You may be able to relieve diabetic nerve pain with medications and exercise. Managing your diabetes may help prevent it from getting worse.

Diabetes can cause long-term problems throughout your body, especially if you don’t control your blood sugar effectively, and sugar levels remain high for many years.

One complication of diabetes is diabetic neuropathy. This can cause numbness or tingling in your fingers, toes, hands, and feet. Another symptom is a burning, sharp, or aching pain (diabetic nerve pain). The pain may be mild at first, but it can get worse over time and spread up your legs or arms. Walking can be painful, and even the softest touch can feel unbearable.

About 50% of people with diabetes experience diabetic neuropathy and 25% can experience pain. Nerve damage can affect your ability to sleep, decrease your quality of life, and can also cause depression.

The most important thing is to control your blood sugar so that your nerve damage doesn’t progress. Talk with your doctor about setting your blood sugar goal, and learn to monitor it.

You may be asked to lower your blood sugar before meals to 80-130 milligrams per deciliter (mg/dL) and your blood sugar after meals to less than 180 mg/dL.

Use diets, exercise, and medications to decrease your blood sugar to a healthier range. Monitor other health risks that can worsen your diabetes, such as your weight and smoking. Ask your doctor about effective ways to lose weight or quit smoking, if necessary.

The first-line treatment for diabetic neuropathy, especially in cases of pain, is usually the anticonvulsants (anti-seizure drugs) Pregabalin (Lyrica) or gabapentin (Neurontin), which are known to help with nerve pain.

They may also choose the selective norepinephrine reuptake inhibitor (SNRI) duloxetine (Cymbalta) because antidepressants interfere with the chemicals in your brain that cause you to feel pain.

If these three medications are not effective, there are others a doctor can choose from within the same classes such as the anticonvulsants oxcarbazepine (Trileptal, Oxtellar XR) or carbamazepine (Tegretol, Tegretol XR, Epitol).

Antidepressants a doctor may choose from include:

In addition, your doctor might suggest trying an over-the-counter pain reliever such as acetaminophen (Tylenol), aspirin (Bufferin), or ibuprofen (Motrin IB, Advil) to manage pain. These are available without a prescription but can cause side effects. Use a low dose for a short time to control your symptoms.

Lidocaine patches also deliver local anesthetic through a patch placed on the skin. These may cause minor skin irritation, however.

Opioid pain medicines

Powerful drugs like oxycodone (Oxycontin) and the opioid-like medicine tramadol (Conzip, Ultram) can treat much stronger pain. However, these drugs aren’t meant for long-term relief because of side effects and the potential for substance use disorder (SUD).

You might use these medications if other treatments aren’t working. Work closely with your doctor and use caution when taking opioid medicines.

A variety of physical exercises or physical therapy may be helpful in reducing pain from peripheral neuropathy, though research has yet to determine the most effective type.

This may include:

Different physical activities might work better for different people. Be sure to speak to your doctor about the best exercise for you based on your specific health and symptoms.

If you go to a physical therapist, choose a trusted professional who understands neuropathy, diabetes, or otherwise, and can help you work through physical therapy methods without further nerve damage.

Proper attention to physical activity by an expert can prevent any further issues from occurring. Also keep in mind that physical therapy can soothe diabetic nerve pain, but not cure it.

Capsaicin cream (Arthricare, Zostrix) can block pain signals using an ingredient found in hot peppers. It is also available as a lotion, jelly, or patch, and can be applied to the skin where diabetic nerve pain is strong.

Research has found that applying capsaicin 0.075% cream to the affected area four times a day may help relieve pain by up to 50%.

That said, talk with your doctor before using treatments based on capsaicin. It can cause skin irritation and even an allergic reaction in some people.

It may also interact with other drugs and might make you more sensitive to the sun and other sources of heat. Avoid excessive exposure to sunlight or heat when using capsaicin creams or lotions.

Diabetic nerve damage causes pain and can also affect your ability to feel pain, so it’s important to maintain your foot health.

To take better care of your feet, check your feet every day for cuts, sores, swelling, and other problems, even if you don’t feel any pain there. They can get infected, and untreated infections can lead to serious complications, including amputation.

Wash your feet daily with warm water, and dry them completely afterward. Then apply a lotion to keep them moisturized. Avoid getting lotion in between your toes.

Wear comfortable, flexible shoes that give your feet room to move. Break in new shoes slowly so that they don’t hurt your feet. Ask your doctor about customized shoes if regular shoes don’t fit well.

Always cover your feet with shoes, slippers, or thick socks to cushion them and prevent injuries.

What triggers neuropathy in feet?

The cause of diabetic neuropathy is high blood sugar, which damages the nerves that send signals from your hands and feet.

Can you fix nerve damage in the foot from diabetes?

Damaged nerves can’t be replaced. However, there are ways that you can prevent further damage and relieve your pain.

What foods should you avoid if you have neuropathy?

When living with diabetes, it’s important to eat a balanced diet that includes plenty of fresh fruit and vegetables, healthy fats from foods like nuts and oils, and lean proteins like chicken or plant-based proteins. Avoid foods containing trans fats, refined carbs, or added sugars to keep your cholesterol and blood glucose levels steady.

Keeping your blood sugar under control to prevent nerve damage is the best way to avoid nerve pain. Follow your doctor’s advice for diet, exercise, and treatments if you already experience diabetic nerve pain.

Diabetic neuropathy doesn’t have any known cures. However, many treatments can help lessen the discomfort and pain caused by diabetic nerve pain, and your doctor can assist you in selecting one that works best for you.