Diabetic Neuropathy: A Common Complication with a New Solution


Editor’s Note: This content was made possible with support from Nevro, an active partner of Beyond Type 1 at the time of publication.

Diabetes complications can happen to anyone. Far more complicated than, “well was your blood sugar always under control?” (although that is a big factor!), complications are due to a complex mix of genetics, environment, access to healthcare and the mix of individual biology, lifestyle choices and daily behaviors.

Unnecessary blame and shame around complications often leads people to not ask for help once issues do arise: anything from vision starting to get blurry, to hands and feet starting to tingle, sting, or burn. But we’re here to remind you that 1) blame and shame have no place in diabetes complications and 2) better options to treat complications are being developed every day.

Below, we’re diving into a common complication—painful diabetic neuropathy (PDN)—and a new, minimally-invasive solution with no side effects, that results in substantial pain relief for the large majority of people who use it.

What is painful diabetic neuropathy?

Painful diabetic neuropathy (PDN) is a condition that develops in people with diabetes who have experienced nerve damage, usually throughout the legs, feet and toes. It is less common in the arms and hands, although possible.

It’s more common in those with chronically high blood sugar levels, obesity, high blood pressure and poor circulation. It’s different from peripheral neuropathy alone, which impacts how nerves outside of the brain and spinal cord perceive touch and temperature and control movement and function. Peripheral neuropathy, with or without symptoms of pain, affects nearly 30 percent of people with type 1 diabetes and 42 percent of people with type 2 diabetes.

When basic peripheral neuropathy progresses to PDN, symptoms are different and can be intense. PDN in your legs, arms, feet, hands, toes and/or fingers can include:

  • Tingling and numbness
  • Burning sensation
  • Sharp, shooting, stabbing pain
  • Electric-like shocks of pain
  • Loss of balance and stability when walking
  • Pain when walking
  • Pain even with light touch
  • Symptoms are often worst at the end of the day

What causes the pain? Damaged nerves are sending abnormal pain signals from your spinal cord to your brain, leading to these painful symptoms throughout your limbs.

A common issue for many people with PDN is how the daily pain interferes with getting enough sleep. Kept awake by various pain sensations, even the touch of bedsheets on your feet can be too painful.

The pain of PDN can limit your ability to do basic tasks like run errands, exercise, or play with your children or grandchildren. PDN also increases your risk of developing ulcers (wounds that won’t heal), infections and the need for an amputation.

Treatment options for painful diabetic neuropathy

There are a variety of medication-based treatment options on the market for PDN, ranging from basic NSAIDs (anti-inflammatory pain reducers like Advil) to SSRIs and SNRIs (that impact brain chemicals) to anti-seizure medications (originally designed to treat people with epilepsy) to opioids (which have shown little success in treating PDN). There are also medicated topical ointments that contain capsaicin, which is found in peppers.

These medications tend to require a lot of experimenting to find one or several that works for the person experiencing PDN, range in how well they are tolerated, and often have quite a few side effects like constipation, lethargy and nausea. If you are experiencing PDN, one of these medications may work well for you, but if they don’t, newer technology-based solutions have become available.

Spinal cord stimulation (SCS) for painful diabetic neuropathy

Spinal cord stimulation (SCS), first used to treat pain in 1967, is well researched and used across a variety of pain management cases. Compared to medication treatments for pain, these devices are not addictive and have no side effects like drowsiness, brain fog, or upset stomach. HFX™ for PDN is a Senza spinal cord stimulation system that uses 10 kHz Therapy™ to treat pain from diabetic neuropathy. The HFX Solution is the only SCS treatment option approved by the U.S. Food and Drug Administration (FDA) to treat painful diabetic neuropathy, developed by a company called Nevro.

The Senza system is a small implantable device that is placed in your back just near your spinal cord during a minimally invasive procedure. The system is set to a specific frequency of 10kHz and sends small electrical pulses to your spinal cord. These pulses calm the nerves throughout your limbs and back. By calming those nerves, the system reduces the pain signals sent to your brain, reducing your physical pain. For those who want to try it, there is an initial seven-day trial you will undergo to see if it’s right for you—details are outlined below.

According to research, about 80 percent of those who try the HFX solution experience a significant reduction in their pain levels, and 90 percent of users keep using it. This technology is a “game-changer” according to many people with diabetes who are using it to manage their PDN pain. Many users report no longer needing any other pain medications and are able to keep up with all of the physical activity they want and need to do throughout the day.

Would spinal cord stimulation work for you?

This treatment method for peripheral diabetic neuropathy might be right for you if you have been diagnosed with PDN but have not found pain relief with conventional treatments or medications.

You can start here with this basic online assessment to further determine if this technology might be a good fit for you.

For those who want to try it, there is an initial seven-day temporary trial period to see if it’s right for you before committing to the full device. The procedure is quick, and most people are able to go home that same day.

The bottom line

No one should have to suffer through complications from diabetes alone, and better treatments are becoming available every day. If you’re experiencing pain from diabetic neuropathy, talk to your doctor or reach out to Nevro, the makers of the HFX system, directly so they can help you start the conversation with your medical provider.

WRITTEN BY Ginger Vieira, POSTED 10/18/21, UPDATED 12/08/22

Ginger Vieira is an author and writer living with type 1 diabetes, celiac disease, fibromyalgia and hypothyroidism. She’s authored a variety of books, including “When I Go Low” (for kids), “Pregnancy with Type 1 Diabetes,” and “Dealing with Diabetes Burnout.” Before joining Beyond Type 1 as digital content manager, Ginger wrote for Diabetes Mine, Healthline, T1D Exchange, Diabetes Strong and more! In her free time, she is jumping rope, scootering with her daughters, or walking with her handsome fella and their dog.