Diabetic Neuropathy Can Nerve Blocks Or Spinal Stimulation Help
For chronic pain sufferers with diabetes, one type of nerve damage that can be at the root of your pain is diabetic neuropathy.
High blood sugar has been known to injure nerve fibers throughout your entire body. However, patients suffering from diabetic neuropathy most often incur nerve damage in their legs and feet. The symptoms from diabetic neuropathy can vary greatly. The patients who come to our clinics throughout Southeastern Louisiana complain of:
- Numbness in their extremities
- Issues with their digestive system
- Problems with their urinary tract
- Discomfort in their heart
Some patients complain of mild discomfort, while others experience far greater pain. In some instances, diabetic neuropathy can be fatal.
Diabetes Complications: Can They Be Reversed
Diabetes complications refers to a group of medical conditions that can develop as a result of living with diabetes over time. These include: retinopathy, neuropathy, kidney disease, heart disease, and others. Some of these conditions can be reversed and some cannot. Here are some of the most frequent questions I get askedâ¦
How Insulin Resistance Is A Threat
In type 1 diabetes, your body already has a hard time dealing with the fact that it can’t produce sufficient quantities of insulin, requiring you to inject insulin to make sure that your blood sugar levels and remain in a healthy range.
Insulin resistance makes this even harder. If you have insulin resistance, you have to not only inject insulin to compensate for abnormal insulin production, but then you also have to inject more to compensate for the fact that your cells are not insulin sensitive.
This is called “Double Diabetes” and is a very costly, exhausting, and dangerous condition.
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Risk Factors For Diabetic Neuropathy
The longer a person has diabetes and the worse the control of their diabetes, the more likely they will develop diabetic neuropathy.Those people experiencing complications of their diabetes elsewhere in their body are also more likely to have or develop neuropathy, as the same factors that cause these problems also contribute to neuropathy. Smoking, high blood pressure and being overweight also make it more likely that people with diabetes will get nerve damage.
Monitor Your Blood Sugar
As high blood sugar levels are one of the contributing factors to the nerve damage associated with the progression of diabetic neuropathy, it is important to do what you can to keep your glucose levels in check.
You ideal blood sugar level can vary based on your age, health, and how long you have had diabetes. It is best to work directly with your doctor to determine your optimal blood sugar levels. Guidelines from the American Diabetes Association is as follows:
Before a Meal : 80-130 mg/dl1-2 Hours Following the Beginning of a Meal : < 180 mg/dl
Use a blood glucose meter to check these numbers and record them so that you can share the data with your doctor and monitor how your numbers are changing over time. If you find that your numbers are too high or too low for multiple days in a row, contact your doctor to learn what this means and to come up with a plan to get your blood sugar levels back under control.
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Why Choose University Foot And Ankle For Your Diabetic Foot Care
Whether youre already living with diabetic neuropathy or just want advice on caring for your diabetic feet, our nationally recognized foot and ankle doctors offer the most advanced foot care and the highest success rates in the nation. We are leaders in the research and treatment of all foot and ankle conditions.
At University Foot and Ankle Institute, we take our patients safety seriously. Our facilitys Covid-19 patient safety procedures exceed all CDC recommendations. Masks are required in our institutes at all times.
For more information or to schedule a consultation, please call 736-6001 or make an appointment now.
We are conveniently located through the Los Angeles area with locations in or near Santa Monica, Beverly Hills, West Los Angeles, Manhattan Beach, Northridge, Downtown Los Angeles, Westlake Village, Granada Hills, and Valencia, California.
What Are The Symptoms
Your symptoms will depend on which nerves are injured. You may not be able to feel pain, especially in your feet. This can lead to serious infections, because sores or other problems may not get treated.
When other parts of your body are affected, symptoms may include:
- Problems with digestion, such as bloating, belching, constipation, nausea and vomiting, diarrhea, and belly pain.
- Problems with body temperature, such as heavy sweating at night or when you eat certain foods. Some people may have reduced sweating, especially in their feet and legs.
- Problems with urination, such as finding it hard to tell when your bladder is full or finding it hard to empty your bladder completely.
- Sexual problems, such as erection problems in men and vaginal dryness in women.
- Heart and blood vessel problems, leading to poor circulation or low blood pressure. This may cause dizziness, weakness, or fainting when you stand or sit up from a reclining position.
- Trouble sensing when your blood sugar is low.
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What Causes Diabetic Nerve Pain
The exact cause of diabetic nerve pain varies from patient to patient. There are four main types of diabetic neuropathy, and each type affects different parts of the body.
Diabetic nerve pain is directly caused by exposure to high levels of blood sugar for an extended period of time. The relation between glucose and nerve damage is not yet clear.
Nerve inflammation is a source of pain in some patients. Inflammation is a natural autoimmune response which occurs when the immune system attacks its own body. Injuries to nerves such as those resulting from carpal tunnel syndrome can also contribute to pain or discomfort.
Genetics play a contributing role in certain patients. Some people are more likely to develop diabetic neuropathy than others for reasons unrelated to diabetes.
Excessive alcohol consumption and smoking may also contribute to damage in blood vessels and nerves.
Hope For Neuropathy Sufferers
Our local newspaper recently had a four-page full-color advertising insert titled Encouraging News for Neuropathy Patients. As neuropathy is a common and frustrating complication of diabetes, I was intrigued, and read the entire insert. According to the insert, Local Doctors Drug-Free, Neuropathy Treatment Relieves Poor Balance and Numbness in Feet and Legs. And the local doctor indicates that he has developed his own way to treat neuropathy His ad states: “This successful protocol is a pain-free treatment available only at the Chiropractic Pain Relief Center. It is noninvasive and drug-free so there are no concerns about drug interactions. It is completely safe and effective in the treatment of neuropathy pain. Many patients have been able to get off medications that can affect them both mentally and physically. Each patients care is tailored to his or her own specific condition.” That seems almost too good to be true a local chiropractor here in South Carolina has an exclusive treatment for a complication about which it is said there are no miracle cures or treatments for neuropathy. Lets be specific. Although neuropathy has many causes, its very common in diabetes, with about half of all people with diabetes having some form of nerve damage. Probably the most common diabetic neuropathy is whats medically called distal , symmetric , sensory polyneuropathy . Its sometimes abbreviated DSPN . It canContinue reading > >
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The Central Problem In Diabetes: High Blood Sugar
Either way, the central problem with diabetes is high blood sugar levels, which can cause a whole slew of different problems.
For example, constant high blood sugar levels can damage the tiny blood vessels in your eyes, which eventually leads to blindness.
It can also cause nerve problems that lead to numbness and pain, especially when it comes in contact with nerves in your feet and hands .
High blood sugar — even if you don’t have diabetes — can also lead to heart disease, especially if you have other risk factors.
And in extreme cases — called a diabetic crisis — your blood sugar can get so high that you slip into a coma and die if it’s not treated immediately.
What Are The Symptoms Of Neuropathy
Symptoms of neuropathy vary depending on the type and location of the nerves involved. Symptoms can appear suddenly, which is called acute neuropathy, or develop slowly over time, called chronic neuropathy.
Common signs and symptoms of neuropathy include:
- Tingling or numbness, especially in the hands and feet. Sensations can spread to the arms and legs.
- Sharp, burning, throbbing, stabbing or electric-like pain.
- Changes in sensation. Severe pain, especially at night. Inability to feel pain, pressure, temperature or touch. Extreme sensitivity to touch.
- Falling, loss of coordination.
- Not being able to feel things in your feet and hands feeling like youre wearing socks or gloves when youre not.
- Muscle weakness, difficulty walking or moving your arms or legs.
- Weight loss .
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Staying Ahead Of Diabetic Neuropathy
A few helpful tips to keep you on top of and in tune with your foot health:
Have a comprehensive foot exam every year, or more often, performed by a healthcare practitioner. This is a good way to check for peripheral neuropathy. Your doctor may perform additional tests to look for signs of neuropathy. Regular doctors-office foot exams, recommended to catch nerve damage and related problems early, only happen at 12 to 30% of medical appointments for people with diabetes, say members of an American Diabetes Association task force on foot health. 15 Its also important to share any symptoms youre having with your doctor, such as pain, numbness, constipation, diarrhea, sexual dysfunction or becoming easily tired when you exercise. In a 2015 the University of Arkansas for Medical Sciences nearly 40% did not get treatments to help ease the pain.16
Keep blood sugar in a healthy range slow development of diabetic neuropathy.
Follow a heart-healthy lifestyle. Studies show that this may reduce the risks associated with autonomic nerve damage of the heart for people with type 1 and type 2 diabetes.¹³ Too often, this condition is not recognized or managed.¹
1. Pop-Busui R et al: Diabetic Neuropathy: A Position Statement by the American Diabetes Association. Diabetes Care 2017 40:136154. http://care.diabetesjournals.org/content/diacare/40/1/136.full.pdf
10. MedlinePlus: Mononeuropathy. Reviewed May 30, 2016. Accessed March 6, 2017. https://medlineplus.gov/ency/article/000780.htm
How We Treat Diabetic Neuropathy With Nerve Blocks/ Spinal Stimulation
Because of the varying degrees of pain, and causes, of diabetic neuropathy, we here at Southern Pain & Neurological of Louisiana offer a variety of treatment options for our patients. Two of the most successful treatments are nerve blocks and spinal stimulation.
Nerve blocks, or injections of medication close to the affected nerves, relieve the pain symptoms of diabetic neuropathy by disrupting pain signals to the brain. Our patients can experience short-term relief through an injection of medication to the area in which they feel pain.
In some cases, we provide longer-lasting pain relief by intentionally damaging the malfunctioning nerve or nerves, with the nerve block.
The reason this treatment method is more effective than oral medication is because the injected medication is delivered immediately, and directly, to the part of the body in pain. Our injections include:
- Steroids which reduce inflammation and irritation to the affected nerve
- Local anesthetic to break the cycle of pain and provide relief
- Opioid injection to provide powerful short-term relief
Spinal cord stimulation can reduce pain by transmitting mild electrical impulses to the spinal cord. This stimulation disrupts the feeling of pain. Rather than feeling pain, patients experience a far more pleasing sensation .
If the trial period is a success, we can move on to the “permanent” procedure .
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Symptoms Of Diabetic Neuropathy
Most people with diabetic neuropathy are unaware that they have nerve damage, until it is picked up on routine screening by their doctor.Typical symptoms vary from person to person, but may include one or more of numbness, pins and needles, tingling, discomfort, or weakness, which usually begin in both feet and spread symmetrically up the legs .About half of those people with diabetic neuropathy experience significant pain in their feet and increased sensitivity to painful stimuli .Neuropathic pain is often worse at night, and can seriously disrupt sleep patterns.These symptoms can have a major effect on health and wellbeing because:
- balance problems increase the risk of falls
- weakness leads to deformities in the feet, like claw or hammer toes, and bunions
- numbness means damage to the feet may go unnoticed.
Together, these can lead to the formation of a foot ulcer.
Initial And Ongoing Treatment
Treatment for diabetic neuropathy depends on your symptoms and the type of neuropathy that you have. In general, treatment focuses on reducing current symptoms and preventing the condition from getting worse by keeping your blood sugar level within your target range. You can keep your blood sugar levels within the target range by taking your insulin or oral diabetes medicine as prescribed, checking your blood sugar levels, following your diet for diabetes, exercising, and seeing your doctor regularly.
Also, it is important to properly care for your feet when you have diabetic neuropathy. Diabetic neuropathy may cause a loss of feeling in your feet. It is possible for a sore or other foot problem to go unnoticed. Without proper foot care, an untreated foot sore can lead to a serious infection or possibly amputation.
It is also wise to maintain healthy habits such as seeing your doctor regularly, controlling your blood pressure, eating a balanced diet, exercising regularly, not smoking, and limiting or avoiding alcohol. Further treatment depends on the specific type of diabetic neuropathy that you have along with your current symptoms.
Many people with peripheral neuropathy have mild to severe pain in specific parts of their bodies. Talk with your doctor about treatment that can reduce your pain and improve your physical functioning, mood, and mental well-being. Some people find these treatments helpful:
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Prevention Is Still The Best Cure
Because there is no cure for diabetes or diabetic retinopathy, the best way to treat these conditions is to stay on top of your health. Taking care of yourself and following your doctors instructions can help you prevent comorbid conditions from developing.
High blood glucose, hypertension, and high ketone levels can increase your risk of retinopathy. As such, managing them is the first step in prevention.
Even though its difficult, eating a healthy diet and exercising will go a long way toward keeping your eyes healthy in the long run. Along with diet and exercise, monitoring your blood sugar levels and taking your medication as prescribed can help as well.
Finally, the importance of frequent eye exams cant be stressed enough.
If you have diabetes, seeing an eye doctor every few months can help you stop retinopathy in its tracks. You should also get a thorough exam with dilation every year. Your doctor may then be able to notice and treat the damage before you experience any symptoms.
What Are Some Risks If I Dont Get Treatment
Diabetes-related foot pain is more than just pain its a warning sign from your body. This type of nerve pain can lead to complications if you dont see a doctor and get treated. Below are some of the problems that can come from untreated diabetes nerve pain:
Dry, cracked skin. This may not sound too bad, but when your skin is too dry, your risk of getting skin infections goes up. If this happens, plain petroleum jelly or unscented hand creams can help. Just avoid placing moisturizers between your toes.
. This is an area of thickened skin that has less feeling. People with diabetes get calluses faster and more often than those without diabetes. You can use a pumice stone daily to help keep them at a minimum. If they get really thick, a doctor can cut or shave them down. Never attempt to do this at home as it can lead to infections.
Ulcers. These are sores that happen to some people with diabetes due to poor blood circulation. All ulcers need to be seen by a doctor. The longer you go without seeing a doctor, the more likely it is that it will become infected. Infected ulcers can spread and cause you to lose your foot or leg.
Amputations. If the previously listed complications are not treated properly, they can all become infected. Skin infections can cause the skin and muscle tissues to die. Once this happens, it cant be fixed. The only way to stop the infection from continuing to spread is by amputating the infected limb.
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Bariatric Surgery And Gastric Bypass
This is the last, most extreme medical procedure people tend to use to treat diabetes.
Bariatric surgery is a very effective, if invasive treatment for type two diabetes.
This is because bariatric surgery changes how your body absorbs and uses nutrients from food. It literally shuts off some parts of your stomach and reroutes your digestive system entirely.
And when it comes to diabetes, this is a very effective treatment because so much type two diabetes is linked with obesity in the first place.
However, there’s a big, big asterisk to gastric bypass and bariatric surgery.
First, there are potential side effects and complications from bariatric surgery that can range from mild discomfort to life-threatening emergencies.
And second, if you don’t change the habits that lead to your bariatric surgery and gastric bypass in the first place, you may end up in the same position years down the line.
When it comes to such a big piece of medical advice, diagnosis, or treatment like this, there’s no way we can make a healthy recommendation about when or if to take this procedure.
We can only recommend trying to use the aforementioned strategies to reverse insulin resistance first, and only use bariatric surgery as a last resort.