There are many types of nerve damage. Our nervous systems are so complex, it’s often hard to decide exactly what type of neuropathy is present. Complicating this is the fact that high blood glucose levels can damage nerves in two ways: directly and by slowing down or stopping their flow of blood.

Sometimes it’s hard to know whether a problem is caused by nerve damage or by circulation problems.

Distal Symmetric Polyneuropathy. This type of neuropathy, also called peripheral neuropathy, can strike the nerves in many parts of your body. Sensation can be either decreased or increased with neuropathy. The treatment is determined by the symptoms.

If sensation is decreased, your feet can feel numb, or you can lose the ability to determine temperature or the position of your feet.

If you have lost sensation, you need to pay special attention to care for your feet and protect them from injury. You can step on something and not feel it or burn your feet with your bath water.
If you don’t realize it and treat it, you can get an infection.

Dealing with the pain of neuropathy can be difficult. Many people find that their pain gets better when their glucose levels are lower. Some even notice that their pain will be worse when their blood glucose levels go up temporarily. Walking may also help to decrease calf pain.
Several types of medications can be used for pain.

Nonsteroidal anti-inflammatory drugs (NSAIDs) are generally the first medications that are tried. Others include low doses of antidepressants, antiseizure medications, and drugs designed specifically for neuropathy pain. Medicines that contain narcotics are generally not used unless the pain is very severe.

Lidocaine patches can be used to numb the area, and a high-potency cream (capsaicin) can be rubbed on the area.

If these therapies aren’t effective, ask for a referral to a pain clinic. There are also less conventional methods to treat the pain. Biofeedback training, hypnosis, relaxation exercises, acupressure, acupuncture, and use of a TENS (transcutaneous electrical nerve stimulation) unit have all been effective for some people.