Treatment of Diabetic Neuropathy

Home Remedies, Medications, Therapy, and Procedures

Medically reviewed by Isabel Casimiro, MD PhD

If you have type 1 diabetes or type 2 diabetes, managing your blood sugar can help you minimize the nerve damage of diabetic neuropathy. However, this complication can develop with long-term diabetes even when blood sugar is well controlled.

If you already are experiencing signs of diabetic neuropathy, it’s crucial that you get proper treatment to help prevent the progression of this nerve condition. Additionally, diabetic neuropathy can cause many complications, including falling, malnutrition, infected wounds, and more.

This article will cover the treatment of diabetic neuropathy. Each of the different effects of diabetic neuropathy requires treatment with specific lifestyle measures and medical therapies.

Home and Lifestyle Remedies

With diabetic neuropathy, you need to keep up with certain day-to-day strategies to stay safe from associated health problems and injuries. Additionally, diabetic neuropathy can be painful, and there are ways to reduce the pain with home remedies.

Pain Control

Pain, burning, and hypersensitive skin can be major problems with diabetic neuropathy. This is neuropathic pain (pain that originates from damaged nerves).

Try to take note of materials and fabrics in your clothing, bed coverings, and furniture that seem to aggravate your pain. Switch to material that is comfortable.

Consider using an ice pack or a warm heating pad if these help you feel better. For some people, rubbing the painful area with their hands, a massaging device, or mild lotion can help make it feel better, but be aware that these things can also make it feel worse.

Over time, you’ll learn which strategies reduce your pain, and you can take these steps on a regular basis to improve your comfort.

Wound Care

While pain control is important, diabetic neuropathy can impair your sensations—so you might not feel some injuries. Be sure to check your skin every day to look for changes.

If you are injured, it’s fine to continue at-home pain measures, but also take care of wounds by covering them and keeping them clean to promote healing and lower the chances of an infection.

When to Get Medical Attention

Contact a healthcare provider if a wound is taking a long time to heal or if it starts to swell, become red, or develop pus.

At-Home Safety

Diabetic neuropathy impairs balance and sensation, and it can affect your fine motor movement. Your sensory impairment might prevent you from noticing excessively hot water temperature. Be careful while cooking and bathing. Consider using a thermometer to measure water temperature.

Diabetic neuropathy can also cause orthostatic hypotension, which is low blood pressure when going from a lying or sitting position to standing. This can cause light-headedness and increase the risk of falls.

Staying safe means being careful to avoid injuries, such as when using sharp objects or walking on uneven surfaces.

Diet

Diabetic neuropathy can affect the gastrointestinal system, causing diarrhea and constipation. Drinking ample fluids can help prevent constipation. For some people, a fiber-rich diet can prevent constipation, but fiber can also make you prone to diarrhea.

Work with a healthcare provider to identify whether certain foods worsen or help your symptoms and adjust your diet as necessary. When making any dietary adjustments, consider your blood sugar control.

Over-the-Counter (OTC) Therapies

Sometimes OTC therapies can help alleviate the discomfort of diabetic neuropathy and help prevent infection. Unfortunately, no OTC treatments can reverse or prevent the nerve damage of diabetic neuropathy.

It’s a good idea to talk to a healthcare provider to ensure that any OTC treatments you use are safe for you and that they don’t interact with any other medications you’re taking.

OTC treatments commonly used for diabetic neuropathy include:

• Topical pain relief: Creams, sprays, gels, or patches can help pain control. These treatments often contain lidocaine and should not be placed on an open wound. Some of these treatments can cause sun sensitivity, so take steps to protect your skin.

• Oral pain relievers: Sometimes, it can help to take an OTC pain medication, such as Tylenol (acetaminophen) or Advil (ibuprofen). In general, these treatments are not very effective for managing the pain of diabetic neuropathy, but they can sometimes provide temporary relief.

• Padding for protection: Soft padding can help prevent pressure sores. For example, you might place padding inside your shoes or wear padded gloves if you use your hands to work.

• Antiseptic ointment: Diabetes can predispose you to infections and poor wound healing. If you have a cut, pressure ulcer, or open wound, clean it and keep it covered. Ask a healthcare provider if you need to use an OTC antibacterial ointment to lower the risk of infection.

Learn More: Using Icy Hot for Muscle Pain

Prescriptions

Treatment of type 1 diabetes , and often type 2 diabetes, requires prescription medication, including insulin or oral diabetes medication. These treatments help control blood sugar. They are the only therapies that can potentially slow down nerve damage.

Other prescription treatments are used only to alleviate symptoms, such as pain. Infected wounds may need to be treated with topical, oral, or intravenous antibiotics if the infection is bacterial.

A healthcare provider may prescribe medication to help with gastrointestinal symptoms if these symptoms are interfering with your nutrition, health, or quality of life.

Pain Control

Prescription pain treatments are a major player in managing symptoms of diabetic neuropathy. Neuropathic pain is treated with daily medication that’s taken on a schedule.

Commonly prescribed treatments for neuropathic pain include:

• Antiseizure medications like Neurontin (gabapentin) and Lyrica (pregabalin)

• Antidepressants like Pamelor (nortriptyline) and Cymbalta (duloxetine)

• Topical pain medications like Qutenza (capsaicin)

Changing Needs

For some people, the pain of diabetic neuropathy can subside as the nerve damage progresses. You might need to use prescription pain medications for months or years at a time—and then if your symptoms change, you may not need the same prescription treatments anymore.

Surgeries and Specialist-Driven Procedures

You and your healthcare provider might discuss interventional options for the treatment of some symptoms or complications of diabetic neuropathy.

Effects of diabetic neuropathy and potential specialist-driven interventions include:

• Balance problems: Physical therapy can help you maintain good mobility and balance. If your diminished sensation is severely impairing your balance, an assistive device, such as a cane or walker, can help you avoid falling.

• Severe pain: Implantation of a therapeutic device in the space near the spine may provide relief for some people. The stimulator is programmed to deliver electrical stimulation.

• Infected or nonhealing wounds: Infected wounds may require surgical drainage. Sometimes surgical repair, such as skin grafting, may be necessary.

• Bowel obstruction: A complete bowel obstruction is a rare and serious complication of diabetic neuropathy. This may require urgent surgery to relieve the obstruction.

Complementary and Alternative Medicine (CAM)

No CAM therapies are proven to heal the nerve damage of diabetic neuropathy. But several types of CAM interventions can help relieve pain and improve comfort. These include:

• Massage: Massage can be a safe way of managing diabetic neuropathy pain, and it can involve various techniques, including the incorporation of aromatherapy (using scented oils).

• Acupuncture or acupressure: These treatments use pressure (acupressure) or fine needles (acupuncture) at specific points on the body. The treatment is not necessarily placed at the area of pain. Research suggests acupressure or acupuncture may help relieve the pain of diabetic neuropathy in some people.

• Herbs and supplements: It’s crucial to be cautious about herbs and supplements if you have diabetes. With diabetes, altered metabolism and diabetic nephropathy (kidney damage) can make some herbs and supplements dangerous for you.

Discuss the risks and benefits of any natural or alternative treatment you’re considering—whether oral or topical—with your healthcare provider.

Summary

Diabetic neuropathy is a common and serious complication of type 1 and type 2 diabetes, especially long-term diabetes or when blood sugar isn’t adequately controlled.

Treatments for pain, gastrointestinal effects, infections, and balance problems involve a combination or lifestyle strategies, OTC treatments, prescription therapies, and sometimes medical interventions or CAM approaches. Physical therapy can be highly beneficial for reducing the risk of falls.

A Word From Verywell

Living with diabetic neuropathy can be a challenge. There are a variety of symptoms that can impact quality of life, such as discomfort and pain. Serious health issues, which may include falls and bowel obstruction, can be life-threatening.

You can live an active and healthy life with diabetic neuropathy.It's key to understand the potential complications and take the necessary steps, such as making lifestyle adjustments, taking medication, or trying other therapies, before diabetic neuropathy negatively impacts your health and comfort.