Treatment for Diabetes-related Nerve Damage

Nerve Pain Image

If you have diabetes and have been diagnosed with diabetic neuropathy, it's extremely important to control your blood sugar levels to help prevent further nerve damage. Talk to your diabetes health care team—managing blood glucose may involve careful blood glucose monitoring, changes in your diet and exercise program, and diabetes medications or insulin. Also, do not smoke. Smoking increases your risk for diabetes complications, including neuropathy, so it's important to quit.

According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), National Institutes of Health (NIH), symptoms of diabetic neuropathy may worsen temporarily when blood sugar is first brought under control. Over time, however, keeping blood glucose within a normal range reduces neuropathy symptoms and lowers the risk for additional problems and diabetes complications.

Treating Diabetic Nerve Pain

Painful neuropathy usually is treated with oral medications. Recommended treatment measures depend on several factors, including the type of nerve damage and the symptoms you’re having. A combination of medicines and treatments may be used, especially in people with severe symptoms.

Oral medications used to lessen the severity of diabetic nerve pain include the following:

  • Tricyclic antidepressants (amitriptyline, imipramine, desipramine [Norpramin, Pertofrane])
  • Other antidepressants (duloxetine [Cymbalta], venlafaxine [Effexor], bupropion [Wellbutrin], paroxetine [Paxil]. citalopram, [Celexa])
  • Anticonvulsants (pregabalin [Lyrica], gabapentin [Neurontin], carbamazepine, lamotrigine [Lamictal])
  • Opioids and opioid-like medications (controlled-release oxycodone, tramadol [Ultram])

Of the medications listed above, Cymbalta and Lyrica are approved by the U.S. Food and Drug Administration (FDA) specifically to treat diabetic nerve pain. Talk to your health care provider about which medication(s) may be right for you, and about possible side effects associated with oral medications for neuropathy. Also, be sure to tell your doctor about other medications you are taking—including prescription or over-the-counter (OTC) drugs, dietary supplements and herbal medicines—to prevent dangerous interactions.

Topical medications—like capsaicin cream, lidocaine patches and nitrate sprays—also may be used to treat diabetic nerve pain. Other treatments, including complementary and alternative medicines, are being studied, have shown some promise, and may be beneficial.

Along with detecting nerve problems early, foot care is crucial in people who experience diabetic neuropathy.

Treating Autonomic Neuropathy Symptoms

In addition to causing pain, tingling, burning and numbness, diabetic nerve damage also can affect:

  • the digestive system,
  • the heart and blood vessels,
  • the urinary tract,
  • sexual function, and
  • other body systems and organs.

Your health care team may recommend lifestyle changes, as well as over-the-counter or prescription medications to help relieve symptoms. For example, eating small, frequent meals and reducing your intake of fats and fiber can reduce indigestion. Medications can be used to help regulate digestion, reduce stomach acid, and improve symptoms like nausea, vomiting, diarrhea and constipation.

Circulation problems that cause lightheadedness or dizziness can be controlled by sitting or standing slowly, raising the head of your bed, or wearing elastic stockings. Physical therapy can be helpful if you experience muscle weakness or loss of coordination.

Urinary tract infection (UTI) requires treatment with antibiotics. If you suffer from urinary problems like incontinence, your doctor may recommend that you drink plenty of fluids and make sure urinate at regular intervals. Sexual dysfunction may be treated using oral medications, vaginal lubricants or other measures.

Treating Focal Neuropathy Symptoms

Focal neuropathy occurs suddenly, is often painful, and affects specific nerves in the body. It may cause vision problems, nerve entrapment (e.g., carpal tunnel syndrome, tarsal tunnel syndrome) or a condition called Bell's palsy, which results in temporary paralysis on one side of the face. Pain and other symptoms of focal neuropathy improve slowly over time. Talk to your health care provider about ways to relieve your symptoms.

Source: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), National Institutes of Health (NIH)

Publication Review By: the Editorial Staff at

Published: 21 Mar 2013

Last Modified: 21 Mar 2013