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Peripheral Neuropathy - Capsaicin

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This thread is now closed. Please contact Anna DUK, Ieva DUK or everydayupsanddowns if you would like it re-opened.
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KPJordan

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Type 2
Good afternoon, I have TII diabetes and extensive foot peripheral neuropathy with increasing hand neuropathy.
It can be extremely painful with general burning and random stabbing 'needle jabbing' pains. As I am not tolerant of the stronger painkillers my Podiatrist has recommended I use Capsaicin cream. I am having trouble finding the right type and dose amongst the many offered for sale and I was also wondering if it is available on prescription?

Apologies if this has been dealt with before but I have searched the forum and didn't come up with much.

TIA.
 
It certainly won’t be on prescription because it’s not licensed for treating neuropathic pain.

That said, there’s no reason why it shouldn’t work. It’s active ingredient is an extract of chilli peppers, which has an effect on nerve conduction, so it’s worth a try. The trouble with using it on your hands is remembering not to rub your eyes, and take care having a wee.

Personally, I reckon an extract of Szechuan Peppercorns would be better, because if I use them when I’m cooking Chinese, they aren’t particularly ‘hot’ but they make my lips numb.
 
Might some of the other numbing creams work? Emla is one I think that some parents use for kids.

They may not have sufficient effect though, depending on the severity of the pain :(

Welcome to the forum 🙂
 
I was prescribed it for neuropathic pain, tried it and can attest to @mikeyB's warnings. For me it was about as effective as muttering incantations over chicken entrails. Might work for you so give it a whirl and see.
 
Just a thought, have you recently improved your control? Sometimes the neuropathic pain can be due to nerves regenerating and it’s only a matter of time until the pain stops.
 
Pattidevans said:
Just a thought, have you recently improved your control? Sometimes the neuropathic pain can be due to nerves regenerating and it’s only a matter of time until the pain stops.
Click to expand...
Yes! This year I have embarked on a low carb/cal diet as I'm under the bariatric NHS service with a view to surgery. I have lost almost 10% of my body weight and my HbA1c has dropped dramatically from ~90 to 37.

But I was led to believe the nerve damage was irreversible?
 
Well KP - sometimes it is and sometimes, it ain't ! - anyone's guess whether yours is one or the other, because as Patti said, regeneration of nerves IS painful - which if you don't know that to begin with sounds potty - so, don't completely write yours off. Live in hope!

There are some prescribed drugs usually only thought of as being used in mental health conditions, which can sometimes be helpful in painful neuropathy for some folk, too.
 
I'd be very wary of applying a cream such as capsaicin to feet that have altered sensation and pain. I've got peripheral neuropathy with numbness, pain & bone collapse in my feet and have reduced & altered sensation in my feet. I tried capsaicin cream once in desperation a few years back and the burning sensation was so painful, it distracted from the neuropathic pain but not in the way I had hoped! Some of the other drugs prescribed for neuropathic pain are duloxetine, gabapentin, pregabalin and amytriptiline but I've found it hard to get proper pain relief ongoing using these despite trying different dosages of various drugs. I hope you can get some relief from the pain and your surgery and control improve things for you.

These are some of the previous threads about painful neuropathy and capsaicin

 
One treatment which could be useful is CBD oil, which I use to stop involuntary movements of my toes, which are an annoyance, and to relax muscles in spasm, which can happen overnight - I only notice that when I wake up with my left leg flexed, and it is incredibly painful to try and straighten it. A dose of CBD oil is the first thing that I consume, before even a thought of a double espresso, and it works in less than a minute.

If it works so effectively on motor neurones, that is perfectly reasonable to expect it to work on sensory neurones. I've noticed latterly that it reduces the pain I get from my arthritic hip.

And there are no side effects, or on diabetic control. The only theoretical potential problem is that CBD traces in your breath will trigger the Police breath test for cannabis, if you ever get stopped by them, so always carry your CBD oil with you if driving.
 
KPJordan said:
Good afternoon, I have TII diabetes and extensive foot peripheral neuropathy with increasing hand neuropathy.
It can be extremely painful with general burning and random stabbing 'needle jabbing' pains. As I am not tolerant of the stronger painkillers my Podiatrist has recommended I use Capsaicin cream. I am having trouble finding the right type and dose amongst the many offered for sale and I was also wondering if it is available on prescription?

Apologies if this has been dealt with before but I have searched the forum and didn't come up with much.

TIA.
Click to expand...
I was prescribed tubes of Capsaisin Cream when I used to go to my local pain clinic. There are two strengths and one has to start with the cream with the lower heat and then move on to the higher heat cream if one wishes. I did find it useful but one has to be careful when applying it as if it gets in your eyes it is very painful and I guess you would have to get assistance if you did. It did work for me but because my pains in my head, therefore close to my eyes. Eventually I was diagnosed as having Trigemenol Neuralgia and the pain was getting worse so they put me onto Ibrupoven Retard a slow release tabled dosed at 800mg twice day.

I am continuing to take the Ibruproven Retard until such time as I have finished logging my results and seeing how I am managing my recently diagnosed diabetes 2. Then I will see if my T. Neuralgia is in remission by stopping the the drug. I don't like having to take strong tablets if there is no need.
 
@KPJordan all I can say is that on diagnosis I had completely numb feet, as I got the D under control I had very painful toes. Eventually they stopped being painful and I now have full feeling in my feet. Fingers crossed you will too. To help with healing I took the Neuropathy cocktail. scroll down for more info
 
KPJordan said:
Good afternoon, I have TII diabetes and extensive foot peripheral neuropathy with increasing hand neuropathy.
It can be extremely painful with general burning and random stabbing 'needle jabbing' pains. As I am not tolerant of the stronger painkillers my Podiatrist has recommended I use Capsaicin cream. I am having trouble finding the right type and dose amongst the many offered for sale and I was also wondering if it is available on prescription?

Apologies if this has been dealt with before but I have searched the forum and didn't come up with much.

TIA.
Click to expand...
I'd just suggest getting you glucose levels under STRICT control. I believe if you can, the situation should improve rather than continue to get worse.
 
KPJordan said:
HbA1c has dropped dramatically from ~90 to 37.

But I was led to believe the nerve damage was irreversible?
Click to expand...

Really hope it turns out to be ‘treatment induced neuropathy’ @KPJordan

This can be very painful, but is a sort of neuropathy / neuritis which resolves over time.

Hope you can find a way to manage the pain in the meantime.

academic.oup.com

Treatment-induced neuropathy of diabetes: an acute, iatrogenic complication of diabetes

Treatment induced neuropathy of diabetes is an iatrogenic neuropathy that develops in the setting of a rapid improvement in glycaemic control. Through retr
academic.oup.com academic.oup.com

Treatment induced diabetic neuropathy– a reversible painful autonomic neuropathy - PMC

To describe the natural history, clinical, neurophysiological and histological features and outcomes of diabetic patients presenting with acute painful neuropathy associated with glycemic control, also referred to as ‘insulin neuritis’. Sixteen ...
www.ncbi.nlm.nih.gov www.ncbi.nlm.nih.gov
 
Last edited:
pmailkeey said:
As I've not been aware of treatment induced neuropathy, does it just affect a small percentage of diabetics ?
Click to expand...

Yes, it’s quite rare, but it’s not the first time we’ve seen it on the forum. And while it used to be called insulin neuritis, it’s now recognised to be a possibility from other forms of treatment.

We have also had a few members who have seen retinopathy or maculopathy develop as a result of rapid improvement in BG levels. Sometimes this is transient, but sadly not always.
 
everydayupsanddowns said:
Yes, it’s quite rare, but it’s not the first time we’ve seen it on the forum. And while it used to be called insulin neuritis, it’s now recognised to be a possibility from other forms of treatment.

We have also had a few members who have seen retinopathy or maculopathy develop as a result of rapid improvement in BG levels. Sometimes this is transient, but sadly not always.
Click to expand...
I have recently had my eye test and have been told I am getting "background" retinopathy. So this could ring true with the fact that my BG has reduced dramatically in the last six months. I have halved my 50/50 insulin intake.
 
This is the first I've heard of treatment induced issues. The NHS has only diagnosed me in the last 5 years but I've known for a decade or two I was going to be diagnosed. In fact, a couple of times I saw my GP for a diagnosis but he refused ! That's despite my BG being around 10mmol/l untreated. Both parents were type II diabetics - dad since early/mid 1980s and Mum this side of the millennium. As a healthy(ish) young adult, my first BM was 4.1 but I can hypo slightly, above that !

One other possibility is that a quick drop in BG may adversely affect those with either long time undiagnosis or more extreme diabetes. Thanks for the info.
 
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