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Coping With Painful Neuropathy

by Wendy J. Meyeroff

Whether in a support group or any other situation, Cushing advises learning to recognize and avoid what she calls “toxic people.” She says, “If some people in your family upset you, don’t pretend otherwise. If you have to see them over the holidays, find a way to limit your time with them, and be prepared for a flare-up.”

Making adjustments
Can you imagine learning to enjoy living with chronic pain? Sounds impossible, doesn’t it? Yet for 14 years, Paul Arnstein has worked in a program to teach people to do just that.

“We teach people to distinguish between sensations that are really indicative of harm versus those that are just annoying,” says Arnstein. “Otherwise, you always receive the same signal: ‘This is bad and I should stop.’ Yet being less active may actually do you more harm,” he says. You gain weight, so obesity-related pain is only likely to increase. You find it harder to enjoy various activities, and that leads to sadness, despair, and isolation.

Another key is pacing. “Maybe you can no longer handle a 200-square-foot garden, so make the plot smaller — or handle a window box. Mix and match your activities. Maybe you can still kneel to weed, but only for 15 minutes. During the next 15 minutes, stand up to hand water the lawn,” says Arnstein.

“Try something new,” says Ouellette. “If five minutes of walking doesn’t give you the high that hiking used to, find a different activity.” Maybe your next adrenaline rush and/or sense of satisfaction will come from swimming or even something less aerobic, like yoga or tai chi.

Avoid overexertion. “There are washers and dryers that are elevated so they require a lot less of the bending and lifting that worsens some people’s pain,” says Arnstein. Try hanging your pots and pans on a rack, so you don’t have to lift six other items before you get the one you want. “The key is adapting,” says Ouellette.

Don’t forget the basics
When diabetes is the cause of peripheral neuropathy, one of the most important steps you can take is to keep your blood glucose level in the near-normal range as much as possible and to learn to prevent wide fluctuations in blood glucose level. “In diabetes, several things are going on: metabolic changes, where cells don’t metabolize properly; vascular impairment (not enough blood flow); poor infection fighting; poor healing; and nerve and blood vessel inflammation, causing continuous nerve damage,” says Latov. “Most drugs generally affect only one of these mechanisms at a time, so medication often isn’t enough.”

Making healthy food choices and staying physically active are, of course, key factors in staying healthy with diabetes, but other lifestyle measures and alternative therapies may help, too. “I had one patient who learned deep breathing and eventually — just by learning to take a few deep breaths when she was feeling stressed — cut her insulin in half,” Ouellette says.

If you smoke, stop. Smoking constricts the blood vessels that supply nutrients to the peripheral nerves and can worsen neuropathy symptoms. Sometimes an external support — such as an orthopedic insert or a specially designed shoe to even out an improper gait or a hand or foot brace to relieve nerve compression — can help lessen neuropathic pain.

As you can see, there are many options. “If you don’t feel your practitioner is committed to helping you find a pain relief option, don’t be afraid to get a second opinion,” Dr. Smith concludes.

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