Managing Neuropathy Pain: What to Mention at Your Next Appointment

You may have heard about (or experienced) diabetes neuropathy pain in the legs and feet. But have you explored your options for managing pain?

Often, as a CDCES, I find many folks lack information beyond what their primary care physician (PCP) recommends. Plus, diabetes neuropathy can be challenging to manage. You will likely need a specialized plan based on your needs.

Exploring options for neuropathy pain management

Review these options for managing pain that you may not have explored yet. Before starting treatment, consult with your doctor and explore options that would work best for you to lessen pain due to neuropathy.

Medications

Multiple guidelines recommend the following medications as options for the treatment of diabetes neuropathy:^1,2

• Pregabalin (Lyrica)
• Duloxetine (Cymbalta)
• Gabapentin (Neurontin)

Other medications can be used as well. Many medicines used to manage diabetes neuropathy are from drug classes meant to treat seizure or mental health disorders like anxiety or depression. So, be honest with your medical team if your pain is not improving or you're having trouble with medication side effects.¹

Herbs and supplements

It's important to note research limitations on supplements and herbs, including CBD (cannabidiol). For example, studies are often very short-term and use a variety of different doses, making it hard to get solid research showing what doses work and for how long a treatment plan should continue.

Alpha-lipoic acid (ALA) is a supplement that may help treat pain and numbness from diabetes neuropathy. According to available research, large amounts are needed to see an impact on symptoms, including ALA given through an IV.^3,4

Another pain treatment option showing promising research outcomes is CBD (cannabidiol) oils and creams. People with diabetes neuropathy reported improvements in pain when using CBD oil over four weeks.⁵

Non-medication options

Non-medication options for neuropathy continue to be explored. Spinal cord stimulation includes an implant that sends electrical waves to calm nerves in your back, legs, and feet. Nerve decompression is a type of surgery to release tendons around affected nerves. Cryoneurolysis or cryoablation involves freezing damaged or overactive nerves. Some of these options need more research before they become routine care for diabetes neuropathy. Others are already FDA-approved and in use.^6-8

Neurologists and other healthcare providers

Neurologists are doctors who specialize in nerve conditions, like diabetes neuropathy. Their expertise gives them different tools and ways to assess your pain. They are also more likely to be aware of new research and treatment options.

There are also clinics and doctors who specialize in treating pain. They help create pain management plans for all types of pain, often including diabetes neuropathy.

Physical and occupational therapists can help you learn new movement patterns to keep you as active as possible while limiting your pain level.

At your next doctor appointment

You can ask your primary care physician to refer you to any of the specialists listed above. You may also want to be seen by a vascular doctor, to make sure your neuropathy isn't caused by a treatable blood flow issue.

Don't be afraid to ask your physician to help you explore other options for your diabetes neuropathy, including referrals to specialists or medication options.