Painful diabetic neuropathy

"Pain-blockers"
Medications that block pain can be very useful in the treatment of diabetic neuropathy. These medications are not painkillers. They were originally developed for the treatment of other conditions, and have been found to work occasionally to relieve diabetic neuropathy. It will be necessary to try a medication program with one of these "pain-blockers" for several months to find out if it might be helpful for your pain.

Needless to say, these medications have a risk of side-effects, which should be discussed thoroughly with your physician before starting a trial. There is no guarantee that any of the "pain-blockers" will work, and they must be tried, and then decide whether it helped enough to keep it going, or whether a second (or third) program might be tried. Pain-blocking medications include:
* antidepressant medications, such as Elavil (amitriptyline), Prozac (fluoxetine), and others;
* anti-seizure medications, such as Dilantin (phenytoin), Tegretol (carbamazepine), and Neurontin (gabapentin).

New medications
Newer prescription medications that treat diabetic peripheral neuropathic pain are also available.
* Cymbalta (duloxetine) is approved for use for the management of diabetic peripheral neuropathic pain, as well as fibromyalgia, depression, and generalized anxiety.
* Lyrica (pregabalin) is approved for use in the management of neuropathic pain associated with diabetic peripheral neuropathy and other conditions including postherpetic neuralgia (nerve pain after shingles) and fibromyalgia.

Skin Creams
A non-prescription pepper cream (capsaicin) for application onto painful skin is available. This medication has been shown to give relief for painful diabetic neuropathy in some cases. If capsaicin is stopped, the pain will return. It does have side effects of a transient severe burning for a week or so before numbing sets in. Advice when using capsaicin include
# Wear gloves when applying capsaicin cream.
# Do not apply it immediately after a hot bath or shower or use it with a heating pad.
# Avoid getting capsaicin cream in eyes and other mucus membranes or broken skin.

Summary

If you have painful burning sensations in your feet, ask your physician about whether you might benefit from one or another of these medications.