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Medications to Treat Diabetic Nerve Pain

You can soothe the pain of diabetic neuropathy when controlling blood sugar isn't enough.

By Rebecca Buffum Taylor
WebMD Feature

Reviewed by Brunilda Nazario, MD

Diabetes is a lifelong companion. Sometimes a complication like diabetic nerve pain takes time to resolve, and you may want to try different treatments and medications before finding one that works for you.

First, make sure you're doing the best job you can of controlling your blood sugar, exercising regularly, and keeping your weight normal. If you still have pain, numbness, or discomfort in your feet or hands (called peripheral neuropathy), you may need to turn to medications to soothe your nerve pain and help you sleep. These days, you have a wealth of options to try.

"We try to find what works for each individual, because there isn't really anything that works for everybody," says Dace L. Trence, MD, an endocrinologist and director of the Diabetes Care Center at the University of Washington Medical Center in Seattle.

As with any medication, it's up to you to weigh the risks and benefits of a drug, given your own medical condition. Talk with your doctor about whether the expected benefits of symptom relief outweigh any potential risks of the drug.

A Nerve Pain Primer

When you're reading labels in a drugstore or talking with your doctor, it helps to know the lay of the land. Here are some common terms:

Analgesic: a pain reliever.
Anti-inflammatory: reduces inflammation, the body's natural response to injury, from sunburn to the nerve damage of diabetes.
Nonsteroidal anti-inflammatory drug (NSAID): reduces both pain and inflammation, since inflammation can increase pain, and a drug that soothes inflammation can also help relieve pain.

Diabetes Nerve Pain: Over-the-Counter Pain Relievers

For mild pain, you may find relief with medications you can buy in a drugstore without a prescription, often called "over-the-counter" drugs.

NSAIDs. Aspirin, Advil, or Motrin (ibuprofen), as well as Aleve (naproxen), are all common, over-the-counter NSAIDs that relieve pain and inflammation from diabetic nerve damage. But because people with diabetes already have a higher risk of kidney damage, the increased risk of kidney and liver damage from long-term use of NSAIDs is a critical concern. NSAIDs can also cause stomach irritation and bleeding, high blood pressure, and fluid retention if you take them regularly for weeks or months.
Tylenol (acetaminophen) aims to soothe pain but doesn't address inflammation. The plus? It doesn't cause the same stomach irritation that NSAIDs do. The minus? It may not be as effective in treating nerve pain. "We still recommend it," says Trence, "but most people find that Tylenol is probably not very helpful for people with painful neuropathy." One risk to consider is liver damage from long-term use.