I am an occupational therapist. In my line of work, I see many clients with neuropathic pain stemming from diabetes. I have never experienced neuropathy myself, but I know from working with my clients that it is often an unrelenting, terrible kind of pain. The burning, the pins and needles, the stabbing sensations, the numbness — peripheral neuropathy is hard to live with and can also be hard to treat.
The causes of peripheral neuropathy (neuropathy affecting the legs, feet, arms, or hands) are not well understood, although it is clear that the condition can have a number of triggers, including physical trauma, infections, and toxins. In people with diabetes, neuropathy is usually the result of elevated blood glucose levels, which in many cases leads to permanent nerve damage. However, many people with diabetes find that improving their blood glucose control — especially if their blood glucose far exceeds recommended levels — can lead to a reduction or even elimination of neuropathy symptoms.
In part because of the unknowns surrounding the physical mechanisms of neuropathy pain, conventional drug treatments can be hit or miss when it comes to getting relief. You may have to be zonked out on pain medicine to get any substantial effect, and even then you may still feel pain. It can be hard to find the balance between pain relief and quality of life. However, we therapists have a few techniques up our sleeves for “tricking” the nervous system into perceiving less pain.
As a disclaimer, everyone responds differently to each of these techniques. You may have to try several approaches before you find one that works for you. The word “works” also carries some ambiguity, since none of these approaches is a cure-all for neuropathic pain. However, one or more of them may help you get your pain to a more manageable level, so you can go about your daily routine and spend more time living again.
The good news: None of these techniques will make your pain any worse — at least not in a lasting way — so what do you have to lose?
Most people find warmth soothing. When is the last time you didn’t feel relaxed in a warm bath or while lying in the sun? Warmth provides the body with a pleasant, comfortable sensation that might just be enough to provide some relief from neuropathic pain. The body only has so many sensory nerve receptors, so why not give some of them something nice to do for a change?
Heat can be applied in a number of ways. You can purchase a plug-in heating pad in almost any pharmacy; many pads have temperature controls to make them adjustable to your needs. Place the heating pad on the body part that needs soothing, taking care to place a layer or two of fabric (such as folded dish towel) between yourself and the heat source. Leave the heat on the affected area for a maximum of 10 minutes; remove it earlier if it becomes uncomfortable. (For more on applying treatments safely, see “Tips for Using Heat and Ice.”)
If you want to experience a spa-like treatment at home, you can purchase a paraffin wax warmer, which is also available at many pharmacies. This device is slightly messier and hotter than a heating pad, but using it can feel nice for your hands. If you use one, be sure to follow the package instructions and to check the temperature of the wax before putting your hand in it. Use a candy thermometer to ensure the wax temperature is no higher than 100°F, and continue to monitor it as you use the bath. Temperatures over 120°F can cause serious burns.
Another option — and the least expensive — is simply to use warm water. Again, make sure the temperature of the water is no higher than 100°F. Run your hands under the faucet, submerge your hands or feet in a basin of warm water for several minutes, or soak towels in warm water and wrap them around the affected area. Add some scented oil or shower gel to the water for an even more pleasant sensory experience.