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If you live with type 1 diabetes (T1D), you’re probably familiar with the complication known as diabetic neuropathy. Unfortunately, this painful condition is quite common, affecting up to 50 percent of people with diabetes (PWDs).
If you are one of those people, what exactly can you do to cope with diabetic neuropathy pain on a daily basis, above and beyond any medications your doctor may prescribe?
This article will outline some of the best tools and personal hacks that PWDs have devised to help them live more comfortably with the pain.
There are four types of diabetes-related neuropathy:
The damage to nerves can affect any area of the body, but one’s extremities are most likely to be affected, such as the toes and feet, which constitute peripheral neuropathy.
In the earliest stages, neuropathy may come with no symptoms at all, but as the condition progresses, people experience various forms of paresthesia. Symptoms include:
- burning sensation
Early symptoms can get better with improvements to blood sugar management, so if you begin to experience any of the aforementioned symptoms, contact your doctor immediately to be seen.
There currently is no cure for neuropathy pain, but many people have found success in treating their symptoms with commercial products or home hacks.
Several highly rated tools to offset neuropathy pain include:
Transcutaneous Electrical Nerve Stimulation (TENS) foot massagers provide relief for many. These devices send electrical pulses through the skin that control pain signals in the body, creating temporary or longer-lasting relief from pain.
One popular option is the Sharper Image TENS foot massager with infrared heat. Users can adjust the electrical intensity and use the optional heat setting. Online, 86 percent of users reported that they would recommend the product to a friend who might need it.
This nonprescription device sells for less than $200, making it one of the more affordable and accessible tools available.
The Sharper Image Shiatsu Dome Foot Massager is an even more affordable option (currently $149) that soothes feet with built-in shiatsu rollers, and self-inflating and deflating air pockets on the interior of the device massage away tension and aches. Users can adjust the intensity and timer, and opt for a heated setting as well.
You can purchase Sharper Image TENS products directly from their online store.
Pain-relieving LED wraps
Medical-grade LED light, with an 850- to 890-nanometer (nm) range is believed to ease discomfort caused by arthritis, tendonitis, sprains, and neuropathy.
It remains under scientific study, but the idea is that the light penetrates beneath the skin to increase circulation, reduce swelling, and temporarily relieve pain. Many people currently rely on these LED light products for temporary relief.
A few products in this space to explore include:
- The Neuropathy Pain Relieving LED Wrap sold by Hammacher-Schlemmer online for $330. It is a flexible wrap that secures with hook-and-loop fasteners around various body parts that might need pain relief. It comes with a 20-minute auto shut-off and charges via included USB adapter. Hammacher-Schlemmer also offers a lifetime guarantee.
- NerveBeam LED Light Therapy Wrap, a similar product with adjustable straps that reaches a temperature of over 100°F (37.8°C). This one sells for $350 and has a 1-year warranty and 60-day money-back guarantee.
- dpl Flex Light Therapy Pad, which is secured with Velcro straps and has an auto shut-off at 20 minutes. The cost is $159, but the vendor notes that it is eligible for reimbursement through healthcare flexible spending accounts (FSAs).
This technology focuses on spinal cord stimulation (SCS), which has actually been used for nearly 30 years, but Nevro has created a completely novel approach. Their solution uses 10 kHz therapy to target patients with painful diabetic neuropathy pain superior relief and no paresthesia.
This is now the first (and only!) FDA-approved drug-free implantable device to treat chronic
This device is implanted in your body near your lower spine with a quick procedure at either your doctor’s office or an outpatient clinic.
The mild electrical pulses are delivered to your spinal cord when needed for relief that can be felt in multiple places, including the arms, legs, feet, and toes. These pulses are aimed to calm the nerves and reduce the pain signals interpreted by the brain. You can learn more about this new technology from DiabetesMine here.
The out-of-pocket costs for this Nevro solution can be significant at $7,000 to $10,000, but according to marketing director Meredith Vornholt, it is covered by all major insurance plans including Medicare, which generally covers spinal cord stimulation very well. The actual amount you would pay depends on your plan specifics for copays, coinsurance, and deductible amounts.
Patients can first try this device in a temporary 1-week trial to decide if it’s right for them. The trial period runs from 7 to 14 days. If you achieve greater than 50 percent pain relief, then you will be recommended to move forward to the next phase, which is the implant procedure.
Click here to find a pain management provider experienced with Senza near you.
Don’t forget about shoes!
Kuru special neuropathy shoes are some of the best on the market for people with painful neuropathy caused by diabetes. Uncomfortable shoes can make neuropathy pain significantly worse, but the beauty of these shoes is that they adapt to fit your foot as you walk.
The design is extremely flexible and versatile, with great designs that (frankly) do not look like traditional diabetic shoes.
These well-fitting, comfortable shoes are designed to help prevent further damage to feet and toes affected by painful neuropathy, but they can also increase comfort levels while you exercise or are just living your day-to-day life.
Recommended by podiatrists with those living with diabetes in mind, these shoes use a foam sock liner called Kurusole. The company states that the technology was designed with the help of experts to create the most comfortable shoe possible for people struggling with neuropathy pain.
These shoes may also be helpful while recovering from injury, or when dealing with shin splints, low back pain, plantar fasciitis, or arthritis.
Margaret Jean, from Grand Rapids, Michigan, has been living with T1D for 39 years. She has struggled with painful neuropathy as she’s gotten older, especially in the harsh, cold winters.
She has not yet tried Kuru shoes specifically, but tells DiabetesMine, “I try to stay as active as I can, and swimming helps when walking is too painful. Having a comfortable, reliable shoe to wear can make all the difference! I miss heels but can’t stand the pain as I’ve aged.”
Kuru shoes run from about $125 to $165, available at the manufacturer’s website.
Some podiatrists recommend alternative paths to treatment as well.
Dr. Brittany A. Portonova, a podiatrist who practices in Hazle Township, Pennsylvania, tells DiabetesMine, “For pain control, mild cases of diabetic neuropathy pain can be managed well with a complex mix of vitamins, most notably Vitamin B6 and B12, in addition to alpha-lipoic acid. Some vitamin stores or pharmacies will offer complex/combined vitamins that are geared specifically toward diabetic neuropathy. Moderate to severe neuropathy pain is usually well managed by a combination of over-the-counter or prescription topical pain creams and oral prescription medications with much success.”
She continues, “Secondarily to pain management, we look to supplement with proper supportive shoes, orthotics, and diabetic shoes. It’s important in the presence of neuropathy to be fitted for these devices by either a podiatrist or credentialed pedorthist to make sure that you are getting a quality product that will not cause any unwanted blisters, sores, or infections in the setting of neuropathy. Lastly, therapy and exercise regimens are highly recommended to help with chronic pain, weakness, and gait disturbances that can affect those with neuropathy.”
Some people with T1D have opted for homeopathic remedies to manage their neuropathy pain.
Anna McCollister, of Washington, D.C., has lived with diabetes for 35 years. She says that painful diabetic neuropathy is awful and at times debilitating. Initially, she didn’t have any idea what the pain and discomfort even was, because even her endocrinologist didn’t diagnose the problem. She thinks this condition isn’t talked about enough in the doctor’s office.
She tells DiabetesMine, “I had to figure out the problem on my own. Now I have to be very conscious of a lot of different factors and my daily activities or risk a stabbing, burning pain and embarrassment throughout my day.”
In terms of what triggers the pain for McCollister, wearing certain kinds of shoes (heels or boots), or even getting a pedicure or stubbing a toe can cause inflammation.
Her feet getting hot or sweaty can also cause extreme burning, she says. “It feels as though my foot is being held over an open fire.” She opts for open-toe shoes that have a lot of ventilation, and even when she’s skiing, she opts for wearing stockings instead of thick socks to prevent her feet from getting too hot.
Acetaminophen and ice packs can also help her deal with the pain. Additionally, she never leaves home without her own TENS unit, often taking it on work trips and even to formal dinners.
Maryann Hutchens, of East Liverpool, Ohio, has lived with T1D for 28 years. She uses a combination of Epsom salt baths, topical CBD cream, and peppermint oil to manage her pain. She tells DiabetesMine, “Sometimes distraction is key. Listening to meditative music and getting a massage has also helped me manage my chronic pain.”
Additionally, she regularly dry brushes her skin to promote circulation and aid in pain relief from her mild diabetic neuropathy. “I’m unsure if I’m experiencing the placebo effect, but dry brushing has really alleviated a lot of my [chronic] pain.”
Other people have voiced their preferences for items like compression socks and regular exercise — like walking or swimming a few times per week — to combat diabetic neuropathy pain.
As with everything else in healthcare and diabetes, prevention is key. Experts recommend the following to avoid the worst of diabetic neuropathy:
- Keep a close watch on your blood sugar management and work with your doctor to make sure you’re meeting your Time in Range (TIR) and A1C goals.
- See your doctor and/or podiatrist regularly for foot checks.
- Check your feet and lower legs daily for any signs of infection (redness, swelling, etc.).
- Always wear shoes when walking outside, and don’t let others bring shoes into your home (bringing in shoes can also bring in nails, glass, splinters, germs, and bacteria that can cause infections in people with diabetes).
- Prevent skin cracking in the winter by using lotion regularly.
- Take care of your toenails, keeping them clean and cropped short.
- Wear well-fitting shoes that are not too tight or loose.
- Wear clean, dry socks with all shoes.
While completely preventing painful diabetic neuropathy may not always be possible, incorporating these tools and hacks can help alleviate the often debilitating pain that the condition brings.
Always work with your doctor to make sure you’re keeping a close, careful watch on your daily blood sugar and A1C levels, and hopefully, these recommendations can bring much-needed relief from pain, tingling, and numbness.