Diabetic peripheral neuropathy

Diabetic peripheral neuropathy is damage to peripheral nerves caused by diabetes. These nerves sense pain, touch, hot, and cold. They affect movement and muscle strength. Nerves in the feet and lower legs are most often affected. This nerve damage can lead to serious foot problems. It usually gets worse slowly, over months or years.

Diabetic peripheral neuropathy may not cause any noticeable symptoms at first. It tends to develop slowly over months or years. Symptoms may include:

• Reduced feeling or numbness in the feet.
• Tightness, burning, shooting, or stabbing pain in the feet, hands, or other parts of the body. This usually happens over time.
• Bone and joint deformities, especially in the feet (such as Charcot foot).
• Greatly reduced or greatly increased sensitivity to light touch or temperature.
• Weakness and loss of balance and coordination.

The first symptom is usually a slight burning sensation in the affected area. If blood sugar levels remain high over several years, this burning sensation greatly increases and then slowly goes away. It is replaced by a complete lack of feeling and sensation, or numbness. This makes you more likely to injure the affected area.

Treatment may help reduce your pain. And it may help improve your physical functioning, mood, and mental well-being. Talk with your doctor about the best treatment for you.

Treatments may include:

Medicines to relieve pain.

This includes pain relievers or creams. Medicines used for pain may include some that are more commonly used to:

• Treat depression. This includes tricyclic antidepressants and duloxetine hydrochloride.
• Control seizures. Pregabalin and gabapentin are two examples.

Your doctor may try using these to reduce your pain even though you do not have depression or seizures.

Complementary therapies.

This can include acupuncture and biofeedback.

Physical therapy.

This includes exercises, stretching, and massage. If you are told to use heat or ice, be careful. Neuropathy can make it hard for you to feel changes in temperature.

Transcutaneous electrical nerve stimulation (TENS).

TENS reduces pain by applying brief pulses of electricity to nerve endings in the skin.