Guidelines for treating diabetic nerve pain were published this spring by two Physical Medicine groups. Unfortunately, the only remedy that had good evidence was pregabalin, which is expensive and has side effects. Many of the existing therapies, such as gabapentin, anti-depressants and narcotics, which are commonly prescribed had only limited evidence for effectiveness. Natural approaches, such as capsaicin, alpha lipoic acid, electrical nerve stimulation, Reiki and cold laser treatments, had mixed results, just like the drugs. The study only looked a pain relief and did not look at side effects and quality of life. The guideline did stress that significant relief might be obtained in specific patients with any of these therapies. I suggest using a combination of natural remedies to attempt to find the best result with the least side effects.
See the April 2011 editions of Muscle and Nerve(click here)