What can I take for diabetic neurology? OTC pain medicine doesn't work.

Qtip,

Thanks for your great question.  Diabetic neuropathy is a disorder in which patients develop nerve pain.  It is most common in the legs, but can occur elsewhere.  The character of the pain might vary in description, but most people describe it as a burning sensation, and sometimes as an ache.  As your husband has learned, over the counter pain relievers have limited success.

Fortunately there are several options for this disorder.  The first thing is to get the optimal control of the diabetes itself.  Better control will help the discomfort.  Please go to the diabetes section of the HealthCentral.com and review all of the areas, which cover treatment, nutrition, medication, and complications of the disease.

The other most important step is for your husband to see his doctor to be sure that his problem is from diabetic neuropathy.  Vascular disease can also cause similar symptoms, and is also common in diabetics.  If your doctor confirms the cause as diabetic neuropathy, then he needs to know that over the counter medication has not controlled the pain.  He will discuss the many options in medication treatment available today.

Anticonvulsant drugs have shown to be very effective and these include Neurontin, Lyrica, Dilantin, Tegretol, Carbatrol, Lamictal, Topamax, Zonegran.

Antidepressant medications are also commonly used.  This is not for depression, but for the neuropathic pain.  These include Cymbalta, imipramine, amitriptyline, desipramine.

Lidocaine is a local anesthetic, available in patches, that can be applied to specific areas and left in place for twelve hours at a time. 

Capsaicin Cream is made from an ingredient contained in cayenne peppers.  It is useful for patients with minor discomfort from diabetic neuropathy.

Finding the right choice for your husband may be trial and error.  And in the case of medication, the dose may have to be increase slowly over time to obtain relief, and patience will be required, as relief may not come quickly.

Best wishes.

Martin Cane, M.D.

Diabetic neuropathy is a disease of the nerves thought to be caused problems of the small blood vessels that feed the nerves. Numbness, tingling, and the burning sensation you describe are common complaints in diabetic neuropathy. Some medications that have been shown to be helpful are not typical pain medications at all, but are generally used as antidepressants (such as amitriptyline) and anti-seizure medications (gabapentin). Speak with your doctor to find out if any of these may be right for you.