Diabetes and Nerve Pain: Rate Your Pain

Reviewed by Brunilda Nazario, MD, November 2009.

When it comes to diabetic nerve pain, your awareness of symptoms can help find just the right treatment for you.

About 60% to 70% of people with diabetes have some form of nerve pain and damage, called diabetic neuropathy, says the American Diabetes Association. When nerve damage shows up in the feet or hands, it's called peripheral neuropathy. Some of its symptoms are obvious, like pain, tingling, or a pins-and-needles feeling in the feet. But numbness and muscle weakness are also signs of nerve damage from diabetes.

Print out this nerve pain symptom checklist, fill it out, and take it with you each time you visit your doctor or other health care professional. Be sure you take a copy to any specialists you see, such as a podiatrist (foot doctor), ophthalmologist (eye doctor), or cardiologist (heart doctor). That way, everyone on your diabetes care team will be familiar with your pattern of symptoms and can advise you on the best diet, exercise, and medications to treat your nerve pain.

1. What kind of pain or numbness do you feel?

Check off the way your pain feels, and rate your symptoms from 1 (mild) to 10 (severe).

Sadness throughout the day, nearly every day ____

Tingling        ____

Dull ache             ____ 

Burning        ____

Stabbing pain      ____

Throbbing pain    ____ 

Too sensitive to touch   ____ 

Too sensitive to heat or cold   ____ 

No feeling at all; numbness    ____

Numbness that comes and goes   ____

Can no longer feel heat and cold   ____

Muscle weakness in hands, feet, or legs   ____ 

Other ____

Has this changed since your last doctor's visit? Yes No

If so, how?

2. Where is your nerve pain or numbness?

Check off the way your pain feels, and rate your symptoms from 1 (mild) to 10 (severe).

Fingers ____ Hands____ 

Arms ____ Toes  ____ 

Feet  ____        Legs ____ 

Other ____ 

Has this changed since your last doctor's visit? Yes No

If so, how?

 3. When is your pain or numbness the worst?

Check off the way your pain feels, and rate your symptoms from 1 (mild) to 10 (severe).

In the morning ____  At night ____

After activity   ____  Other     ____

Has this changed since your last doctor's visit? Yes No

If so, how?

4. Do your symptoms keep you from any normal, daily activities?

Check off the way your pain feels, and rate your symptoms from 1 (mild) to 10 (severe).

Walking   ____ Exercising    ____

Driving   ____ Going to work  ____ 

Sleeping   ____ Socializing    ____

Other   

Has this changed since your last doctor's visit? Yes No

If so, how?

5. What seems to relieve your symptoms?

Activity that helps: 

Self-care that helps: 

Medications that help: 

 Other treatment that helps: 

What causes diabetic nerve pain?

If you're wondering what causes nerve pain in the first place, it's probably a combination of factors, according to the National Diabetes Clearing House.

 - Nerves exposed to high glucose levels for long periods of time

 - High blood fats like high cholesterol, which damage the blood vessels that nourish nerves

 - Inflammation in the nerves caused by an autoimmune response (when your body reacts to a natural internal substance as if it's foreign and tries to "fight it off")

 - Genetic factors that make some people more prone to nerve damage

 - Smoking and alcohol (although precisely how these cause nerve damage is still unknown).

So while you're talking with you doctor about your nerve pain, you may want to explore which of these factors may be behind your symptoms and look for solutions together. There's no final "score" that's good or bad, too high or too low. Pain is a highly personal, subjective experience. Rating your pain isn't intended to diagnose your condition but to encourage an ongoing awareness of your symptoms and an open dialogue with your doctor. And since your symptoms are likely to change over time, tracking your pain between visits with your doctor can help you feel more empowered in your health care and more in touch with your own well-being.