PainCare Florida Physicians

Diabetic Pain

PAIN CONDITION

Diabetic Pain: Causes, Treatment & Pain Relief

Pain caused by diabetes is also called diabetic neuropathy or neuralgia.[1] Diabetic nerve damage is caused by high blood sugar and high metabolic levels (triglycerides and cholesterol).[2] Diabetic pain can vary from shooting pains and cramps to hypersensitivity and numbness. Nerve pain can feel different for each person, but its impact is consistent—it disrupts daily life with uncomfortable or painful sensations.
Understanding diabetic pain and its treatment options is crucial for effective pain management.

About Diabetic Nerve Pain

Diabetic pain or neuropathy occurs when glucose (blood sugar) levels aren’t appropriately managed, damaging nerves and causing them to malfunction.[3] Most diabetics describe their pain as tingling, burning and numbness. [3] Nerve damage commonly affects hands, legs and feet but can also affect the digestive system, bladder, blood pressure, eyes and heart.[2] People with Type 1, Type 2 and other diabetes types are all susceptible to mild to severe nerve pain and sensations throughout the body.[4]

Diabetic Pain Symptoms

Diabetic neuropathy symptoms usually begin slowly, with the feet being affected first.
Symptoms can vary depending on the area affected and the extent of the damage but often include:
  • Numbness or inability to feel pain or temperature changes [3]
  • Tingling or burning sensations [3]
  • Cramping [3]
  • Sharp pains [3]
  • Muscle weakness [3]
  • Extreme sensitivity to touch [3]
  • Foot problems such as ulcers, infection and bone or joint damage [3]
  • Thigh pain [5]
  • Severe lower back or pelvis pain [5]
  • Aching behind eyes [5]
  • Loss of balance [5]

The physical symptoms above are due to Peripheral neuropathy, Proximal neuropathy (diabetic polyradiculopathy) and Mononeuropathy (focal neuropathy). Autonomic neuropathy affects the nerves that control automatic functions like heart rate, blood pressure, digestion, waste elimination, and sexual function.

Diabetic Pain Causes

“Diabetic pain is primarily caused by nerve damage due to prolonged high blood sugar levels, which leads to poor blood flow to the nerves, oxidative stress, and inflammation. These factors result in structural changes to the nerves, impairing their ability to function properly and causing pain, numbness, or weakness.”
(Adapted from World Journal of Diabetes)[6]

Diabetic Neuropathy Pain Risk Factors

As noted by the Mayo Clinic, certain factors increase your risk of developing diabetic nerve damage pain, including:

  • Uncontrolled or poorly managed blood sugar levels.
  • Long-term diabetes
  • Being overweight.
  • Smoking, which affects circulation.
  • High blood pressure or cholesterol.
If any of these apply to you, it’s essential to work closely with your healthcare provider to reduce your risk.

Pain Management Treatments

Existing nerve damage can’t be reversed, but the goal of diabetic pain treatment is to control blood glucose levels (medically and naturally), preventing further nerve damage.[5] Diabetes management requires a comprehensive approach that includes lifestyle changes like healthy eating (avoiding sugary, processed foods), meal planning, exercise and medication.[7]

People with diabetes should always practice proper foot care, including nail trims, daily washing, moisturizing, wearing well-fitting shoes and regular foot exams.[3] Relieving nerve pain often relies on over-the-counter (OTC) pain relievers such as oral and topical NSAIDs.[7] Your doctor may prescribe antidepressants, antiseizure drugs and prescription pain relievers to ease nerve pain and uncomfortable sensations.[7]

Pain management clinics offer many non-pharmacological and non-surgical intervention options to relieve severe, chronic diabetic neuropathy, including:

When to Consult a Diabetic Pain Care Specialist

Nerves are the messengers between your brain and every body part, enabling you to see, hear, feel and move. They also control the involuntary operations in your body, such as breathing, digestion, and organ function. Managing your diabetes and nerve health is crucial to prevent complications, including nerve pain.
Receiving treatment for your diabetic pain plus receiving a holistic plan that addresses your glucose levels, pain symptoms and lifestyle can make a significant impact on your nerve health and your overall well-being. Your pain specialist will create a treatment plan to relieve pain and prevent further nerve damage.
Early intervention against diabetic pain is essential to slowing the progression of diabetic neuropathy and reducing the risk of severe complications. With prompt intervention from a pain specialist, you can achieve more effective symptom control, preserve nerve function, and significantly improve your overall quality of life.

Resources:

  1. Ellis ME. Neuralgia: Types, Causes, and Treatments. Healthline [Internet]. Updated January 06, 2023. Accessed September 05, 2024. Available from: https://www.healthline.com/health/neuralgia 
  2. Pop-Busui R. Diabetic Neuropathy. National Institute of Diabetes and Digestive and Kidney Diseases | NIDDK [Internet]. Published March 6, 2019. Accessed September 05, 2024. Available from: https://www.niddk.nih.gov/health-information/diabetes/overview/preventing-problems/nerve-damage-diabetic-neuropathies 
  3. Diabetic neuropathy – Symptoms and causes. Mayo Clinic [Internet]. Published April 29, 2022. Accessed September 05, 2024. Available from: https://www.mayoclinic.org/diseases-conditions/diabetic-neuropathy/symptoms-causes/syc-20371580 
  4. Nerves (neuropathy). Diabetes UK [Internet]. Published 2017. Accessed September 05, 2024. Available from: https://www.diabetes.org.uk/guide-to-diabetes/complications/nerves_neuropathy 
  5. Diabetic neuropathy (nerve problems). Johns Hopkins Medicine [Internet]. Published 2020. Accessed September 05, 2024. Available from: https://www.hopkinsmedicine.org/health/conditions-and-diseases/diabetes/diabetic-neuropathy-nerve-problems 
  6. Schreiber AK. Diabetic neuropathic pain: Physiopathology and treatment. World Journal of Diabetes [Internet]. 2015;6(3):432. doi:https://doi.org/10.4239/wjd.v6.i3.432 Accessed September 05, 2024. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4398900/ 
  7. WebMD Editorial Contributors. Treatment for Diabetes Nerve Pain. WebMD [Internet]. Accessed September 05, 2024. Available from: https://www.webmd.com/diabetes/peripheral-neuropathy-treating-nerve-pain
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