Diabetic Peripherial Neuropathy
Diabetic peripheral neuropathy is a painful nerve condition that typically affects the hands and feet. Most often, it will affect the farthest areas of the extremities first than gradually work its way proximally towards the body. This causes pain in a "stocking and glove" distribution.
Treatment first and foremost is strict control of blood glucose through diet, exercise, and medication management if indicated. You should speak routinely with your primary care provider who will likely follow progress through blood work checking a Hemoglobin A1c. Additionally, it is suggested that you also seek consultation with a podiatrist on a routine basis for foot exams to ensure there are no sores or wounds which could worsen over time if not treated early.
Unfortunately, despite these efforts pain can sometimes persists. Options for pain relief at this point commonly falls to topical medications and oral medications to decrease the intensity of the burning or painful sensations. We are happy to review any medications you may be presently taking and discuss titration or alternative options.
Recently, the FDA has approved Spinal Cord Stimulation for the management of painful diabetic neuropathy. Such intervention offers the potential pain relief without having to take daily medications. See below to find out more.
Complex Regional Pain syndrome
Complex regional pain syndrome (CRPS) is a painful condition that often arises following trauma to the extremity or an orthopedic surgery. It was previously referred to as Reflex Sympathetic Dystrophy or Causalgia. Now it is subdivided into the following:
- CRPS Type 1- Does not follow a direct nerve injury
- CRPS Type 2- Follows a distinct nerve injury
Regardless of Type 1 or 2, the symptoms are characterized by intense burning pain particularly in the setting of light touch or temperature changes. It can be affiliated with swelling, skin and hair growth changes, as well as alterations in motor function. The diagnosis is predicated on the fulfillment of the Budapest Criteria.
Treatment for both consists of physical and occupational therapy with a particular focus on rehab and desensitization therapy. Additionally, neuropathic pain medications can assist in decreasing pain symptoms. In severe pathology, the utilization of sympathetic blocks or Spinal Cord Stimulation can offer notable pain relief.
