6 Tips for Tackling Tingling Neuropathy 

Diabetic neuropathy can be debilitating — but it doesn’t have to be. Here are some tips from experts on how to tackle this complication.

For those living with type 2 diabetes, “pins and needles” isn’t a figure of speech used to describe feeling nervous. It’s a sensation you may feel when dealing with diabetic neuropathy.

Never heard of it?

“Diabetic neuropathy refers to a sensation [people with diabetes feel] due to irritation of their sensory nerves from having diabetes,” said Andres Splenser, MD, an endocrinologist with Memorial Hermann in Houston. “Often, this happens to patients who have high blood sugars or uncontrolled diabetes, and over time, the high sugars cause nerve irritation and even nerves to die.”

This sensation is usually felt in the feet and legs but can also happen in the arms and hands.

“This nerve fiber damage can lead to areas of numbness or areas of tingling, a ‘pins and needles’ sensation, and burning pain,” said Prachi Patel, MD, a pain medicine specialist at Houston Methodist Willowbrook Hospital.

“The pain can get worse at night and lead to poor sleep quality,” Patel said. “Numbness of the feet can make it challenging to walk and increases the risk of injuries going unnoticed as sensation from the feet is decreased.”

You may be able to find relief through at-home and prescription remedies. There are also ways to prevent (or at least delay) diabetic neuropathy. These top tips can help.

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1. Prevention

Experts like Splenser suggest taking preventive steps now to avoid issues later.

“The number one and most important thing to do is prevention,” Splenser said.

Here are the tips Splenser offered:

• Eat a nutritious diet, such as the Mediterranean diet, that includes fruits, vegetables, whole grains, and fewer processed foods.
• Exercise regularly.
• Maintain a weight that is considered healthy for your body type.
• Manage your blood sugars.
• Get plenty of quality sleep.

These suggestions align with those of the National Institute of Diabetes and Digestive and Kidney Diseases. They also add that you should:

• Seek help to quit smoking, if possible.
• Manage your blood pressure and cholesterol levels.
• Limit drinking alcohol to no more than one drink each day for women or two drinks for men.
• Take your diabetes medications as prescribed.

2. Pace yourself

Exercise can help reduce your chances of experiencing neuropathy. However, it’s essential to pace yourself.

“Aim for balance and pacing in your behaviors,” said Garry L. Spink Jr., PhD, a licensed psychologist in Liverpool, New York, who specializes in helping people with chronic illnesses. “This means trying to not overexert or underexert yourself.”

Spink explained that when you’re resting all day, you avoid helpful distractions that might help the pain feel better in that moment or long term.

“Your attention is more likely to be focused on the pain, and it can increase the intensity of the pain and increase the likelihood of sensitization, which can cause other pain in the future,” Spink said. “Doing too much or overexerting can also cause pain. A balance is necessary to best manage pain.”

He suggests taking part in activities that mean something to you and that you can enjoy, like socializing with family and friends, even when you’re experiencing pain.

3. Oral and topical medications

Splenser usually suggests capsaicin cream (Arthricare, Zostrix) for people he treats who experience pain. This cream is a topical medication that can relieve joint and muscle pain.

As with any new treatment, it’s important to talk with your doctor before trying anything new — over-the-counter or prescription.

“Initially, capsaicin cream may feel irritating, but it improves over a few days of use,” Splenser said.

Research from 2022 found that applying topical capsaicin cream (0.075%) to painful areas for about 8 weeks might lower pain and help people with painful diabetic neuropathy walk, work, and sleep better.

Patel also recommends speaking with your doctor about other medications like gabapentin or duloxetine, which can help manage pain. 

4. Eat foods rich in B12 and folic acid

Vitamin deficiencies, particularly B12 and folic acid, can contribute to diabetic neuropathy, Splenser said.

Research published in 2022 showed that vitamin B12 supplementation can improve neuropathy symptoms and lower pain for people with diabetes.

Vitamin B12 can also keep nerves healthy, according to the National Institutes of Health Office of Dietary Supplements. The group recommends that most adults consume 2.4 micrograms of vitamin B12 daily. You can find B12 in foods like fish, eggs, and chicken.

5. Breathing and meditation

Breathing, mindfulness, and meditation are often recommended for managing many issues. And while you can’t breathe your way out of diabetes, Spink still suggests giving it a try.

“Although not for everyone — as with all treatments — engaging in such activities can reduce your stress and fear around pain, which are two factors that can worsen pain,” Spink said. “It can also activate top-down mechanisms, like brain circuitry, that help to reduce the intensity of pain we experience in the body.”

“Mindfulness, additionally, helps to strengthen your ability to control your awareness, helping the person in pain become more capable of keeping their attention where necessary and not always on their pain,” Spink said.

There’s endless research on mindfulness and how it can help with chronic illness. For example, a trial from 2020 found that muscle relaxation and mindfulness meditation could help people with neuropathy.

Spink suggests trying the following strategies:

• diaphragmatic or belly breathing
• using guided imagery
• practicing mindfulness
• relaxing your muscles

Spink said different apps offer guided versions of these exercises.

“You might have to experiment to find exercises that work specifically for you,” he said. “Notably, though, these exercises are long-term focused and require regular practice before benefits can be seen.”

6. Tap your health network

While there are ways to manage at home, Spink stressed that you’re not alone when coping with diabetic neuropathy.

“Ask for professional help if you feel overwhelmed,” he said.

But from who? It may be more than one specialist. Your care team may include:

• a pain physician
• occupational or physical therapists
• a pain psychologist

“It will also help you better understand all the biological, psychological, and sociological factors that can impact your pain, thus allowing you to have a well-rounded treatment to help reduce your pain and suffering and its impact on your life,” Spink said.

Spink suggested using the American Association of Pain Psychology to find mental health professionals.

You can also ask your current care team and insurance for recommendations for and listings of physicians, occupational and physical therapists, and pain psychologists.

Takeaway

Diabetic neuropathy is a complication that can happen in diabetes because of nerve irritation. It’s often the result of high blood sugar.

This condition can be painful and debilitating, so managing and preventing it can improve your quality of life.

Keeping your blood sugar managed is a way to prevent or delay diabetic neuropathy. Engaging in activities you like and mindfulness can also help when you’re experiencing pain. Doctors may also recommend therapies, like oral and topical medicines.

Expanding your healthcare network with a pain physician, physical therapist, or a pain psychologist may help you best find holistic support (and relief).