Diabetic Neuropathy Treatments
Medications and Other Treatments for Diabetic Peripheral Nerve Pain
Diabetic peripheral neuropathy is the most common and most painful type of diabetic neuropathy, which is nerve damage caused by diabetes. To find pain relief from diabetic peripheral neuropathy, you have several medication options.
Before starting any medication—even over-the-counter medications—you should discuss the medication with your doctor. It may have side effects you’re unaware of, or it may have interactions with other medications you’re taking. Especially since you have diabetes, you should talk to your doctor about medication options.
Medications for diabetic peripheral neuropathy cannot, unfortunately, prevent more nerve damage. To do that, you should work hard to keep your blood glucose levels near normal. Frequent blood glucose monitoring, as well as careful meal planning, exercise, and diabetes medications or insulin, can help you control your blood glucose levels.
Over-the-counter Medications for Diabetic Peripheral Neuropathy
If your diabetic peripheral neuropathy is in the early stages, over-the-counter medications may provide pain relief. But remember, check with your doctor before taking these.
For nerve pain relief, you can try:
- topical medications: People who have foot pain from diabetic peripheral neuropathy sometimes use topical medications, which you apply directly to your skin. Capsaicin cream, for example, can temporarily reduce pain.
Prescription Medications for Diabetic Peripheral Neuropathy
There are several prescription medications that can be used to treat more severe diabetic peripheral nerve pain. Your doctor will explain your medication options to you and help you find the best option for you. It may be necessary to take more than one medication to deal with the effects of nerve pain.
Three prescription medications are FDA-approved to treat diabetic peripheral neuropathy: Cymbalta, Lyrica, and Nucynta.
Here are the prescription medications available for diabetic peripheral neuropathy:
- Anti-depressants: Being prescribed an anti-depressant doesn’t mean that you’re depressed. These medications can help block pain messages from getting to your brain.
Some examples are: amitriptyline (eg, Elavil), desipramine (eg, Norpramin), imipramine, and duloxetine (eg, Cymbalta—FDA-approved).
- Anti-seizures (anti-convulsants or anti-epileptics): As with anti-depressants, being prescribed an anti-seizure medication doesn’t mean that you’re being treated for seizures. Anti-seizure medications can slow down the nerve signals going to your brain, which means that the pain message isn’t transmitted as well.
Some examples of anti-seizure medications for diabetic neuropathy are: pregabalin (Lyrica—FDA-approved) and gabapentin (eg, Gabarone, Neurontin).
- Opioids: Opioids are very strong analgesics. They can provide immediate relief to intense pain. They can be addictive, though, so you must use them under a doctor’s careful supervision.
Some examples of opioids for diabetic neuropathy are: tapentadol (Nucynta—FDA-approved).
- Topical Medications: A lidocaine patch is a topical prescription medication for diabetic peripheral neuropathy. It may relieve pain, especially on the feet. Lidoderm is one type of lidocaine patch.
Besides medications, there are a few other treatments for diabetic peripheral neuropathy. Complementary and alternative medicine (CAM) may help you find nerve pain relief; acupuncture is an example of an alternative treatment. Additionally, magnetic therapy, laser (light) therapy, or nerve stimulation may provide pain relief.
- TENS: In 2012, the FDA-approved a non-medication treatment for diabetic neuropathy—Sensus Pain Management device. The device uses low frequency electric impulses through the body (transcutaneous electrical nerve stimulation) to help improve circulation and nerve damage. According to the makers, NeuroMetrix, "the device is worn on the calf, works at the press of a single button, and is equipped with a rechargeable battery that should last about two weeks based on the recommended once-daily, hour-long treatment sessions.")
Talk to your doctor about treatments for diabetic peripheral neuropathy. You will probably need medications to help deal with the nerve pain, but there are other treatments available.