Nerve damage from diabetic neuropathy develops when you suffer from the persistent high blood sugar levels associated with diabetes. High blood sugar harms the nerves throughout your body, but especially in your feet, legs, hands and arms. Damaged nerves limit your ability to feel pain, temperature, touch and vibration. Get the care you need to treat painful diabetic neuropathy at Pain Physicians NYC, a pain clinic serving New York and New Jersey. Call today for an appointment.

What is Diabetic Neuropathy?

Diabetic neuropathy refers to a common type of peripheral neuropathy — nerve damage outside your brain or spinal cord — that affects people living with diabetes. The condition causes pain, numbness and weakness in different parts of your body. It’s especially common in feet and legs, where poor circulation and high blood sugar damage nerves.

The pain management specialists at Pain Physicians NYC include Drs. Leon Reyfman. These board-certified physicians have extensive experience treating many painful nerve disorders. They have the knowledge and skills to diagnose and treat diabetic neuropathy using the latest medical techniques, including Spinal Cord Stimulation (Nevro HFX™ and Medtronic) and Peripheral Magnetic Nerve Stimulation. They deliver compassionate care for your diabetic neuropathy so you can return to your daily life without pain.

What Causes Diabetic Neuropathy?

High levels of blood sugar for a long period of time can damage the nerve fibers, causing eventually diabetic neuropathy. The real cause of diabetic neuropathy is not known, however, it is believed that a combination of factors plays a great role.

High levels of blood sugar damage the delicate nerve fibers, interfering with their ability to transmit signals, as well as the small blood vessels that supply the nerves with oxygen and necessary nutrients.

Other factors thought to have a great role in diabetic neuropathy include:

  • Cigarette smoking
  • Alcohol abuse
  • Genetics
  • Nerve inflammation

Not everyone suffering from diabetes develops diabetic neuropathy. However, people who have poor control of blood sugar, are overweight or have diabetes for a long period of time are at a greater risk of suffering from diabetic neuropathy.

Signs and Symptoms of Diabetic Neuropathy?

The signs and symptoms of diabetic neuropathy vary from the nerves that are affected. However, legs and feet are the most affected. There are four different types of diabetic neuropathy:

  • Peripheral neuropathy – is the most common type of diabetic neuropathy. As mentioned above, legs and feet are the most affected, followed by hands and arms. The signs and symptoms of peripheral neuropathy are usually worse at night and they include sharp pain, cramps in the legs and feet or hands and arms, muscle weakness, loss of balance, loss of coordination, loss of reflexes, a burning sensation, numbness, ulcers, infections, etc.
  • Autonomic neuropathy – is a neuropathy that affects the autonomic nervous system. The autonomic nervous system controls the major vital organs like the heart, lungs, stomach, intestines, bladder, eyes, etc. The signs and symptoms of autonomic neuropathy include problems regulating the body temperature, increased or even decreased sweating, increased heart rate, difficulty swallowing, slow stomach emptying, constipation, diarrhea or an alternation of both of them, erectile dysfunction in men, etc.
  • Diabetic amyotrophy – is a neuropathy that affects the nerves of the legs, buttocks, hips, and thighs. Diabetic amyotrophy is more common among people suffering from type II diabetes and who have been having this disease for a long period of time. Signs and symptoms of this type of neuropathy usually affect only one side of the body. However, sometimes these signs and symptoms can spread to the other side. Characteristic signs and symptoms include sudden pain in the hips, thighs or buttocks, muscle weakness, difficulty rising from a sitting position, weight loss, etc.
  • Mononeuropathy – is diabetic neuropathy that affects specific nerves of the body.

How Do I Know if I Have Diabetic Neuropathy?

Diabetic neuropathy causes a variety of symptoms, but most are recognizable. Commonly, diabetic neuropathy affects your feet and legs first, followed by your hands and arms — the parts of your body farthest away from your spinal cord. Symptoms of diabetic neuropathy include:

  • A reduced ability to feel pain or temperature changes
  • Tingling, burning or prickling sensations
  • Sharp, stabbing or shooting pains
  • Muscle weakness
  • Loss of reflexes and balance
  • Sensitivity to touch or pressure
  • Ulcers, infections or deformities in your foot

Autonomic neuropathy, another type of diabetic neuropathy, affects the nerves that control your internal organs. Symptoms of autonomic neuropathy include:

  • Bladder or bowel problems, such as incontinence or constipation
  • Slow stomach-emptying, causing nausea, vomiting or loss of appetite
  • Difficulty swallowing or breathing
  • Erectile dysfunction in men or vaginal dryness in women
  • Changes in blood pressure or heart rate
  • Problems sweating or eyes adjusting to light

Diagnostic tests for diabetic neuropathy are non-invasive or minimally invasive. If you show symptoms of painful diabetic neuropathy, Pain Physicians NY conducts nerve testing and imaging studies. Your doctor may recommend an electromyography (EMG), nerve conduction study or MRI.

What Are Effective Treatments for Diabetic Neuropathy?

The primary aim of painful diabetic neuropathy treatment is to minimize additional nerve damage while relieving the symptoms you have. Since every case is unique, Pain Physicians NY provides a variety of therapy options. Based on the findings of diagnostic tests, your past health conditions, and the intensity of your signs and symptoms, your neuropathy specialist will decide on the most appropriate course of treatment for you. Treatments for diabetic neuropathy that work well include:

  • Medical therapies. These therapeutic approaches lessen your acute discomfort and enhance nerve function. These include:
    • Nevro HFX, a spinal cord stimulation device, which represents the most recent long-term relief option
    • Neurostimulation techniques
    • Peripheral nerve stimulation
    • Dorsal root ganglion stimulation
    • Nerve blocks
    • Stem cell therapy
  • Medications. Certain drugs can ease the pain associated with painful diabetic neuropathy. While anti-seizure medications, antidepressants, analgesics, and topical creams can be helpful, prolonged use of these medications can have unfavorable side effects, such as impaired concentration.
  • Physical therapy. Consider physical therapy to increase the strength of your muscles, balance, and range of motion. It minimizes infections and other issues like foot ulcers. If necessary, your physical therapist also instructs you on how to utilize braces or splints, among other helpful devices.

The goals of the treatment are to slow the progression of the disease, to relieve the pain once diabetic neuropathy is confirmed and to manage further complications and to restore the functions of the legs and feet as much as possible. Low dose infusions of ketamine have been shown to provide effective relief of neuropathic pain from diabetic peripheral neuropathy.

To help slow the nerve damage as much as you can, it is very important to keep normal body weight, to follow a healthy eating plan, to keep blood pressure under control and to stay active as much as you can. Alcohol, as well as smoking, should be avoided.

Pain killers are recommended for nerve pain relief.

Is Spinal Cord Stimulation (SCS) Effective Against Painful Diabetic Neuropathy?

Nevro HFX is an implantable device that’s FDA-approved as a diabetic neuropathy treatment. The device delivers long-term relief from painful diabetic neuropathy. It overrides pain signals, reducing pain and improving sleep. Nearly 80 percent of patients treated with HFX in a study reported significant pain relief after one year.

You may qualify for Spinal Cord Stimulation if other treatment options, such as pain medication, haven’t worked for you, and you still suffer chronic nerve-related pain in your legs, arms, back or abdomen. If your doctor suggests SCS, you must first pass a one-week test to determine if it’s right for you. The trial phase includes:

  • A minimally invasive, outpatient procedure to implant a small device just under the skin, either above your waist or around your buttocks area
  • Small, flexible wires that connect the device to an area near your spine
  • A weeklong period to see if you receive significant pain reduction
  • Covered by all major commercial health insurance plans, including Medicare

Where Is Spinal Cord Stimulation for Diabetic Neuropathy Available?

Visit Pain Physicians NYC for the latest and most effective treatment for painful diabetic neuropathy. Untreated diabetic neuropathy has serious and even life-threatening consequences. Since this condition causes foot problems that are slow to heal or don’t heal properly, you may lose a foot or leg. It’s not an uncommon outcome for diabetes sufferers.

Dr. Reyfman and Dr. Kosharskyy are top doctors in the field of interventional pain medicine. They have extensive experience and training in treating your pain. Since diabetic neuropathy is a treatable condition, you don’t have to suffer from it any longer. Don’t let pain stop you from living your best life. Contact Pain Physicians NYC to schedule an appointment and find the relief you seek.

Am I at Risk of Developing Diabetic Neuropathy?

Diabetic neuropathy can affect anyone with diabetes, whether it’s type 1 or type 2. Other factors that increase your risk of developing diabetic neuropathy include:

  • Not treating poor blood sugar levels
  • Having uncontrolled diabetes
  • Being overweight
  • Smoking or drinking alcohol excessively
  • Having high blood pressure or high cholesterol
  • Being older than 40

Diabetic neuropathy may also cause frequent urinary incontinence or retention, both of which increase the risk of infection. If you don’t seek treatment, diabetic neuropathy causes serious complications, such as infections and ulcers that may lead to amputations. Seek professional help as soon as possible.

Page Updated on Feb 26, 2024 by Dr. Reyfman (Pain Management Specialist) of Pain Physicians NY