Neuropathy is a Pain: Solutions for Diabetic Nerve Pain

When you live with any type of diabetes, complications can happen over time—even when blood glucose control is tight. This is because diabetes is a complex disease and can wear on your body, especially over long periods of time.

It’s important to talk to your healthcare provider about the possible complications of diabetes early and often to monitor and prevent them as much as possible. One common complication is known as diabetic neuropathy.

People with diabetic neuropathy may sometimes experience a condition known as Diabetic Peripheral Neuropathic Pain (DPNP), resulting in pain, weakness, numbness, extreme sensitivity or tingling in the hands, fingers, feet and toes. Diabetic neuropathy and its pain are actually quite common, affecting as many as 50% of people who live with diabetes. 

This article will highlight the best medical devices and home remedies and people with diabetes (PWD) have used to help them cope while experiencing this painful diabetes complication.

What is Diabetic Peripheral Neuropathy (DPN)?

Diabetic peripheral neuropathy is nerve damage resulting from prolonged high blood sugar from diabetes. 

The damage to nerves can affect any area of the body, but the lower limbs, feet and toes are the most likely to be affected, which is peripheral neuropathy. 

Diabetic Peripheral Neuropathic Pain (DPNP) is the pain resulting from this nerve damage. 

What are the symptoms of DPNP?

In the earliest stages, neuropathy may come with no symptoms at all, but as the condition progresses, symptoms of DPNP include:

• Tingling
• Numbness
• Burning sensation
• Pain 
• Sensitivity to touch 

If you have diabetes and are experiencing symptoms of DPNP, contact your doctor right away.

What are the latest and upcoming treatment options for DPNP?

While there is no permanent cure for DPNP, there are some new medications and medical devices that can increase comfort and provide lasting pain relief, even from the comfort of home.

Medical devices 

• Quell is a pain relief device and app that is a transcutaneous electrical nerve stimulation (TENS) device used to treat knee, foot, and leg pain. TENS passes a weak electrical current to the nerves, helping to ease pain in the feet from DPNP.
  
  This technology pairs with any smartphone or Apple watch. The device wraps around your calf, and you can go about your routine while the stimulation reduces pain. You can even wear the cuff while you sleep. The device, which is about the size of a credit card, can be worn 24 hours a day and links to the app to adjust settings.
  
  This drug-free device has helped thousands of people better deal with their chronic pain, including diabetic neuropathy pain, by blocking pain signals from reaching the brain.  
• Sharper Image makes more basic TENS devices, with two options targeting the feet. Their TENS foot massager with infrared heat is a non-prescription option for neuropathy pain that uses tiny electrical impulses to stimulate the feet, providing temporary relief from nerve pain. Users can adjust the electrical intensity and use the optional heat setting for optimal pain relief.
  
  The company’s Dome Foot Massager soothes feet with built-in shiatsu rollers to relieve pain, and self-inflating and deflating air pockets on the interior of the device to massage away tension and aches. Users can adjust the intensity, timer and opt for a heated setting as well.  
• Senza is an FDA-approved, drug-free, implantable device that uses spinal cord stimulation (SCS) to treat chronic painful diabetic neuropathy pain. While SCS has been used for nearly 30 years, the company that created the device, Nevro, uses a novel approach to SCS with 10 kHz Therapy.
  
  First, a small device is implanted in your body and placed near your lower spine. Then, mild electrical pulses are delivered to your spinal cord for relief that can be felt in the arms, legs, feet and toes. These pulses are aimed at calming the inflammation of the nerves and reducing the pain signals interpreted by the brain. 
• Inceptiv, Intellis and Vanta are neurostimulators for diabetic peripheral neuropathy pain relief, each made by Medtronic. Like Senza, these FDA-approved neurostimulators use SCS, with its mild electrical pulses, to treat DPNP by blocking pain signals before they reach the brain.
  
  In studies, 86% of people with DPN using Medtronic’s technology experienced treatment success at 1 year and benefitted from clinically meaningful pain relief up to 10 years.
  

New approach on the horizon — Pilavapadin 

Non-invasive, non-opioid pain treatments are on the horizon. This upcoming medication, currently in clinical trials, targets and minimizes the brain’s pain signals. 

Pilavapadin (LX9211), made by Lexicon Pharmaceuticals, is a non-opioid, orally-delivered investigational small molecule inhibitor of AAK1. This novel target for neuropathy pain inhibits reuptake and recycling of neurotransmitters involved in pain signaling. 

In its Phase 2b study, Pilavapadin 10mg resulted in a two-point reduction from baseline in average daily pain scores (ADPS) by week 11 and was well-tolerated in patients with DPNP. 

This new medication has the potential to become the first non-opioid, oral medication approved for DPNP in over 20 years, and researchers are looking forward to Phase 3 trials for new treatment options for patients with diabetes. 

Home remedies 

• Sometimes, home remedies such as over-the-counter pain-relievers and ice packs can help calm low-level inflammation and pain. Always check with your provider before taking any pain medication, as some may interfere with other diabetes therapies and technology you may be on.  
• A combination of Epsom salt baths, topical CBD cream, peppermint oil and gentle massage may also help. Dry brushing the skin around your forearms, hands, lower legs and feet can promote circulation and aid in pain relief from mild diabetic neuropathy pain. 
• Compression socks and regular exercise may also combat neuropathy pain. 

Preventing painful diabetic neuropathy and DPNP may not always be possible. Work with your doctor to make sure you’re keeping a close, careful watch on your blood glucose and A1c levels, which can keep complications from worsening. 

This content was made possible by Lexicon Pharmaceuticals, an active partner of Beyond Type 1. Beyond Type 1 maintains editorial control over its content.