pain with neuropathy

Nurses General Nursing

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In diabetic neuropathy a patient's sensory and motor nerves are effected.

I don't think I am familiar with a patient having pain with this condition. If they do have it seems to me it is not much pain.

Is it likely for such a patient to have pain associated with diabetic neuropathy? AND is it treated with M.S.? Would a physician likely perscribe MS Contin 30mg. TID? I understand that M.S. tolerance has developed in such a case but is this realistic to allow tollerance to go this far? This pt is 55 years old.

Thank you for considering these questions.

Yes diabetic neuropathy causes pain. Sometimes severe pain. Neurontin can be helpful. But if not narcotics are indicated.

Research shows that tolerance to narcotics may begin to develop as early as 2 weeks after regular dosing. The sustained release narcotics allow for better pain relief and better functioning during the day.

MS Contin 30 mg twice daily isn't an extraordinary dose. The patient will invariably be titrated even higher before it is all said and done. I would suggest a pain clinic if one is available in your area. These practitioners are most helpful to manage chronic pain, such as pain associated with diabetic neuropathy.

There seems to be confusion surrounding the ideas of physical dependence (which someone chronically taking narcotics will develop), tolerance (which will also develop with chronic narcotic use), and addiction (which is a physical and psychological phenomenon). This confusion often results in people taking narcs for chronic pain being labeled as addicts. Oops, got up on my soapbox for a minute.

I have to add....

How realistic is it to allow tolerance to go this far? Quite realistic.

Thak you, your reply is very helpful.

Thak you, your reply is very helpful.

There is another treatment that is said to be very effective with the pain associated with this condition. There is a paste that is made from hot peppers that is then applied to the affected area. Evidently it does causes a burning sensation at first, but then later actually numbs the area. The effects can last for weeks at a time.

Tonight I admitted a gentleman with painful diabetic neuropathy. He takes a lot of neurontin but states he still suffers. Apparently he has a friend who swears by plexi-pulses (intermittent pressure machine for increased venous return). My patient asked his doc if he could have an order for plexi-pulses to try them out because if they give him relief he said he was going to shell out the $3,000 for a machine. Has anyone ever heard of anyone getting pain relief for neuropathy in this way? Just wondering. Darn, I am not scheduled to work till Saturday and I betcha this gentleman will be long gone and I won't get a chance to ask how it went!

There is another treatment that is said to be very effective with the pain associated with this condition. There is a paste that is made from hot peppers that is then applied to the affected area. Evidently it does causes a burning sensation at first, but then later actually numbs the area. The effects can last for weeks at a time.

Hi Guys,

I am a newbie to this site but I am a woman in my 40's and I have this condition and it is so very painful I can't sleep a full 8 hours or even a 6 hour sleep is impossible, much less function outside of the home in the sunlight, it just gets worse. I have 7 grand babies almost 8 this coming December and I am interested in the paste you are talking about. I have type 2 diabetes and Fribromyalgia as well and the peripheral neurolopathy in my feet and legs. They burn get really red in color and consume me with so much pain I can't even wear regular enclosed shoes even in winter! Does this paste really work and where can I get it?

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