Diabetic Leg Pain
Diabetes is a condition which occurs when the pancreas is unable to make enough insulin, or the body’s cells are unable to use insulin effectively. This leads to increased blood sugar levels, which can cause many different complications over time. One of the most common complications of diabetes is leg and foot pain.
What Is Diabetic Leg Pain?
Diabetic leg pain is usually due to a condition known as peripheral neuropathy. The word ‘peripheral’ means affecting the arms or legs, and the word ‘neuropathy’ means nerve damage.
The nerves are responsible for relaying messages from the surface of the skin to the brain, and back to the muscles allowing them to move. When the nerves are damaged, these messages are interrupted, resulting in altered sensation, loss of mobility, and pain.
There are many different types of neuropathy. In diabetic leg pain, the most common types are sensory neuropathy, which affects the nerves responsible for sensation, and motor neuropathy, which affects the nerves responsible for movement. It is not uncommon for people with diabetes to have neuropathy which affects both the sensory and motor nerves.
Causes of Diabetic Leg Pain
Peripheral neuropathy happens when the nerves are damaged, changing the way that they communicate with the brain.
In diabetes, this is thought to happen as a result of high blood sugar and increased levels of fats called triglycerides. Over time, the nerves themselves become damaged, leading to symptoms such as leg and foot pain.
The risk of peripheral neuropathy is higher in people who have had diabetes for a long time, usually those over the age of 40. It is also more likely to affect people who smoke or drink large amounts of alcohol.
Symptoms of Diabetic Leg Pain
The symptoms of peripheral neuropathy can range from mild to severe and can vary depending on whether the sensory or motor nerves are being affected.
Some of the most common symptoms of diabetic leg pain may include:
- Sharp pains or cramps in the legs or feet
- Increased sensitivity, even to very light pressure
- Burning, tingling, or ‘pins and needles’ in the legs and feet
- Numbness in the legs or feet
- Reduced sensitivity to temperature changes
- Muscle weakness
- Loss of balance or coordination
- Difficulty lifting the foot
Although peripheral neuropathy can cause pain, it can also have the opposite effect, causing a loss of sensation, especially in the feet. This symptom is potentially very serious, as you may not notice if your feet have been injured in some way. With peripheral neuropathy, even a tiny blister can easily turn into an ulcer which is difficult to heal and may become infected. In extreme cases, this can develop into gangrene, which causes the surrounding tissue to die. If left untreated, this can lead to the loss of a toe, foot, or leg.
Another problem which may occur as a result of peripheral neuropathy is a condition known as Charcot's joint. This occurs when one of the bones in the feet gets broken, but is not noticed due to reduced sensation or numbness. In this situation, the bone may heal abnormally, leading to deformities and pain.
Type 1 diabetes, once known as juvenile diabetes, is primarily diagnosed in children and young adults and affects just a small fraction of the population
Treatment for Diabetic Leg Pain
If you have diabetes, you can reduce your chances of developing peripheral neuropathy by maintaining a healthy lifestyle and keeping your blood sugar, blood pressure, and cholesterol within your target range. Stick to the nutritional guidelines provided by your dietician, take any medication as prescribed, do not smoke, and keep alcohol consumption to a minimum.
If you are already suffering from diabetic leg pain, there are also many options for managing your symptoms.
If you have mild to moderate pain, you may be able to control it using over-the-counter medications such as acetaminophen and ibuprofen.
If your pain is more severe, your physician can prescribe stronger painkillers such as tramadol. However, you should avoid taking these for long periods due to the risk of side effects and dependence.
Other medications which can be used to treat peripheral neuropathy include antidepressants such as amitriptyline and duloxetine, and anti-seizure medications such as pregabalin.
If you are suffering from any type of pain, it is a good idea to attend regular physical therapy sessions to maintain muscle tone and keep your joints mobile. Exercises such as walking and using a stationary bike can also help to improve your circulation and reduce pain.
Some people find therapies such as massage and acupuncture useful as a way to relax and manage pain. If you suffer from leg pain at night, you can use a bed cradle which is specially designed to keep your bedding away from your legs and reduce discomfort.
There are several supplements which may be useful in treating diabetic neuropathy, although the evidence for these is limited. Some of the most commonly used supplements for diabetic leg pain include alpha-lipoic acid (ALA), vitamin B12, and vitamin D.
Talk to your physician before starting any of these supplements to ensure that they are suitable for you.
The Bottom Line...
Last but not least, if you have diabetes, it is essential that you pay close attention to your foot health. Prevent ulcers and infections from developing by checking your feet daily, and reporting any changes to your physician.
You should always keep your feet and socks clean and dry, trim your nails carefully, and wear comfortable, cushioned shoes. It is also advisable to visit a podiatrist at least once a year to have your feet checked over professionally.