, Ultram) can treat much stronger pain. But these tend to be a last resort for pain relief. You might use these medications if other treatments aren’t working.
What is the best pain reliever for a swollen ear?
Your doctor might suggest trying an over-the-counter pain reliever, such as acetaminophen (Tylenol), aspirin (Bufferin), or ibuprofen (Motrin IB, Advil), which are available without a prescription but can cause side effects. Use a low dose for a short time to control your symptoms.
How to lower blood sugar levels?
Use diets, exercise, and medications to decrease your blood sugar to a healthier range. Monitor other health risks that can worsen your diabetes, such as your weight and smoking. Ask your doctor about effective ways to lose weight or quit smoking, if necessary.
Can nerve damage be replaced?
Damaged nerves can’t be replaced. However, there are ways that you can prevent further damage and relieve your pain. First, control your blood sugar so the damage doesn’t progress. Talk to your doctor about setting your blood sugar goal, and learn to monitor it.
Can diabetic neuropathy be cured?
Diabetic neuropathy doesn’t have any known cures. However, many treatments can help lessen the discomfort and pain caused by diabetic nerve pain, and your doctor can assist you in selecting one that works best for you. Last medically reviewed on October 2, 2017.
What is the best medication for nerve pain?
Antidepressants. Some antidepressants ease nerve pain, even if you aren't depressed. Tricyclic anti depressants may help with mild to moderate nerve pain. Drugs in this class include amitriptyline, desipramine (Norpramin) and imipramine (Tofranil). Side effects can be bothersome and include dry mouth and drowsiness.
How to diagnose diabetic neuropathy?
Diagnosis. A doctor can usually diagnose diabetic neuropathy by performing a physical exam and carefully reviewing your symptoms and medical history. Your doctor will check your: Overall muscle strength and tone. Tendon reflexes. Sensitivity to touch and vibration. Along with the physical exam, your doctor may perform or order specific tests ...
What is the best antidepressant for nerve pain?
Serotonin and norepinephrine reuptake inhibitors (SNRIs) are another type of antidepressant that may help with nerve pain and have fewer side effects. The American Diabetes Association recommends duloxetine (Cymbalta) as a first treatment. Another that may be used is venlafaxine (Effexor XR).
Does blood sugar management help with diabetes?
Good blood sugar management may even improve some of your current symptoms. Your doctor will figure out the best target range for you based on factors including your age, how long you've had diabetes and your overall health. Blood sugar levels may need to be individualized.
What is nerve conduction test?
Nerve conduction testing. This test measures how quickly the nerves in your arms and legs conduct electrical signals. It's often used to diagnose carpal tunnel syndrome.
Does Tens work for neuropathy?
Although safe and painless, TENS doesn't work for everyone or for all types of pain. Acupuncture. Acupuncture may help relieve the pain of neuropathy, and generally doesn't have any side effects.
How to stop neuropathy from getting worse?
Other important ways to help slow or prevent neuropathy from getting worse include keeping your blood pressure under control, maintaining a healthy weight and getting regular physical activity.
How to prevent nerve damage?
Keeping your blood sugar as close to your target range as possible is the best way to help prevent or delay nerve damage. Other things you can do are: Keep your blood pressure below 140/90 mm Hg (or the target your doctor sets). Get regular physical activity. Lose weight if you’re overweight.
How many types of nerve damage are there?
Types of Nerve Damage. There are four main types of nerve damage. You can have more than one type. Symptoms depend on the type of nerve damage you have and which nerves are affected.
What are the symptoms of autonomic nerve damage?
Autonomic nerve damage affects your heart, bladder, stomach, intestines, sex organs, or eyes. Symptoms may include: Bladder or bowel problems that may cause urine leakage, constipation, or diarrhea. Nausea, loss of appetite, and vomiting. Changes in how your eyes adjust from light to dark.
Why is it important to notice nerve damage early?
When you do this, you’ll also have more energy, and you’ll feel better! Symptoms of nerve damage usually develop slowly, so it’s important to notice your symptoms early so you can take action to prevent it from getting more serious.
What are the risk factors for nerve damage?
Risk Factors for Nerve Damage. Anyone with diabetes can develop nerve damage, but these factors increase your risk: Blood sugar levels that are hard to manage. Having diabetes for a long time, especially if your blood sugar is often higher than your target levels. Being overweight.
Can diabetics touch their feet?
Your feet may be very sensitive to touch—even a bed sheet can hurt. These are all symptoms of peripheral nerve damage. Peripheral nerve damage affects your hands, feet, legs, and arms, and it’s the most common type of nerve damage for people with diabetes. It generally starts in the feet, usually in both feet at once.
Why is it important to manage blood sugar?
Not only does it help you with day-to-day wellness, it can help prevent serious health problems down the road.
What is neuropathy in diabetes?
Neuropathy is a complication of diabetes that can lead to problems throughout the body. Diabetes can affect nerves that control movement, sensation and other functions.
What causes diabetic neuropathy?
Although the exact causes of diabetic neuropathy are unknown, several factors may contribute to the disorder, including: High blood sugar (glucose). High blood glucose causes chemical changes in nerves and impairs the nerves’ ability to transmit signals. It can also damage blood vessels that carry oxygen and nutrients to the nerves.
What is the term for a sensation that is tingling?
Unusual sensations (paresthesias) such as tingling, burning or prickling.
Can diabetic neuropathy be a medical condition?
The symptoms of diabetic neuropathy may resemble other conditions or medical problems. Always consult your doctor for a diagnosis.
What is the pain in the upper leg?
The main symptom is nerve pain that starts in the upper thigh of one leg and can involve the hip and lower back. Weight loss is a symptom in about 35% of patients with proximal neuropathy, and about 18% experience weakness in the affected area in addition to the pain.
What is the name of the neuropathy that affects the internal organs of the heart, digestive system, and sweat
Diabetic Autonomic Neuropathy. Diabetic autonomic neuropathy primarily affects the autonomic nerves that serve internal organs, processes, and systems of the heart, digestive system, sexual organs, urinary tract and sweat glands. This kind of diabetic polyneuropathy can cause symptoms such as:
What is the name of the condition that affects the nerves in the arms, hands, legs and feet?
Diabetic polyneuropathy (DPN) affects multiple peripheral sensory and motor nerves that branch out from the spinal cord into the arms, hands, legs and feet. Typically, the longest nerves — those that extend from the spine to the feet — are affected the most.
What is the pain of diabetic peripheral neuropathy?
It typically causes burning pain, paresthesias, and numbness in a stocking-glove pattern that progresses proximally from the feet and hands.
What is the best medication for DPN?
Only two medications, pregabalin (Lyrica) and duloxetine (Cymbalta), have been approved by the U.S. Food and Drug Administration (FDA) for the treatment of DPN. Guidelines from national organizations such as the American Academy of Neurology, however, recommend the use of a broader range of medications.
Does pregabalin help with pain?
Pregabalin provides consistent pain relief based on a dose-dependent response compared with placebo. A meta-analysis of seven RCTs (n = 1,596) comparing pregabalin with placebo showed that dosages of 300 mg daily and 600 mg daily (or divided twice daily) resulted in greater than 50% pain reduction in 39% and 47% of patients, respectively, vs. 22% with placebo. Onset of action occurred at five days with 300 mg and at four days with 600 mg. Dosing at 150 mg daily was ineffective. 1 – 3
Is DPN pharmacologic or nonpharmacologic?
Pharmacologic and nonpharmacologic interventions are available for the treatment of painful DPN. However, there are few high-quality, head-to-head clinical trials comparing these therapeutic approaches, and because the available studies use varying methodologies, it is difficult to know which treatment strategy may be most effective.
What is distal symmetric polyneuropathy?
Distal symmetric polyneuropathy, which is characterized by burning pain, paresthesias, and numbness that follows a stocking-glove pattern and progresses proximally, occurs in approximately 26% of patients with DPN. Less than 20% of patients with diabetes experience dynamic mechanical allodynia (pain in response to stroking lightly), thermal hyperalgesia (increased sensitivity to pain by thermal stimuli), or pain attacks.
Is valproate a good treatment for DPN?
Few high-quality studies have investigated the effectiveness of valproate, topiramate, carbamazepine (Tegretol), oxcarbazepine, lamotrigine, and lacosamide. Thus, these agents are not recommended for the treatment of painful DPN. 2, 17