What Is Diabetic Nerve Pain? Symptoms, Causes, Treatments

Diabetic nerve pain is nerve damage, or neuropathy, that can occur in people living with diabetes. There are four different types of diabetic neuropathy:

1. peripheral (the most common type)
2. autonomic
3. radiculoplexus (also known as diabetic amyotrophy)
4. mononeuropathy (or focus neuropathy)

Diabetic nerve pain symptoms and experiences vary according to type. People can experience just one type or more than one.

Consequences of nerve damage in diabetes can be dire. People might experience physical and emotional pain that lead to diminished quality of life, mental health problems such as anxiety and depression, and increased mortality rates compared to those without diabetic nerve pain ("Diabetic Nerve Pain and Depression"). Given that almost 45 percent of people living with diabetes develop at least one type of neuropathy (Gore, et al., 2005), understanding the symptoms, causes, and treatments is crucial.

Diabetic Nerve Pain Symptoms

Diabetic nerve pain symptoms typically develop gradually; unfortunately, people sometimes don’t notice them until irreversible nerve damage has already occurred. Knowing what to watch for can help minimize damage or lead to earlier treatment.

Symptoms depend on the type of neuropathy experienced and where in the body the damage is located. While diabetes nerve damage is most common in the feet and legs, it can occur anywhere in the body. Regardless of where nerve pain occurs, symptoms can range from mild to disabling. These are common symptoms:

Diabetic Peripheral Neuropathy:

• Tingling
• Pain that is burning, stabbing, sharp, or shooting
• Muscle weakness
• Reduced ability to feel pain
• Sensitivity to touch
• Loss of balance
• Loss of coordination
• Foot problems (ulcers, infections, pain)

Autonomic Neuropathy:

• Hits the autonomic nervous system, the system that controls the heart, bladder, digestive system, sex organs, and eyes
• Symptoms affect the area of nerve damage and include pain as well as functional problems in the given system

Radiculoplexus Neuropathy

• Severe pain in the legs, buttocks, and hips
• Difficulty standing from a seated position
• Weight loss
• Abdominal swelling

Mononeuropathy

• Damage to one specific nerve, often in the face, torso, or leg pain
• Vision problems, including double vision and difficulty focusing
• Carpal tunnel syndrome
• Bell’s palsy (paralysis on one side of the face)

Causes of Diabetic Nerve Damage

While there are multiple contributing factors to neuropathy, or diabetic nerve pain, there is one primary cause: hyperglycemia, or high blood sugar. Hyperglycemia is a problem in diabetes because it occurs easily and can cause extensive damage throughout the body. Diabetes involves a problem with the metabolism of glucose. Glucose, or sugar, is created when the body digests carbohydrates. It’s used by the cells for fuel, but in diabetes, glucose can’t get into the cells so accumulates in the bloodstream. The more glucose—sugar—in the blood, the more damage someone experiences.

Too much blood sugar damages nerves directly as well as weakens the walls of small blood vessels called capillaries that supply nutrients and oxygen to the nerves. Other factors contributing to nerve damage and pain include:

• Inflammation of the nerves due to the immune system attacking them
• Genetic factors that make someone more prone to damage and pain
• Smoking
• Alcohol abuse

Certain risk factors increase the likelihood that someone with diabetes will develop nerve damage. The longer someone has lived with diabetes, the higher their chances of developing nerve problems. Kidney disease, which can be caused by diabetes, damages nerves because of toxins that remain in the bloodstream. Being overweight, with a BMI over 24, is another risk factor.

The moment you start to notice symptoms, especially if you experience any of the diabetic nerve pain causes, it’s important to check in with your doctor to begin treatment. While most nerve damage is irreversible (except, perhaps, mononeuropathy, which often disappears on its own over the course of months), you can minimize pain and maintain an active lifestyle with treatment.

Nerve Pain Treatments in Diabetes

Because diabetic nerve damage, pain, and other symptoms affect all aspects of someone’s life, it’s important to treat the whole person—complete physical and mental health—rather than only targeting the area of pain. Typical treatment approaches include:

• Controlling blood sugar to avoid spikes
• Medication
• Nutritional supplements
• Physical activity
• Foot care, including wearing supportive, well-fitting shoes
• Acupuncture
• Applying capsicum cream (an analgesic derived from chili peppers)
• Mental health therapy

You can find detailed information about these treatments in "What Treatment for Diabetic Nerve Pain is Available?"

Diabetes can damage nerves, and it can cause significant pain as well as lower quality of life. Pay close attention to symptoms of diabetic nerve pain in order to reduce its negative impact on your life.

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