Diabetic neuropathy… touchy subject here. Most know what it is (neuropathy means affecting the legs, feet, arms, or hands), but many might be unaware that there is a whole host of triggers. In people with diabetes, neuropathy is usually the result of elevated blood glucose levels, which in many cases leads to permanent nerve damage. However, many people with diabetes find that improving their blood glucose control – especially if their blood glucose far exceeds recommended levels – can lead to a reduction or even elimination of neuropathy symptoms.
The good news is there are some ways to help get some relief from neuropathy pain/discomfort. Keep in mind that everyone responds differently to treatments; always use your best judgment.
- Heat – Most people find warmth soothing. When is the last time you didn’t feel relaxed in a warm bath or while lying in the sun? Warmth provides the body with a pleasant, comfortable sensation that might just be enough to provide some relief from neuropathic pain. The body only has so many sensory nerve receptors, so why not give some of them something nice to do for a change? This can include heating pads, a warm bath, warmed towels, or a paraffin wax warmer. Also, be sure to monitor temperatures closely – temperatures over 120°F can cause serious burns.
- Ice – In general, ice is not as soothing as heat. However, it does have the advantage of being an analgesic: It can provide a mild numbing effect, which can relieve pain. Ice is also anti-inflammatory, meaning it helps reduce swelling. This can be useful if your hands or feet are prone to edema (fluid buildup), which can increase sensations of pain. Ice may also be the key for someone whose pain does not respond to heat. You can use an icepack, a frozen sponge, or just put some ice cubes inside a freezer bag, apply a towel to the affected area, and place the ice bag on top. Use for no more than 10 minutes.
- “Contrast baths” – Contrast baths can be a little messy, but they may offer some relief from both pain and swelling in the hands or feet. Start with two basins: one filled with ice water, the other with warm water. Starting with the ice water, submerge your hand or foot for 30 seconds – if you can tolerate it – and then immediately switch to the warm water for 2 minutes. Repeat the process about five times. If you can’t tolerate the entire 30 seconds of cold, you can cut the time for each bath in half. They are nice for people who get good results from ice but cannot tolerate using it for long periods of time (like myself!). Like ice, contrast baths can keep edema under control. But if you decide to try this method, be sure to keep several towels handy – no matter how careful you are, water tends to get everywhere.
- Distraction – Distraction works under the principle that pain is all in your head. It’s not that you are imagining your pain; it’s that your brain – where feelings of pain are processed – only has so much attention to give. The more it focuses on pain, the less likely it is to notice much else. The flipside, however, is that if you can direct some of that attention elsewhere, your brain will have to turn down the “noise” caused by the pain (it is kind of like when you really have to go to the bathroom but aren’t close to a toilet… many people distract themselves by thinking of something else, such as a dry desert, to take some of the concentration of how much you have to go to the bathroom away). Anything can be grounds for distraction: music, a good book, television, calling up a friend to chat. Whatever you enjoy and can focus on, do it. Distraction can be especially helpful when your pain is holding you back from a task that needs to be done. This applies most often to physical tasks such as exercise or mundane housework – although if a mental task does not demand all of your focus, it may benefit from distraction, too.
- Journaling – Pain has a tendency to make people feel grumpy and edgy – meaning that the frustration caused by neuropathic pain can be about far more than the pain itself. Holding this frustration inside is almost always a bad idea, and it can be enormously therapeutic just to vent. One excellent way to do this – even though it may sound a bit hokey – is to write about your feelings. A major advantage of using a journal over, say, a good friend to vent is that the journal never gets tired of listening to you gripe. It never judges you. You can use the strongest language you want, and no one ever has to hear it. A journal is a safe place to write anything you need to get out of your system – just be sure to keep your journal locked or hidden away if you want to keep your thoughts private. After you have vented in your writing, you can then call a friend and talk about something more pleasant. Another advantage of journaling is that you can track your pain. By noting what you are doing when your pain gets worse (or better), including what time of day it is and details such as what you’ve been eating, you may discover patterns that you might not otherwise notice.
- Relaxation – Relaxation is a powerful pain-fighting tool. Think about it: When you’re in pain, do you feel relaxed or tense? Are your muscles at rest, or clamped up? Is your nervous system calm, or do you feel anxious and edgy? By consciously working to control these reactions to pain, you can sometimes reduce your perception of the pain itself. To use an analogy, the fire alarm may be disturbing you as much as the fire – and you’ll feel better if you manage to turn it off.
- Exercise – (my personal favorite!) You may be skeptical of exercise as a remedy for neuropathic pain – and such skepticism would be justified, since some exercise can make pain worse. But exercise can also help; you just have to do it the right way. This means, above all, exercising gently – no grunting, heavy lifting, or sweating bullets. People with peripheral neuropathy may experience more than just nerve pain; they can also have motor nerve damage, which affects how the muscles function. Exercise won’t repair damaged motor nerves, but it can help your muscles compensate for any damage. Specialized strengthening exercises can help you reclaim muscle function and thereby lessen the burden of day-to-day tasks. If you are new to exercise or if you haven’t exercised in a while, it is a good idea to consult an experienced occupational or physical therapist before embarking on any program. Unlike a personal trainer, therapists have specialized education in treating a wide range of health conditions. A therapist knows how muscles and nerves function, and what can interfere with their performance. By seeing a therapist, you can get an exercise program that is tailored to your particular needs.
If none of these provide any relief (or not enough relief), it’s always a good idea to seek professional help. Neuropathic pain can range from annoying to practically debilitating, and sometimes the available remedies may seem troublesome or inadequate. But many people find at least partial relief from one or more of the treatments and strategies described in this article. If one attempt to soothe your pain doesn’t work, it is important to keep trying. Whether through heat or cold therapy, relaxation, exercise, or adaptations to your daily routine, you may find a reduction in pain – and greater peace of mind – somewhere you didn’t expect to find it.
Do you experience neuropathic pain? If I may be 100% honest right here – neuropathy pain is one of the main reasons I am bound and determined to keep my Diabetes under control – I hate pain. I hate chronic pain. I dealt with chronic pain in my lower back for 7 years due to a car accident – no fun. It wasn’t until I started exercising regularly, thus strengthening my core, that I found some relief… and I don’t really want to go back to being in pain. I am determined!