Treatment Of Diabetic Peripheral Neuropathic Pain

Treatment Of Diabetic Peripheral Neuropathic Pain - Diabetic sensory neuropathy, or nerve pain, triggered by long term diabetes, can be acute, non-stop, and challenging to deal with. It usually begins as a tingling feeling in the feet or hands, then a numbness, and eventually, pain. However, if you do have diabetic peripheral neuropathy, you should remember two important facts:

· You are able to improve your general health, and stop the nerve pain from becoming worse just by controlling your blood sugar levels.

· New medications are being developed all the time that can assist in easing nerve pain, improve your comfort, and enhance your living.

It is a confirmed fact that by controlling blood sugar, neuropathy can be prevented, but if you already have it, its progress can be slowed, and some of the symptoms eased.

Should you have diabetes as well as diabetic neuropathy, discuss alternative methods of blood sugar control with your doctor. It may be necessary for you to take insulin.

After you've got, and can keep, your blood sugar levels at a safe level, including medication, exercise, diet and meal planning; your doctor will be able to assist in choosing the best pain relieving medication for your remaining symptoms.

The ever increasing range of drugs suitable for easing the symptoms of diabetic sensory neuropathy can permit you to enjoy a near-normal work life. The list of pain easing medicines is long. Several different drugs may have to be tried before one is found that actually assists you.

Non-prescription preparations for the relief of diabetic nerve pain.

Certain people find relief for slight diabetic nerve pain right on their drug store shelves. Some common analgesic creams and/or pills could possibly help with some of the very minor instances of pain.

As an initial line of treatment, such medicines can be very useful; on the other hand, someone with diabetes ought to speak to their doctor prior to taking any other medication. Even over-the-counter remedies can react with other drugs or result in extreme side effects in people with diabetes

Below, a few off-the-shelf pain easing medications to think about:

· NSAIDs (non-steroidal anti-inflammatory drugs). These medications reduce inflammation and soothe pain. NSAIDs that may be used are aspirin, naxopren, and ibuprofen, and no prescription required.

But NSAIDs can trigger damaging side effects such as stomach irritation and hemorrhaging in a few people if taken for many weeks. If used over a lengthy period, NSAIDs can cause liver and kidney damage, which is highly likely in diabetics.

However, in many cases, particularly with younger individuals who are reasonably healthy, the danger is rather low.

· Acetaminophen. Acetaminophen and other off-the-shelf medications that contain acetaminophen can ease the diabetic nerve pain, but do nothing to reduce inflammation. These medicines are not as savage on the stomach as NSAIDs are. Make sure that you observe all the directions regarding dosage of acetaminophen, and if in doubt, check with your pharmacist, because liver damage could result if the specified dosage was exceeded.

· Capsaicin. A substance that occurs naturally in chili peppers, Capsaicin is marketed under different brand names such as Capzasin-P and Zostrix. Capsaicin has demonstrated its ability to soothe pain, but there is some worry. It may not be the ideal method. Capsaicin is believed to relieve pain by lowering the quantity of a compound called Substance P, which is active in transmitting pain impulses through the nerves.

Although this may be an effective approach over the short-term, the long-term effects are worrying. These are the nerves that are important in wound healing. We're worried that Capsaicin could deter that recovery, which is already a big problem for diabetes patients.

· Lidocaine is an anaesthetic which de-sensitizes the area it has been applied to. Marketed as Xylocaine or Topicaine, it's available both off-the-shelf and by prescription as a gel or cream.

· More topical creams or gels.

· Salicylate is a compound equivalent to aspirin, and is identified in pain-relieving ointments such as Bengay and Aspercreme.

· Cortisone products consist of corticosteroids, and are effective anti-inflammatory medicines that can help soothe pain.

Both of these preparations are available over-the-counter, but whether they help to ease nerve pain caused by peripheral neuropathy has not been confirmed.

Prescription Drugs for Diabetes Nerve Pain

Should you require a doctor's script for diabetes nerve pain relief, your choices include:

· NSAIDs. Although some drugs are obtainable over-the-counter, your physician may recommend a higher dose, or a different NSAID, that need a script. Although there are plenty of script only NSAIDs available, diabetics are particularly susceptible to kidney damage that can result from prolonged use of NSAIDs. Besides, these script only NSAIDs could increase the risk of heart disease, particularly in diabetics who already have a big chance of developing that problem.

· Antidepressants. Whereas originally, antidepressants were produced for depression, they have also come to be beneficial in relieving extreme pain, whether or not the person is depressed. These drugs have been prescribed by doctors for the control of pain for several years, and include TCAs (Tricyclic Anti-Depressants) mainly affect the levels of norepinephrine and serotonin in the brain. These TCAs have been extensively studied, are the most utilized, and are the most beneficial of the anti-depressants which are used for pain relief.

A brief rundown on Tricyclic Antidepressants (TCAs):

Elavil is a good option for pain relief, but has some worrying side effects. Drowsiness, weight gain, dries mouth and eyes. Also, for sufferers of peripheral neuropathy, it has added problems of blood pressure, heart rate, and dizziness.

Pamelor is effective, with fewer side effects, and is better tolerated.

Norpramin. Is also good and has the least side effects of all.

Then There Are The Newer Antidepressants.

Selective serotonin reuptake inhibitors (SSRIs).

SSRIs are relatively a new antidepressant, and work by changing the amount of serotonin in the brain. Effective for depression, but less so for pain.

Serotonin and norepinephrine reuptake inhibitors (SNRIs).

SNRIs treat depression by increasing accessibility of the brain compounds serotonin and norepinephrine. Effexor and Cymbalta are very effective for pain. They are both as effective as SSRIs or TCAs, but have fewer side effects.

Also

Anti-seizure drugs.

Drugs that were originally developed to prevent epileptic seizures can relieve neuropathic pain. They work by managing the abnormal firing of nerve cells - in the brain and in other parts of the body, like legs and arms.

Neurontin is the anti-seizure drug most frequently chosen for nerve pain from peripheral neuropathy. It can cause sedation or dizziness at larger dosages, but if the dose is raised slowly, it is quite easily tolerated.

Lyrica is an anti-seizure drug that is approved for peripheral neuropathy pain by the US FDA, but not by the Australian PBS. The most common side effects are giddiness and sleepiness.

And

Opioid Drugs.

Opioids such as Ultram or Ultracet are used conjointly with Neurontin, which gives immediate relief from pain, and allows the dosage of Neurontin to be slowly increased.

Ultram and Ultracet are painkillers that contain Tramadol, and they also have an effect on the brain chemicals, which reduces the awareness of pain.

Doctors specializing in neuropathic pain prefer not to use strong Opioids due to the common resistance of patients towards using narcotic drugs. There could also be a problem, depending on the sort of work that the patient does.

Additional Therapy Options for Diabetes Nerve Pain.

· Injections of local anaesthetics such as lidocaine - or patches containing lidocaine.

· Surgically destroy nerves or relieve a nerve compression that causes pain.

· Implant a device that relieves pain.

· Perform Transcutaneous Electrical Nerve Stimulation using a TENS unit which may relieve pain.

And What of the Future?

A new line of attack on Diabetic Peripheral Neuropathy related pain could be in view, with the development of Metanx. But I need to do a lot more research on this.

Article Source: http://EzineArticles.com/6554608

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