Foot Pain at Night

Q:
I have neuropathy in my feet. It can be extremely painful at night, and it keeps me awake most nights. Is there any way to reduce the pain, and will this ever subside?

— Debbie, Wichita, KS
A:
Neuropathy is a painful and distressing complication of diabetes. In some people, it disappears on its own over a period of about 12 months. In others, however, it persists. There are medicines your doctor can prescribe to relieve your symptoms.

The U.S. Food and Drug Administration has approved two drugs, duloxetine and pregabalin, to treat the foot pain from diabetic neuropathy. Duloxetin is an antidepressant, and pregabalin is used to treat seizure disorders. Both have some side effects. Duloxetin can cause nausea, sleepiness, dizziness, decreased appetite, hot flashes, and constipation. Pregabalin can cause sleepiness and confusion and can also lead to dependence.

You might consider other kinds of treatment too, both traditional and not. In one Australian study, the antioxidant alpha-lipoic acid was shown to reduce pain. And other medications — including some antiseizure medications, antidepressants, and opiates — have been used with some success. Some people have used acupuncture, topical creams containing capsaicin (a substance found naturally in hot peppers), and other alternative therapies. Of course, many of these treatments have not been well studied enough to determine their effectiveness.

I would advise you to consult with your doctor to decide which treatment works best for you. It's important to remember, of course, that none of these medicines cure the underlying cause of neuropathy. That's why it's important to focus on tight glucose management. The basic problem that leads to neuropathy is nerve and blood vessel damage caused by high blood glucose levels.

Learn more in the Everyday Health Type 2 Diabetes Center.