Gabapentin is used for Neuropathic pain (other than postherpetic neuralgia)

In a meta-analysis of trials evaluating the treatment of neuropathic pain, including painful polyneuropathy and spinal cord injury pain, gabapentin was shown to be safe and effective . Data from meta-analyses support the use of immediate-release gabapentin for reducing pain by more than 50% in diabetic neuropathy.

Diabetic Peripheral Neuropathy
Diabetic Peripheral Neuropathy

Data from a limited number of clinical trials support the use of extended-release gabapentin in reducing pain by more than 50% and improving sleep in diabetic neuropathy.

Based on guidelines from the International Association for the Study of Pain (IASP), European Federation of Neurological Societies (EFNS), and Society of Critical Care Medicine (SCCM), gabapentin is effective and recommended for the management of peripheral neuropathy .

Based on guidelines from the EFNS, IASP, and National Institute for Health and Care Excellence (NICE), gabapentin is effective and recommended as first-line therapy, supported by strong evidence, in the management of diabetic neuropathy.

The IASP guidelines recommend both immediate- and extended-release gabapentin . In contrast, a guideline from the American Academy of Neurology (AAN), American Association of Neuromuscular and Electrodiagnostic Medicine, and American Academy of Physical Medicine and Rehabilitation states that gabapentin is probably effective and should be considered an alternative treatment for painful diabetic neuropathy based on limited benefit in 2 controlled trials.

Similarly, a position statement from the American Diabetes Association (ADA) recommends gabapentin as a second-line option .

Gabapentin can be used to treat more than 30 diseases

Gabapentin is used with other medications to prevent and control seizures. It is also used to relieve nerve pain following shingles (a painful rash due to herpes zosterinfection) in adults. Gabapentin is known as an anticonvulsant or antiepileptic drug.

OTHER USES: This section contains uses of this drug that are not listed in the approved professional labeling for the drug but that may be prescribed by yourhealth care professional. Use this drug for a condition that is listed in this section only if it has been so prescribed by your health care professional.

Gabapentin may also be used to treat other nerve pain conditions (such as diabetic neuropathy, peripheral neuropathy, trigeminal neuralgia) and restless legs syndrome.

Gabapentin can also be used to treat following health conditions:

  • Alcohol Withdrawal
  • Anxiety
  • Benign Essential Tremor
  • Bipolar Disorder
  • Burning Mouth Syndrome
  • Cluster-Tic Syndrome
  • Cough
  • Diabetic Peripheral Neuropathy
  • Epilepsy
  • Erythromelalgia
  • Fibromyalgia
  • Hiccups
  • Hot Flashes
  • Hyperhidrosis
  • Insomnia
  • Lhermitte’s Sign
  • Migraine
  • Nausea/Vomiting, Chemotherapy Induced
  • Neuropathic Pain
  • Occipital Neuralgia
  • Pain
  • Periodic Limb Movement Disorder
  • Peripheral Neuropathy
  • Postherpetic Neuralgia
  • Postmenopausal Symptoms
  • Pruritus
  • Pudendal Neuralgia
  • Reflex Sympathetic Dystrophy Syndrome
  • Restless Legs Syndrome
  • Small Fiber Neuropathy
  • Spondylolisthesis
  • Syringomyelia
  • Transverse Myelitis
  • Trigeminal Neuralgia
  • Vulvodynia

Neuropathic pain in diabetic people

Neuropathic pain in diabetic people or diabetic neuropathies is series of nerve disorders caused due to diabetes. People suffering from diabetes after period of time develop damages in nerve all through their body. Some people face no symptoms even with nerve damage whereas others experience problems such as numbness, pain or tingling of legs, feet, arms, hands. Every organ in system like heart, sex organs, and digestive tract can get nerve problems.

Causes of diabetic neuropathies

  1.  The causes vary but the common cause is nerve damage that occurs due to exposure to high levels of blood glucose.
  2. Metabolic factors like prolonged diabetes, abnormal levels of blood fat, low insulin levels, high levels of blood glucose
  3. Neurovascular factors like blood vessel damage and blood vessels carry nutrients and oxygen to our nerves
  4. Autoimmune factors lead to inflammation in our nerves
  5. Mechanical injury to our nerves like carpal tunnel syndrome
  6. Lifestyle factors like alcohol use and smoking
  7. Inherited traits which increase the chances of nerve damage

Symptoms – Diabetic neuropathies

Symptoms solely depend on the nerves that are affected and type of neuropathy and other symptoms are

  • Indigestion, vomiting and nausea
  • Urinating problems
  • Faintness or dizziness due to low blood pressure after sitting or standing up
  • Wasting hand, feet muscles
  • Numbness, pain or tingling in finger, arms, legs feet and toes
  • Constipation or diarrhea

Diabetic neuropathy is basically nerve disorders cause due to the abnormalities that are linked to diabetes like high level of blood glucose. Treatments involve correcting the levels of blood glucose to normal range. Regulating the blood glucose levels can help prevent or starting of future problems. Foot care is considered as essential part of neuropathic pain treatment. People suffering from neuropathic pain having diabetes should take very good care of their feet on a daily basis and check for injuries. If the injuries are left untreated it can lead to infection and foot sores.

Treatment for neuropathic pain in diabetic patients also includes medications for pain relief and other medications depending on the severity of nerve damage. Smoking too increases problems of foot or amputation.

Exercise can also help a lot in showing improvements in neuropathic pain especially in diabetic people.  People having diabetes should consult their doctor before they start with any exercise and once decided; making exercise part of daily routine can be helpful.

Look for exercises with low impact as such exercises are easily tolerated by most diabetic people. Exercises like aerobics, swimming, yoga, are ideal options. These exercises can help improve relaxation skills.

Try to avoid exercises of high impact as such exercises can have adverse impact on neuropathic pain. Exercise can really help in nerve pain and doing it consistently is helpful. Start slowly and then increase the time to half an hour, at least five times in a week. The key is to start slowly and increase the time gradually and be consistent.

In case of neuropathic pain, diabetic people should focus on keeping their sugar levels in control and follow the diet recommended by their doctor.

Herbal Supplements can give you relief from Neuropathic pain

Neuropathic pain is really difficult to manage. In some cases where the pain occurs due to herniated disc can be easily resolved and also the pain can go off. But, in patients having chronic medical conditions like diabetes, prolonged pain due to an injury, even conventional type of pain management techniques aren’t successful.

Dysfunction of nerve cause neuropathic pain and nerves can get damaged due to a disease or an injury and sometimes the reason for the dysfunction remains unknown. People who suffer with neuropathic pain often experience severe, sharp pain that passes through the pathway of affected nerve. The pain can be followed by numbness, weakness, tingling or burning.

Conventional methods used for pain management focus on pharmaceuticals use and medications available for pain management do not work well for relieving neuropathic pain and also include risk like overdose, addiction and organ damage.

Herbal remedies that work well for neuropathic pain like Corydalis is a plant that yields flowers and is used since ages to treat depression, high blood pressure, menstrual cramps, abdominal pain, spastic intestines and other health problems.  The tuber part and roots of the plant are used. Corydalis can be used for people suffering from neuropathic pain and recent research has shown that a compound known as DHCB is quite effective in getting some relief in case of neuropathic pain.

To avoid side effects more and more people are opting for herbal supplements or remedies to treat naturopathic pain. Some herbs that are effective for relieving naturopathic pain are

Cayenne

It is also called as red pepper and is a spice which is used due to its medicinal properties. Capsaicin is a chemical constituent that gives hotness to the pepper. Capsaicin is basically a pain reliever which is being used since decades to promote circulation, improve digestive problems and encourage appetite. As per the research the medicinal use of cayenne is implemented for reduction of pain related to surgery, arthritis, peripheral neuropathy and nerve neuropathy. Capsaicin is also added to oils, creams and gels for applying on affected areas to get relief from pain.

Magnesium

Magnesium is very important mineral that the body uses for formation of fatty acid, protein, clotting blood, creation of new cells, supporting nerve and muscle function and generating energy in our body. The foods containing magnesium are sea food, dark green vegetables, whole grains, legumes, nuts and they are easily available in food stores.

Chiropractic massage

 People suffering from different types of neuropathic pain get benefited from chiropractic massage taken regularly. Massage loosens the tight muscles and aids circulation and nerve connection and also relaxes your body. You can approach a chiropractic professional and start with regular massage sessions to get relieve from neuropathic pain.

There are many herbal remedies and supplements available for treating neuropathic pain, but you need to find out the right one that suits you. As every person and health differs so the treatment one person is taking might not be suitable for the other.

Causes and Treatment for Neuropathic pain

Neuropathic pain is a type of pain that occurs due to problems that happen with signals that takes place through nerves. The causes are many. The common neuropathic pain occurs due to pressure, burn and injury etc., traditional painkillers like codeine, paracetamol, anti-inflammatories aren’t of much help. Neuropathic pain gets relieved with the help of anti-epileptic medicines and antidepressants.

Neuropathic pain is caused when a problem occurs with one or more than one nerves. The nerve function gets affected in such a way that it starts sending pain messages to your brain. In other words it is also described as aching, stabbing, shooting and similar to electric shock.

There are different conditions that affect the functioning of nerves. This includes the following

  • Cancer
  • Pain that occurs after chemotherapy
  • Facial pain
  • Uncommon disorders in nerves
  • Pain in phantom limb
  • Diabetic neuropathy
  • Pain followed by shingles
  • Alcoholism

Treatment for Neuropathic pain

  1. If possible treating the main underlying cause
  2. Physical treatments
  3. Psychological treatments
  4. Medicines

Treating the underlying cause helps ease down the pain. For example if you are suffering from diabetic neuropathy, then keeping a check on your diabetes to keep in control helps reduce the neuropathic pain. If you are suffering from cancer and if it can be treated, it also reduces pain.

Medicines for neuropathic pain treatment

Common and traditional painkillers

In most cases common painkillers like paracetamol, ibuprofen isn’t much effective in reducing down the pain.

Tricyclic antidepressant

In tricyclic group the antidepressants are used to treat neuropathic pain. It is not actually used to treat depression. These antidepressants actually work on treating neuropathic pain apart from treating depression.

Duloxetine

This antidepressant according to the research has shown good results in reducing neuropathic pain. Duloxetine is proved to be a good treatment for diabetic neuropathy whereas it hasn’t worked well for other types of neuropathic pain.

Opiate painkillers

These painkillers are stronger for example morphine, codeine and other related drugs. These drugs cannot be used for a long-term as it has some side-effects associated with it.

Physical Treatments

Depending on the cause and site of neuropathic pain, a specialist may advise some physical treatments to reduce pain. This may include acupuncture, physiotherapy, PENS etc.

Physiological treatments

Pain can get worse due to stress, depression or anxiety. The feeling of having pain and it becomes impossible for the individual to decide how to react to pain and face circumstances. In such cases pain management programs, therapy related to cognitive behavioral, counseling and stress management plays an important role in reducing neuropathic pain and helping people deal with pain easily.

Neuropathic pain directly affects an individual’s life as he/she needs proper guidance and medical help to recover from pain. If the pain is chronic, it might take a longer period of time but again with right counseling and pain management programs the ability to deal with pain becomes easily and patient can deal with pain positively without getting into depression.