Diabetic nerve PAIN

I know this is a PD site (my husband is a PD patient) but probably a lot of patients are also diabetic. He has had increasing diabetic nerve pain over the last 6 weeks or so. Particularly in his legs below the knee. His Doctors and us do not really want him to go on Neurontin, it seems like a very unpleasant drug. Does anyone have any other suggestions on how to relieve this pain soemwhat or any natural/homeopathic remedies. Thanks.

Hi Jacqueline,

I’m not a doctor, but when you say that your husband’s neuropathy has gotten worse over the past 6 weeks or so, that’s a red flag. Maybe others who have experienced neuropathy can say whether it tends to get worse in spurts, but my sense is that it’s more progressive, so that if it gets worse suddenly over a defined period, it’s important to look at what’s changed.

Has your husband’s PD prescription changed? Has he started or stopped any drugs? Has his diabetic control suddenly gotten worse? These are some things to think about, anyway. Since neuropathy can be caused both by diabetes AND by not getting enough dialysis, it’s also worth checking his PD adequacy. Does he have any signs of not getting enough PD? (This would include uremia symptoms, like loss of appetite, a metallic taste in the mouth, muscle twitches, etc.)

Cymbalta (duloxetine; an antidepressant) has been prescribed for neuropathy, though this is off-label (the drug is not FDA-approved for this purpose). It has been tested in double-blind, placebo-controlled studies, however, and was found to be safe and more effective than a placebo.

A brand new study in Diabetes Research and Clinical Practice (2007 Feb 20, Agrawal RP et al) has found that glyceryl trinitrate (GTN) spray was significantly more effective than a placebo–and this was a randomized, double-blind, placebo crossover study.

Ultracet–a combination of Ultram (tramadol) and acetaminophen has also been found to be significantly better than a placebo at reducing nerve pain from neuropathy and was well-tolerated.

Lamictal (lamotrigine) has also been tested in double-blind, randomized, placebo-controlled trials and found to be safe and effective.

There are probably others as well–this was the result of about a 15-minute search of the published medical studies. Clearly there are options beyond Neurontin (which can be an excellent drug itself for folks who tolerate it).

I use a massager on the back of my legs and lower back. I use it just before going to bed and usually once during the night when the pain wakes me up. I also rub alcohol on these same area’s before going to bed. I have heard B-12 helps but not sure on that one yet. As a last resort I will take a Loritab. I guess some people can get hooked on these but it doesn’t seem to bother me. I might take one in a week if the pain keeps up. They ease the pain so you can get some sleep. Keeping the blood sugar down is a must. I’m also on dialysis and the pain is worse when they pull my blood pressure down to low. Keep check on that.