Topical Medications for Painful Diabetic Neuropathy

by Christina Lasich, MD Health Professional

Do your feet tingle, burn or itch? If so, then you might have some nerves going haywire in your feet. Millions of people are affected by neuropathy which causes the nerves in the feet and eventually the hands to start acting weird. The feet are usually affected first because those nerves are the longest and therefore the most difficult to keep healthy. Sometimes neuropathy does not hurt; it just causes a strange or numb sensation. But when neuropathy does hurt, it can feel like the limbs are being attacked by thousands of sharp needles, ice buckets or hot pokers.

You might feel like you are under attack if you have painful diabetic neuropathy. Treatment of painful diabetic neuropathy should first start with supplements and gaining control of blood sugar levels. Next, the treatment usually involves medications that are ingested by mouth. These oral medications treat nerve pain. Unfortunately, these same treatments can lead to other problems like drowsiness, dizziness and difficulty concentrating, just to name a few of the common side effects. Wouldn't it be nice if there were medications without side effects? Well, there is if you consider topical medications that can be rubbed on the feet and/or hands.

Although there are many topical medications available without a prescription, the ones that might work the best for painful neuropathies are only available with a prescription. In a recent study conducted at Johns Hopkins School of Medicine, researchers proved that topical clonidine applied three times daily for 12 weeks reduced the pain from diabetic neuropathy in the right candidates.1 Clonidine is an interesting drug because it is also used to treat high blood pressure and hyperhydrosis. But because of its unique action on the nervous system, clonidine is also useful for treating nerve pain. In those individuals with both high blood pressure and nerve pain, clonidine administered orally could be a very good way to solve both problems. But for those who don't want to take pills or deal with their side effects, topical clonidine applied to painful feet is probably worth a try.

Another topical medication available only by prescription and used to treat painful neuropathy is lidocaine. Yes, the same stuff that dentists use to numb your mouth can be applied to the skin in painful areas. In Europe, lidocaine plasters are applied to painful limbs affected by haywire nerves from diabetic neuropathy and other syndromes.2 Here, the most common form of topical lidocaine is the Lidoderm patch which is really difficult to use on the feet and hands. Lidocaine also comes in gel form, too. But, some doctors may want to go one step further and ask compounding pharmacies to mix a lotion or gel that contains not only lidocaine but also clonidine. Other medications can be added to the compounded mix like gabapentin or amitriptyline as well. Other combinations exist, but the topical medications proven to be most effective against painful diabetic neuropathy are clonidine and lidocaine. (Hands down or, maybe in your case, feet down.)

So if you are one of millions tired of feet that sting, burn or itch, consider rubbing the discomfort out with a medication applied to your skin. The side effects are minimal and results might surprise you. If you are looking for a solution to painful diabetic neuropathy, ask your doctor about topical medications that are available by prescriptions.

  1. Pain. 2012 Jun 8

  2. Curr Med Res Opin. 2012 May 2

Christina Lasich, MD
Meet Our Writer
Christina Lasich, MD

Christina Lasich, M.D., wrote about chronic pain and osteoarthritis for HealthCentral. She is physiatrist in Grass Valley, California. She specializes in pain management and spine rehabilitation.