FAQs on Diabetic Neuropathy from the Top Arizona Pain Clinics
Diabetes mellitus is a common endocrine disease that affects 171 million people globally, according to the World Health Organization. While type 1 diabetes begins during childhood, type 2 diabetes affects older persons. This condition affects many body systems and structures, including the nerves.
How common is diabetic neuropathy?
According to estimates, around 65% of people with diabetes develop some form of neuropathy. This form of neuropathy tends to occur after a person has had diabetes for five years or more, but it typically peaks 25 years after initial diagnosis.
What are the symptoms associated with diabetic neuropathy?
People with diabetic neuropathy experience tingling, numbness, and pain in the feet, legs, arms, and/or hands. Most patients first complain of foot symptoms. These symptoms do not usually occur until damage is done, and they are mild at the beginning of the disease process.
Some people describe hypersensitivity of the feet and/or hands. When specific nerves and muscles are affected, symptoms arise such as double vision, facial weakness, and pain of the chest, abdomen, or thighs.
What causes diabetic neuropathy?
Years of high blood sugar can damage the blood vessels and nerves of the extremities. The neurons (nerve cells) will not function properly after damage has occurred. Because the main factor associated with diabetic neuropathy is high blood sugar, the main goal for prevention is to keep blood sugar normal.
How is diabetic neuropathy diagnosed?
You should go see a doctor as soon as you suspect a diagnosis of diabetic neuropathy to reduce the risk for permanent nerve damage. The doctor will conduct a detailed neurological examination, as well as take a detailed medical history.
Specific tests used for diagnosis include nerve conduction velocity studies (NCV), electromyography (EMG), and nerve biopsy. A NCV records impulse speed and measures electrical responses, whereas the EMG records the electrical activity in the muscles. A nerve biopsy involves examination under the microscope as well as chemical analysis.
What are the treatment options for diabetic neuropathy?
Treatment of diabetic neuropathy depends on the severity of the condition. Options include:
- Medications – Certain medications are used for diabetic nerve pain, such as anticonvulsants (gabapentin), antidepressants (duloxetine and amitriptyline), and analgesics. In addition, compounded topical agents include lidocaine, capsaicin, and menthol.
- Lumbar sympathetic nerve block – With an efficacy rate of 77% per clinical studies, this block involves injecting a long-acting anesthetic onto the nerves. A needle is inserted into the back and positioned near the sympathetic nerves using x-ray guidance. This procedure is useful in alleviating leg pain associated with nerves that supply the lower extremities.
- Celiac plexus block – For pain associated with the abdominal area, the doctor will inject the celiac plexus nerves with an anesthetic medication. A recent clinical study reported an 85-90% success rate with this block.
- Transcutaneous electrical nerve stimulation (TENS) – To interfere with pain signal transmission from the nerve to the brain, this unit emits electrical current to the spine. The devices is worn outside the body, and wires run from the unit to the electrodes, which are positioned on the skin.
- Spinal cord stimulation (SCS) – This is an implantable unit that has an efficacy rate of around 77%. The procedure involves placing a small device in the abdomen or buttocks, and wires run from the unit to the spinal cord, where electrodes are positioned.