You know only too well that when you touch a hot stove, you quickly move your hand away because you feel pain. Likewise, if you step on a nail, your body knows to pick that foot up quickly. Sometimes, when you have pain, you also may notice that your heart rate and breathing get a bit faster, too. All these responses happen thanks to the nerves all over your body that carry messages to and from the brain.
But more than half of all people with diabetes have one or more signs of nerve damage and, as a result, their bodies don’t sense pain in the same way.
The medical name for nerve damage is neuropathy. It is the most common problem that occurs from having diabetes. While no one knows exactly why people get nerve damage, it is thought that years of high blood glucose levels cause the damage.
Nervous system basics
The nervous system is made up of the brain, spinal cord and two kinds of nerves—peripheral nerves and autonomic nerves. The peripheral nerves go from the spinal cord all the way to the tips of your fingers and toes.
The autonomic nerves control the “automatic” functions of the body, such as breathing, heart rate, the moving of food through your body and sexual functioning.
Two kinds of nerve damage
Diabetes does not affect the brain and spinal cord, but sometimes it affects the autonomic nerves. Signs of autonomic neuropathy are: feeling full after only a few bites of food, diarrhea followed by constipation, feeling dizzy when standing up slowly and changes in heart rate. If you have these symptoms, you need to let your health care provider know so he or she can have you tested for neuropathy.
The most common type of nerve damage is to the peripheral nerves. This is called peripheral neuropathy or polyneuropathy, which means damage to many nerves. For many people with neuropathy, the pain caused by peripheral neuropathy is the hardest part of living with diabetes. Some people describe the pain as burning, aching, cramping, pins and needles or electrical shocks. The foot and leg pain caused by neuropathy is often worse at night. Even your clothes or the covers on the bed can make the pain worse.
The first thing you must do to treat neuropathy is to make sure that your blood glucose reaches and stays in your target range. Sometimes, people with neuropathy report that doing so makes the pain worse at first, but it usually gets better over time.
The next step for you might be a medication to ease your symptoms. Not too long ago, people with diabetes were told that they would just have to live with the pain. Today, however, there are better medications available than ever before. Some of the medications take time to begin working, so it is important to give them a fair chance before trying something else.
Alternative Therapies For Neuropathy
In addition to medications, there are other treatments for neuropathy. Two of these involve electrical stimulation. Electrical spinal cord stimulation (ESCS) and trans- cutaneous electrical nerve stimulation (TENS) both stimulate nerves with an electrical current. Although this sounds painful, it actually blocks the nerves’ ability to sense pain and, as a result, can relieve the pain.
Some people find that acupressure, hypnosis and meditation also are helpful. Not smoking, limiting alcohol intake and even walking to relieve leg pain may also help.
Taking Extra Care
Along with pain, nerve damage can cause numbness in the feet and hands. When that happens, there is no feeling in those nerves at all. While not feeling pain may sound good, pain actually helps to protect us. When people are not able to feel pain, they can’t feel if their shoes fit, if the bath water is too hot or if they have stepped on a nail. As a result, wounds that go unnoticed can lead to serious problems and even amputation, in some cases.
When you have numb feet, you have to do what your body used to do for you. You can protect your feet and greatly reduce the chances for serious problems if you look at them every day for any redness or sores, wear shoes and socks that fit and call your health care provider if you have any problems that do not begin to heal within 24 hours.
Aside from numbness, you may also have a loss of balance, have a hard time telling where your feet are and have trouble walking, especially on rough surfaces. Inserts that fit into your shoes (orthotic devices) and special shoes can help to protect your feet.
Neuropathy is a problem for many people with diabetes. If you have symptoms of neuropathy, let your health care provider know. He or she can help you get the tests you need to diagnose any problems properly and then help you get the proper treatment. The good news is that there are treatments available and steps you can take to feel better now and have fewer problems tomorrow.