Health Tips

Pain Treatment drugs for people with diabetes

The below listed medicines and methods will provide you at least temporary relief from nerve pain and discomfort related to nerve damage:

– Simple pain killers such as aspirin and acetaminophen (Tylenol), or non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Motrin, Advil) reduce or relieve nerve pain. If these medications do not help, the doctor may prescribe stronger NSAIDs such as diclofenac sodium (Voltaren), and diclofenac potassium (Cataflam) for pain relief.

– Capsaicin cream (ArthiCare, Zostrix), which contains extract of chili peppers and is available over-the-counter, is also usually helpful in relieving nerve pain in most people. This cream, when rubbed on the skin where you feel pain, blocks pain signals.

– When the above medications fail to bring pain relief, the doctor may prescribe antidepressant drugs, which have been found effective in treatment of nerve pain also. Two classes of antidepressant drugs, namely, TCAs such as amitryptiline (Elavil), and SSRIs such as fluoxetine (Prozac) are usually effective in relieving nerve pain. These drugs take several weeks to give the full benefit. (See chapter 29 for more information on antidepressants.) Another recently approved antidepressant drug called Cymbalta (duloxetine) is also effective in relieving pain caused by diabetic nerve damage.

– Two drugs, carbmazepine (Tagretol) and phenytoin (Dilantin), which are used to treat convulsions, have also been shown to decrease pain from nerve damage. Another anticonvulsant drug, gabapentin (Neurontin), has also been found to be effective, relatively safe, and better tolerated in treatment of pain from diabetic nerve damage. Mexiletine (Mexitil), a drug usually used to treat irregular heart rhythm, has also been shown to relieve pain due to nerve damage.

– Recently a drug, namely, Lyrica has been approved by the FDA for the treatment of pain in the feet, legs, hands, or arms caused by nerve damage from diabetes.

– A study undertaken by American and Russian researchers has shown that alpha-lipoic acid, an antioxidant, can significantly reduce nerve pain, pin pricking sensation, numbness, and other symptoms of nerve damage.

– The pain management therapy called transcutaneous electronic nerve stimulation (TENS) is also used to relieve nerve pain in the extremities (legs, feet, arms, and hands). In this therapy, electrodes are placed on the skin and a small amount of electricity is passed through vibrations. The electric vibrations help provide pain relief by blocking the pain sensation.

– For pain reduction and improving blood circulation in muscles and joints, an infrared therapy called the Anodyne Therapy System has been shown to be helpful. The therapy applies strong infrared rays on the affected joints and muscles, increasing blood circulation in the area, thereby providing relief from pain. The therapy is used for about 20 to 45 minutes per treatment. The treatment program typically consists of three therapy sessions per week for 4 weeks. The actual frequency of the treatment will depend upon the severity of condition.

– Evidence shows that stretching exercises can relieve muscle pain, spasms, and night cramps usually coexisting with nerve pain arising from nerve damage.

Medications for Autonomic Nerve Damage

Here is a partial list of disorders from autonomic nerve damage and the medications to treat them:

Digestive Disorder

A prescription drug, metoclopramide (Reglan), is used to stimulate digestion and treat gastroparesis in diabetes. Another drug, clonidine (Catapres), which is basically a drug to treat high blood pressure, has been found effective in controlling diabetic diarrhea and other bowel problems.

Increased Heart Rate

Beta-blockers, drugs that are used to treat high blood pressure, are also given to slow down increased heart rate caused by nerve damage.

Low Blood Pressure on Rising

If your blood pressure falls when you rise up from a sitting or lying position (orthostatic hypotension), do not sit up or stand up suddenly.

Your movements should be slow and gradual to prevent loss of balance and to avoid a fall. Wearing elastic stockings may help you with this condition. Increased intake of salt may benefit some people in reducing the symptoms of this disorder; however, you must check up with your doctor before increasing your salt intake.

A drug, midodrine (ProAmatine), is often used to treat orthostatic hypotension. This drug, by tightening the blood vessels and increasing their resistance to the blood flow in the body, increases blood pressure.