The symptoms are continuous burning pain in areas of the face, tongue, mouth, hands and feet. The pain is due to inflamed nerves (neuritis) which occur frequently in diabetes especially when it is poorly controlled.

Good control of diabetes by eating the right diet, frequent monitoring of your blood sugar and taking your medications as scheduled. Chromium picolinate is a natural co-factor for insulin that is available as a herbal supplement. It makes insulin more effective in metabolizing sugar into energy and thus enables better control of your blood sugar.

Take pain relievers, such as Tylenol. A new ointment called Zostrix (Capsaicin) may also help painful areas by decreasing the amount of substance P that sends pain signals to the brain. Zostrix is the burning ingredient in red-hot chili peppers. The ointment itself may give you a funny burning sensation that lasts the initial couple of days. Wear rubber gloves when you apply it and keep it out of your eyes. Specially compounded ointments containing the medication combination gabapentin/DMSO/clonidine/ketoprofen may help relieve the burning pain. Local treatment with DMSO ointment promotes healing in diabetic ulcers. DMSO is a free radical scavenger. Oxygen derived free radicals or neuropeptides are responsible for the breakdown of our bodies, including the joints, skin and organs. Aging, joint, muscle and tissue inflammation, plus poor functioning of the circulatory system, nervous system and immune system often result from free radical damage. A herbal pill that is a free radical scavenger is pycnogenol, which is an extract of the pine bark.

The active ingredients are also found in grape seed extract. Pycnogenol is 50 times more potent as a free radical remover (scavenger) than Vitamin E and 20 times more powerful than Vitamin C. Your doctor may need to examine you and make sure your diabetes is under control. Your doctor may prescribe the blood thinner medication Trental (pentoxifylline). Trental used alone is effective in most diabetics in relieving the burning and numbing pain. Doctors sometimes prescribe strong anti-inflammatory drugs such as Tolectin or strong painkillers such as Vicodin ES or Norco 10/325, which may be given for short periods. The strong painkillers should be used carefully so that they do not produce drug dependency. Antidepressants like Paxil, Elavil, St. John's Wort help ease the burning pain. They work by blocking pain messages traveling through the spinal cord and may act directly on injured nerves, stopping painful spasms or decreasing their sensitivity. These pain-relieving actions are separate from their mood-lifting effects. Anesthetic ointments such as Lidocaine or an anti-itch cream called Zonalon (Doxepin) may be used to numb the area of pain. Anticonvulsant medication e.g. Tegretol, Dilantin or Neurontin may be added to help prevent and treat the pain. Take the medications regularly. Some of these medications may decrease the production of blood cells so your physician may have to check your blood every few weeks. Occasionally some of these medications may produce a skin rash. Acupuncture, hypnosis, electrical nerve stimulation and psychotherapy are helpful in some people.

Call your Doctor if your pain is severe or you have difficulty controlling your diabetes.

Note: All medications mentioned on this site--including, specialty compounded ointments such as Capsaicin, Gabapentin, Ketamine, Vitamin E--may be ordered directly from L.A. Pain Clinic.