Sometimes at night the medications that have kept your pain in check during the day can wear off. Even though your medication is working the way it should during the day, it will eventually wear off. For some people, the tension that results from excessive stress will intensify their pain sensations.
But, living stress-free these days is next to impossible, so we just have to do what we can to lessen our stress. Spend some quiet time in nature, listen to relaxing music, or enjoy a warm bath if you feel extra stressed.
You should try to get most of your vitamin D from your food, but your doctor may also recommend supplements. Living in a chronic state of stress wreaks havoc on your physical and mental health.
Sometimes medication dosing and timing might need to be adjusted, which could be particularly true for some short acting medications used for neuropathy pain. Cognitive behavioral therapy, physical therapy and meditation may be complementary tools to reduce pain as well.
Claytor stresses the importance of talking to your doctor sooner rather than later. Learn more about vaccine availability. Advertising Policy. Some people find that using a transcutaneous electrical nerve stimulation TENS machine helps.
This device interrupts nerve messages by delivering a small electric current. Research has not confirmed the effectiveness of this treatment. These include:. Disorders of the small blood vessels can reduce blood supply to the nerves, resulting in nerve tissue damage. Certain benign tumors can also affect nerve tissue and lead to neuropathic pain. Diabetes is the most common cause of chronic peripheral neuropathy in the U. About percent of people with diabetes will have some form of damage to their sensory, motor, or autonomic nerves.
Many will have foot problems and ulcers. High blood sugar levels cause damage to the walls of the tiny blood vessels that supply oxygen and nutrients to the nerves in the ends of the hands and feet, and the essential organs in the body, such as the eyes, kidneys, and heart.
Whenever skin becomes damaged, the loss of sensation further increases the risk of damage. The next step should be a physical and neurological exam that will help the doctor identify any nerve damage.
These tests measure nerve signal strength and electrical activity. A doctor may also do a nerve biopsy. In cases of suspected autonomic peripheral neuropathy, a person can get a QSART test, which measures their ability to sweat. For some types of neuropathies, like nerve compression, a person can also get a magnetic resonance imaging MRI scan or a computed tomography CT scan.
Another option is a muscle and nerve ultrasound, but this is not common. If the doctor confirms that neuropathy is present, the doctor will look for the cause. The doctor may then send the person to get blood tests in order to check for diabetes and other potential underlying conditions. The doctor may check for vitamin deficiencies, liver or kidney dysfunction, infections, metabolic disorders, or any immune cells that may indicate an immune disorder.
It is more common in people who, like Zimmerman at the time, are overweight, over 40, and have high blood pressure. In early , Zimmerman underwent bariatric surgery and her diabetes went into remission. After the surgery, the highest it's ever been is a 5, and most recently, it was a 4. And while the neuropathy still flares up sometimes, I notice it much less often and I have found ways to control it. Current medications cannot reverse the nerve damage of diabetic neuropathy once it is established.
She's also the lead author of a new position statement on diabetic neuropathy from the American Diabetes Association ADA. For people with type 1 diabetes, research has consistently demonstrated that keeping hemoglobin A1C levels under tight control is the most important and most effective strategy for preventing diabetic neuropathy. Once neuropathy has developed, glucose control is important to keep it from progressing.
But for people with type 2 diabetes, the research is less clear as to whether glycemic control by itself can help control neuropathy.
Currently, three drugs are approved by the US Food and Drug Administration to treat pain from diabetic peripheral neuropathy: duloxetine Cymbalta , pregabalin Lyrica , and tapentadol Nucynta, Palexia, and Tapal. These other medications include tricyclic antidepressants, venlafaxine Effexor , oxcarbazepine Trileptal , tramadol Ultram , and alpha-lipoic acid.
It's also important to find a physician skilled in managing neuropathic pain, says Dr. Tight glycemic control and appropriate medication are only part of the puzzle of managing diabetic neuropathy and pain.
The other part is following a balanced diet, exercising regularly, and quitting smoking. In patients with prediabetes, research has shown that a healthy diet and exercise can slow the progression of prediabetic neuropathy or even improve it. That's what Lisa Lake has found. The year-old public relations professional and single mom from Greenbelt, MD, first developed type 2 diabetes in her late thirties while pregnant with her son.
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