If you suffer from nerve pain as a complication of Diabetes, you know it can take time to resolve. The best way to help keep nerve pain at bay is to carefully manage your Diabetes. That means controlling your blood sugar levels, exercising regularly and maintaining a healthy weight.
However, if you still have pain or numbness in your feet or hands, there are a number of over-the-counter and prescription medications you can try to help relieve the pain. These medications come in several different forms, such as pills, creams and gels. You might have to try more than one to see what works for you.
Over-the-Counter Pain Relievers
Over-the-counter pain relievers such as non-steroidal anti-inflammatory drugs, acetaminophen, or topical creams may help relieve mild symptoms of diabetic neuropathy.
Non-steroidal Anti-Inflammatory Drugs (NSAIDs)
This class of pain relievers includes aspirin (Bayer), ibuprofen (Advil, Motrin) and naproxen sodium (Aleve). These common over-the-counter NSAIDs may help decrease nerve pain and inflammation in the short term, but they should not be taken as a long-term treatment. When taken for extended periods of time, NSAIDs can irritate the stomach and cause kidney damage, particularly for people with Diabetes.
Acetaminophen
Acetaminophen such as Tylenol is a common pain reliever, but it is not an anti-inflammatory, so it may not be as helpful as NSAIDs in relieving nerve pain. It doesn’t irritate the stomach, but it may cause liver damage if taken for a long time.
Topical Creams and Gels
Applied directly to the skin where you feel pain, capsaicin cream, such as Capzasin-P or Zostrix, can help reduce nerve pain by blocking nerves from transmitting pain signals. To be effective, you must apply it 4-5 times a day, and you must be patient. It might take a couple of weeks or more for capsaicin to start working. However, if you have a wound, such as a diabetic foot ulcer, you might want to hold off using capsaicin because it may prolong wound healing.
Lidocaine is a topical anesthetic which numbs the area to which it is applied. You can typically find it as a cream or gel.
Prescription Drugs for Pain Relief
There are a number of prescription drugs your doctor may suggest for chronic diabetic neuropathy, including prescription-strength NSAIDs, antiseizure medications, antidepressants such as selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs), or narcotics.
Prescription-strength NSAIDs
Some of the most common brand names include Celebrex, Relafen and Lodine. These drugs have similar risks as their over-the-counter cousins, but there is also an increased risk of heart problems with prescription NSAIDS.
Antiseizure Medications
Anticonvulsants such as Neurontin or Dilantin may be prescribed for diabetic nerve pain. These drugs have anesthetic effects that block pain signals from the nerves.
Antidepressants
Antidepressants may help patients combat diabetic nerve pain, and also address the depression that can occur in response to chronic pain. There are several types of antidepressants indicated for nerve pain, including tricyclic antidepressants, SSRIs and SNRIs.
Tricyclic antidepressants, such as Elavil, can help those with diabetic neuropathy sleep better. Selective serotonin reuptake inhibitors, or SSRIs such as Prozac or Zoloft, increase the level of a “feel-good” neurotransmitter in the brain called serotonin. SSRIs are better at treating depression than nerve pain, but their cousins, serotonin and norepinephrine reuptake inhibitors, or SNRIs such as Cymbalta or Effexor, also work to relieve pain. SNRIs work by changing the levels of both serotonin and norepinephrine, two neurotransmitters involved in the stress response and release of glucose from cells in the body.
Narcotics
Narcotics such as oxycodone may be prescribed to treat moderate to severe diabetic nerve pain. However, these drugs can be habit-forming and should not be used on a long-term basis.
Talk to Your Doctor
As with any new medication, be sure to talk to your doctor before beginning any course of treatment for your nerve pain – even over-the-counter drugs, creams, supplements or homeopathic remedies. There is always the risk they may interfere with your Diabetes medication or insulin, not to mention cause unpleasant or dangerous side effects.
SUPPORTER