If you have been diagnosed with diabetes, you already understand the challenges that lie ahead. One of the most frustrating and painful challenges is diabetic leg pain. Here are nine tips for preventing and managing the pain of diabetic peripheral neuropathy.
What is diabetic leg pain?
Diabetic neuropathy is a nerve disorder that originates as a comorbid condition of diabetes and the word “neuropathy,” which indicates a condition of the nerves. Also known as diabetic peripheral neuropathy, this condition is unfortunately common in patients with poorly controlled diabetes.
There are two types of diabetes: Type 1 and Type 2. Type 1 diabetes is a congenital condition (present at birth). Type 2 can develop over time in susceptible people. For both, blood sugar must be controlled either through medication or diet (or a combination of the two).
If blood sugar is not properly controlled, the small capillaries that deliver blood to the nerves become damaged. This damage occurs mainly on the periphery of the body—the legs and feet, most commonly—but it can occur anywhere. When the nerves are damaged, diabetic leg pain can occur.
The condition can affect several nerves in the limbs including sensory nerves, motor nerves, and autonomic nerves. Sensory nerves are those that receive sensations like pain or touch. Motor nerves control movement. And autonomic nerves control functions like blood pressure.
Risk factors
An estimated 50% of people with diabetes experience neuropathy. The condition is most common in individuals who have difficulty controlling their blood sugar levels.
While diabetes, especially with uncontrolled blood sugar, is the most common cause of peripheral neuropathy there are other risk factors. These include:
- Alcoholism
- Vitamin deficiencies
- Infections, such as Lyme disease or shingles
- Autoimmune diseases
- Repetitive motions
What does diabetic leg pain feel like?
We explore more of the symptoms in an earlier post here, but in general, symptoms can impact not only feeling but also movement. Diabetic neuropathy typically begins gradually with numbness or tingling in feet or hands, which then spreads throughout the limbs. Burning and sharp pains are also common.
Other symptoms that occur as the syndrome progresses are varied and can include the following.
- There may be changes in the skin, hair, or nails
- People often experience muscle weakness
- Sharp, shooting, or burning pain occurs
- Paralysis can also occur if the motor nerves are affected
- Changes in blood pressure causes dizziness or digestive problems (depending on the affected nerves)
- Wounds heal more slowly
- Some patients experience gastrointestinal issues
- Others have an increase in urinary tract infections
Symptoms follow a progression, but everyone who suffers from diabetic leg pain may experience them to different degrees. The progression depends on being alert for symptoms early on and taking action to slow the damage.
Can diabetic neuropathy be reversed?
Your body is incredibly resilient. There are many types of nerve damage that can be healed. In fact, one of the most frustrating things about some chronic pain treatments (e.g., radiofrequency ablation) is the fact that nerves heal and begin sending pain signals again!
But when it comes to leg pain caused by diabetic peripheral neuropathy, the damage is usually permanent and irreversible. This is why blood sugar control, weight management, and other preventative treatment is so important.
Recent research into diabetic leg pain
Over 100 million adults in the U.S. are either living with diabetes (or heading that way). Researchers have been hard at work in the past two decades trying to untangle a standard of care for diabetes and related diabetic leg pain.
It’s clear from the following studies that there are ways to better prevent and manage diabetic peripheral neuropathy. Here are five of the key findings.
1. Management and prevention of diabetic leg pain: It depends
Research in 2016 debunked other studies that focused on aggressive management of blood sugar. It appears that successful prevention strategies depend on the type of diabetes a person has.
Blood sugar control is most important for Type 1 diabetes, while controlling weight is the focus for Type 2.
2. Monitoring at-risk people is key
Because diabetes relies on patient compliance with treatment protocols, one of the best ways to prevent diabetic peripheral neuropathy is to monitor patients who might not comply with care.
Using better diagnostic tools and paying close attention to at-risk patients can prevent diabetic leg pain from developing or worsening.
3. Management of symptoms is multi-pronged approach
The symptoms of diabetic neuropathy are challenging to manage. Because of this, researchers are finding that the best treatment approach is a multi-pronged one. Crucial aspects include:
- Early diagnosis
- Prompt intervention
- Pain treatment
4. Exercise can reduce symptoms
Even if you are experiencing diabetic leg pain, exercise has been shown to relieve some of the most disturbing symptoms (e.g., pain, numbness, difficulty with movement).
In the simplest terms, exercise appears to prevent pain-inducing triggers from occurring and increase positive nerve signaling when it comes to movement.
5. Quitting smoking dramatically lowers your risk
One of the healthiest things you can do in general is quitting smoking.
It turns out that smokers with diabetes have a much higher risk of developing diabetic peripheral neuropathy than those who do not smoke. Smokers also have trouble regulating blood sugar and are more likely to be obese.
How to prevent, treat, and relieve diabetic leg pain
Our bodies are wonderfully individual, so your treatment path won’t be the same as every other patient. The best approach is to talk to your doctor to find the best way to prevent, treat, and relieve diabetic leg pain for you.
Here are nine tips to help manage and relieve diabetic leg pain.
1. Use exercise to promote overall health
Physical activity remains one of the most basic lifestyle modifications recommended to patients with diabetes. For patients with Type 2 diabetes, one of the key benefits of exercise may be prevention of diabetic leg pain.
Physical activity helps cells develop greater sensitivity to insulin. This helps the body better process it. Exercise also activates a special cellular activity that involves absorbing blood glucose, according to the American Diabetes Association.
Other benefits of exercise include:
- Weight loss
- Stress relief
- Reduced risk of heart attack and stroke
- Better circulation
These all improve health and reduce the likelihood of complications from diabetes, including diabetic leg pain.
2. Eat a diabetic-friendly diet
Very few people get excited when they hear the word “diet,” but focusing on food as medicine can be a way to prevent diabetic leg pain. In a 20-week pilot study of diet for patients with Type 2 diabetes, participants who switched to a plant-based diet had less pain, better nerve conduction, and weight loss.
But you don’t have to become a vegetarian to improve your diet. Following Michael Pollan’s “eater’s manifesto” can help:
- Eat food
- Not too much
- Mostly plants
Whole grains, lean proteins, and lots of fruits and vegetables are key here. Limiting processed foods, sugar, and excessive dairy can all help manage inflammation in the body and keep blood sugar levels stable.
Nutritional counseling can help you understand how simple changes to your diet can help.
3. Manage weight
Related to lifestyle changes that include diet and exercise are all of the steps you take to lose weight. Losing weight is an important step for reducing any types of leg pain, but especially diabetic leg pain.
Lower weight simply reduces the amount of pressure on the legs. Because obesity is a risk factor for developing Type 2 diabetes, weight loss can also help with prevention. Once a person is diagnosed with Type 2 diabetes, though, weight loss can also help to manage diabetes symptoms.
4. Maintain appropriate blood sugar levels
Maintaining stable blood sugar levels is key to preventing nerve damage that occurs with wild blood pressure spikes.
Work with your doctor to figure out an appropriate strategy for this. Some people with diabetes benefit from several small meals a day (instead of three big meals). Others might manage their weight and stabilize their blood sugar with a standard breakfast, lunch, and dinner.
Each person’s best practice will be different. Work closely with your doctor to find your most appropriate strategy.
5. Practice daily foot and leg care
Because early detection is key, proper foot and leg care is crucial in preventing diabetic peripheral neuropathy.
Check your feet and legs every day for cuts, scrapes, blisters, swelling, or redness. Apply moisturizer (massage for good circulation!). Keep your feet clean and dry. Wear clean socks every day, and invest in high-quality, properly fitted footwear.
6. Build healthier habits for compounded prevention
If you can only manage one change at a time (i.e., you can only change your exercise habits), that is certainly better than nothing. But the most powerful prevention and treatment occurs when you use each of these strategies together.
Changing your diet and adding exercise will help you with weight management. Symptom management plus diet and exercise magnifies the effects of each one of those tools.
Change is hard. It may seem like an insurmountable obstacle. But every step you take to prevent further damage from diabetic peripheral neuropathy means a better quality of life.
7. Try physical therapy
As diabetic leg pain progresses, it may become harder and harder to maintain the motivation to exercise. This is where physical therapy can be a lifesaver.
Physical therapists design a tailored set of exercises that help increase circulation, relieve pain, and stretch and strengthen the muscles of the legs. These sessions can also help manage both weight and blood sugar—two keys to easing leg cramps and other diabetes leg pain.
Another benefit of physical therapy is that it can ensure proper posture and gait training. If you have been walking off-balance due to leg pain, that can affect your whole body. A physical therapist can help you recognize that and work to fix it for better overall health and prevent other related pain issues.
8. Look into topical treatments and medications
Topical treatments can help relieve diabetic leg pain with few side effects or drug interactions. Consider using lidocaine patches and capsaicin cream to alleviate your pain.
Although opioids are not suggested for diabetic leg pain, over-the-counter pain relievers may provide relief when pain flares up. Other medications to treat this type of chronic pain may include tricyclic antidepressants.
9. Talk to your doctor about diabetic leg pain treatments
If more conservative approaches do not work and your pain is progressing, there are other options. Interventional strategies that can help relieve diabetic nerve pain include:
- Pain-relieving injections
- TENS unit therapy
- Nerve blocks
Get help with your diabetic leg pain
At Arizona Pain, or goal is to help you get your life back. We recognize the challenges that people with diabetes face, and we want to help you meet them head on.
If you are experiencing diabetic leg pain (or want to explore comprehensive strategies to prevent it), get in touch to schedule an appointment today. We can help.