Diabetic Peripheral Neuropathy is a condition of nerve related pain most often affecting the patients’ legs and feet. It is estimated that there are close to twenty million Americans who suffer from Peripheral Neuropathy, an estimated fourteen million of these are due to complications from diabetes.
Persons with diabetes who do not properly monitor their blood sugar, smokers, and persons who drink alcohol are more susceptible to developing peripheral neuropathy. It is found most commonly in persons who have had diabetes for twenty five years or more.
What symptoms are associated with Diabetic Peripheral Neuropathy?
Persons suffering from diabetic peripheral neuropathy may experience some or all of the following symptoms;
- Numbness, tingling or a burning sensation in the extremities
- Inability to detect change in temperature or feel pain in your feet and toes (the person may be injured and not even notice it)
- Sharp, stabbing pains, often worsening at night
- Difficulty or pain when walking
- Touch sensitivity some patients feel pain from the slightest touch, even the bed sheet on their body can feel painful
- Muscle weakness and fatigue
- Ulcers, deformities, infections, joint and bone pain
How is diabetic peripheral neuropathy diagnosed?
There are several tests to help diagnose peripheral neuropathy; one of these is the filament test. A thin monofilament is used to gently rub the foot to test for sensitivity to touch.
Another test is nerve conductive testing when electrical impulses are used to test the nerve function, often electromyography is used in conjunction with the nerve conductive test to measure electrical discharge of the muscle. Quantitative sensory testing is a test to determine the ability to sense vibration or changes in temperature.
What treatment is available for patients suffering from diabetic peripheral neuropathy?
While there is no known cure for diabetic peripheral neuropathy, there are ways to help the patient manage pain and other symptoms. Managing and monitoring your blood sugar levels can help to slow the progression of the condition and help ease symptoms.
Anti-seizure medications like pregabalin (Lyrica), gabapentin (Neurontin, Gralise), and carbamazepine (Tegretol , Carbatrol), and tricyclic antidepressant medications like nortriptyline (Pamelor), amitriptyline, imipramine (Tofranil), and desipramine (Norpramin) can all be used to treat neuropathic pain with some success for many patients.
For patients with stronger pain or who do not respond to the other medications their doctor may prescribe opioid analgesics like hydrocodone (Vicodan), and oxycodone (Percocet), however these medications are often prescribed reluctantly as they have high potential for dependency.
Nerve block injections and spinal cord stimulation are available treatments for patients who are still not being effectively treated with oral medications.
What are expectations when a patient receives treatment?
The majority of patients experience some level of relief from one or more of the available treatments. It has been shown that spinal cord stimulation reduced pain by as much as 85% for many patients, and over half of patients that underwent this procedure became pain free. Nerve block injections have shown similar results as well.
How are these treatments performed?
Spinal cord stimulation utilizes implanted electrodes and an implantable generator to produce electrical impulses that block the pain impulses to the brain. Nerve block injections are an outpatient procedure where the doctor utilizes a device called a fluoroscope to accurately place a needle and inject a mixture of local anesthetic and corticosteroid in order to numb the nerves that are causing the patients pain.
How long do the effects of the spinal cord stimulator or injections last?
The effects of the stimulator last as long as the device is active although the power of the impulses may need to be occasionally increased and the device runs on a battery that periodically needs changed. Patients who receive the injections have reported relief lasting for up to several months at a time.
What risk or side effects are possible with these procedures?
Injections are a very low risk procedure; the most common side effects are slight bruising, swelling, and bleeding at the injection site. The spinal cord stimulator however poses more risk. The body may reject the device and electrodes, infection may occur, the electrodes can migrate and become ineffective, spinal fluid may leak, the battery may leak.
How successful are these procedures for the relief of pain?
Both of these procedures have shown to be very effective in relieving pain. More than half of patients report better than 50% reduction in felt pain levels with these procedures.
The bottom line is if you think you are suffering from peripheral and/or diabetic neuropathy seeking treatment asap at a top Colorado pain clinic can bring amazing relief. Discuss your symptoms with your pain management specialist in Colorado to see if you are a candidate for medication or interventional pain procedures.
The top Northern Colorado pain management clinics are Colorado Clinic with 3 locations in Greeley, Boulder and Loveland. Dr. Sisson is a Double Board Certified Boulder pain management doctor offering both medical and interventional pain treatments with exceptional success rates.
At Colorado Clinic, most insurance is accepted. Patient appointments are readily available, call the location closest to you today!