Skip to content
WebMD: Better Information. Better Health.
Other search tools:Symptoms|Doctors|Videos
This content is selected and controlled by WebMD's editorial staff and is funded by Lilly USA.

Diabetes and Nerve Pain: Rate Your Pain

Reviewed by Brunilda Nazario, MD, November 2009.

When it comes to diabetic nerve pain, your awareness of symptoms can help find just the right treatment for you.

About 60% to 70% of people with diabetes have some form of nerve pain and damage, called diabetic neuropathy, says the American Diabetes Association. When nerve damage shows up in the feet or hands, it's called peripheral neuropathy. Some of its symptoms are obvious, like pain, tingling, or a pins-and-needles feeling in the feet. But numbness and muscle weakness are also signs of nerve damage from diabetes.

Print out this nerve pain symptom checklist, fill it out, and take it with you each time you visit your doctor or other health care professional. Be sure you take a copy to any specialists you see, such as a podiatrist (foot doctor), ophthalmologist (eye doctor), or cardiologist (heart doctor). That way, everyone on your diabetes care team will be familiar with your pattern of symptoms and can advise you on the best diet, exercise, and medications to treat your nerve pain.

1. What kind of pain or numbness do you feel?
Check off the way your pain feels, and rate your symptoms from 1 (mild) to 10 (severe).

Has this changed since your last doctor's visit?
If so, how?

2. Where is your nerve pain or numbness?
Check off the way your pain feels, and rate your symptoms from 1 (mild) to 10 (severe).

Has this changed since your last doctor's visit?
If so, how?

3. When is your pain or numbness the worst?
Check off the way your pain feels, and rate your symptoms from 1 (mild) to 10 (severe).

Has this changed since your last doctor's visit?
If so, how?

4. Do your symptoms keep you from any normal, daily activities?
Check off the way your pain feels, and rate your symptoms from 1 (mild) to 10 (severe).

Has this changed since your last doctor's visit?
If so, how?

5. What seems to relieve your symptoms?

Activity that helps:
Self-care that helps:
Medications that help:
Other treatment that helps:

What causes diabetic nerve pain?

If you're wondering what causes nerve pain in the first place, it's probably a combination of factors, according to the National Diabetes Clearing House.

  • Nerves exposed to high glucose levels for long periods of time
  • High blood fats like high cholesterol, which damage the blood vessels that nourish nerves
  • Inflammation in the nerves caused by an autoimmune response (when your body reacts to a natural internal substance as if it's foreign and tries to "fight it off")
  • Genetic factors that make some people more prone to nerve damage
  • Smoking and alcohol (although precisely how these cause nerve damage is still unknown).

So while you're talking with you doctor about your nerve pain, you may want to explore which of these factors may be behind your symptoms and look for solutions together. There's no final "score" that's good or bad, too high or too low. Pain is a highly personal, subjective experience. Rating your pain isn't intended to diagnose your condition but to encourage an ongoing awareness of your symptoms and an open dialogue with your doctor. And since your symptoms are likely to change over time, tracking your pain between visits with your doctor can help you feel more empowered in your health care and more in touch with your own well-being.

Print This Page

SOURCES: National Diabetes Information Clearinghouse: "Diabetic Neuropathies: The Nerve Damage of Diabetes," "Prevent Diabetes Problems: Keep Your Nervous System Healthy," and "Prevent Diabetes Problems: Keep Your Diabetes Under Control." American Diabetes Association: "All About Diabetes," "Diabetic Neuropathy (Nerve Damage) and Diabetes," and "Could You Have Diabetic Neuropathy and Not Know It?" WebMD Medical Reference: "Peripheral Neuropathy & Diabetes: Risk Factors & Symptoms."

    Diabetes Nerve Pain: Understand It. Treat It.
    Cymbalta
    Sponsored
    Cymbalta is approved for the management of diabetic peripheral nerve pain.

    Important Safety Information About Cymbalta

    Antidepressants can increase suicidal thoughts and behaviors in children, teens, and young adults. Suicide is aknown risk of depression and some other psychiatric disorders. Call your doctor right away if you have new or worsening depression symptoms, unusual changes in behavior, or thoughts of suicide. Be especially observant within the first few months of treatment or after a change in dose. Approved only for adults 18 and over.

    What should I talk about with my healthcare provider?

    Patients on antidepressants and their families or caregivers should watch for new or worsening depression symptoms, unusual changes in behavior, thoughts of suicide, anxiety, agitation, panic attacks, difficulty sleeping, irritability, hostility, aggressiveness, impulsivity, restlessness, or extreme hyperactivity. Call your healthcare provider right away if you have thoughts of suicide or if any of these symptoms are severe or occur suddenly. Be especially observant within the first few months of antidepressant treatment or whenever there is a change in dose.

    Who should NOT take Cymbalta?

    You should not take Cymbalta if:

    • You have recently taken a type of antidepressant called a monoamine oxidase inhibitor (MAOI)
    • You have uncontrolled narrow-angle glaucoma (increased eye pressure)
    • You are taking Mellaril® (thioridazine)

    What other important information should I discuss with my healthcare provider?

    Before starting Cymbalta, talk with your healthcare provider:

    • about all of your medical conditions, including kidney or liver problems, glaucoma, diabetes, seizures, or if you have bipolar disorder. Cymbalta may worsen a type of glaucoma or the control of blood sugar in some patients with diabetes
    • about your alcohol use
    • if you are taking nonprescription or prescription medicines, including those for migraine, to address a possible life-threatening condition
    • if you are taking NSAID pain relievers, aspirin, or blood thinners. Use with Cymbalta may increase bleeding risk
    • if you are pregnant, plan to become pregnant during therapy, or are breastfeeding an infant

    While taking Cymbalta, talk with your healthcare provider:

    • if you have itching, right upper belly pain, dark urine, yellow skin/eyes, or unexplained flu-like symptoms, which may be signs of liver problems. Severe liver problems, sometimes fatal, have been reported
    • if you have high fever, confusion, and stiff muscles to address a possible life-threatening condition
    • before stopping Cymbalta or changing your dose
    • if you experience dizziness or fainting upon standing, especially when first starting Cymbalta or when increasing the dose.
    • about your blood pressure. Cymbalta can increase your blood pressure. Your healthcare provider should check your blood pressure prior to and while taking Cymbalta
    • if you experience headache, weakness, confusion, problems concentrating, memory problems, or feel unsteady while taking Cymbalta which may be signs of low sodium levels
    • if you develop problems with urine flow

    If you have any questions, talk to your healthcare provider before taking Cymbalta.

    What are the possible side effects of Cymbalta?

    In clinical studies of depression, the most common side effect of Cymbalta was nausea. Other common side effects included dry mouth, constipation, decreased appetite, fatigue, sleepiness, and increased sweating. This is not a complete list of side effects.

    Other safety information about Cymbalta:

    Cymbalta may cause sleepiness and dizziness. Until you know how Cymbalta affects you, you should not drive a car or operate hazardous machinery.

    See Prescribing Information for additional Important Safety Information, including Boxed Warning.

    Safety Information and Boxed Warning | Prescribing Information | Medication Guide