Understanding and Managing Diabetic Peripheral Neuropathy

At Horizon Spine & Pain of Utah, we specialize in diagnosing and managing diabetic peripheral neuropathy, a common yet challenging complication of diabetes that affects millions of people. Early intervention and comprehensive care are critical to preserving function, reducing pain, and improving quality of life.

Diabetic peripheral neuropathy (DPN) refers to nerve damage caused by prolonged high blood sugar levels, primarily affecting the nerves in the hands, legs, and feet. It is the most common form of diabetic neuropathy and can lead to numbness, tingling, burning pain, and weakness.

Left untreated, DPN can progress and significantly impair mobility and daily functioning.

DPN develops over time due to:

• Prolonged elevated blood glucose levels, damaging small blood vessels that nourish the nerves
• Inflammation in the nerves caused by metabolic imbalances
• Oxidative stress, leading to further nerve fiber injury
• Genetic predisposition in some individuals

Tight blood sugar control significantly reduces the risk of developing or worsening neuropathy.

Factors that increase the risk of diabetic peripheral neuropathy include:

• Poorly controlled diabetes
• Long duration of diabetes (typically more than 10 years)
• Obesity
• High blood pressure or high cholesterol
• Smoking, which reduces blood flow to the nerves
• Kidney disease

Identifying and addressing these risk factors early can prevent serious complications.

Symptoms of diabetic peripheral neuropathy often start gradually and may include:

• Numbness or reduced ability to feel pain or temperature changes
• Tingling, burning, or sharp pains, especially at night
• Sensitivity to touch (even a bedsheet can cause pain)
• Muscle weakness or coordination difficulties
• Foot ulcers or infections due to unnoticed injuries

Symptoms typically begin in the toes and feet and may progress upward toward the legs.

At Horizon Spine & Pain of Utah, our thorough diagnostic process includes:

• Detailed medical history, including diabetes management review
• Comprehensive physical examination, focusing on neurological function
• Nerve conduction studies (NCS) and electromyography (EMG) to assess nerve function
• Quantitative sensory testing to evaluate sensitivity to pressure, temperature, and vibration
• Blood tests to rule out other causes of neuropathy

Accurate diagnosis ensures that treatment is appropriately targeted.

Effective management of diabetic peripheral neuropathy focuses on controlling symptoms and preventing progression. Options include:

• Strict blood sugar control to minimize further nerve damage
• Medications:
  • Anticonvulsants like gabapentin and pregabalin
  • Antidepressants such as amitriptyline or duloxetine
  • Pain relievers (topical or oral)
• Physical therapy:
  • To improve strength, balance, and flexibility
• Nutritional counseling:
  • To optimize blood sugar control and nerve health
• Foot care education:
  • Preventing injuries that can lead to serious infections

A combination approach is often most effective for symptom management.

For patients with severe or persistent symptoms, we offer advanced injection therapies:

• Nerve blocks:
  • Local anesthetics or corticosteroids can be injected near affected nerves to reduce severe pain
• Spinal cord stimulation (SCS):
  • A device that delivers mild electrical pulses to disrupt pain signals traveling to the brain
• Infusion therapy:
  • Specialized medications delivered intravenously for widespread pain relief

These advanced treatments can dramatically improve the quality of life for those with intractable symptoms.

Surgery is rarely needed for diabetic peripheral neuropathy, but may be considered in rare cases of:

• Nerve entrapment syndromes (e.g., carpal tunnel syndrome) caused or worsened by diabetes
• Severe ulcers or infections requiring surgical debridement

Our primary focus remains on non-surgical, minimally invasive approaches whenever possible.

Horizon Spine & Pain of Utah is uniquely equipped to help patients with diabetic peripheral neuropathy by offering:

• Board-certified specialists in pain management and neurology
• Comprehensive diagnostic evaluations using the latest technology
• Personalized, multidisciplinary care plans tailored to your needs
• State-of-the-art non-surgical treatments

We are committed to treating not just the pain but the underlying cause, empowering you to live a more active and fulfilling life.