Diabetes and Pain Treatment

 Why do diabetics have pain?

Diabetic Patients very commonly asked me this question, “Doc, I have diabetes and am concerned about managing my back pain, the neuropathy in my legs and is it safe to receive steroid injection treatments for pain relief”.

Diabetes is a serious disease that can affect a patient’s health, well-being, and lifespan.

Patients must be closely monitored by their family doctor or endocrinologist.

High blood sugar may be a result of diet, activity, genetics, age, and/or medical history.  Diabetes can profoundly affect your health.  Diabetes affects multiple body organ systems.  Diabetes can affect the way the patient feels due to high blood sugar and if sugars are high enough, can result in loss of consciousness and even death. Very serious !  Diabetes affects the brain, the eye, the heart, the bowel, the vascular system, the nervous system and more.  Many patients suffer from painful diabetic neuropathy.

 Chronic Pain

For those patients with chronic pain from diabetic neuropathy, musculoskeletal injuries or Arthritic causes, Diabetes complicates the treatment plan.  Your general doctor must work with you to control the blood sugar with the best diabetic medications for you.  Your diet, exercise routine and weight must also be well managed.  Strict Control of Diabetes is essential to minimizing the damage.

 So now the PAIN

The Pain Doctor will evaluate your medical condition, evaluate the pain condition, order appropriate diagnostic studies and make the Pain Diagnosis and then design the best plan based upon your specific medical condition.  You must report to the pain Doctor, all your current Medications. Accurate Blood Glucose levels must be assessed.  The Doctor will then decide on what is the best and safe treatment will be for you.


Often medications such as gabapentin may be all that the patient needs to reduce the pain.  Those patients with other causes of pain may require different medications.  It is best to avoid opioid medications.  The doctor may decide to offer you physical therapy, acupuncture or other conservative treatments.  A pain injection may be recommended and will require you to be properly informed.

Pain management injections may include joint injections, nerve injections, trigger point muscle injections, epidural or other spinal injections.  For those patients with advanced damage to the sympathetic nervous system, the doctor may have treatment options.

Spinal implants may also be an option, you will need to talk to your doctor about this.


The inclusion of steroids is usually beneficial, but may raise your blood sugar temporarily.  Some patients have minimal effects, but some patients have wide swings in blood sugar.  Close attention must be placed on the effects of steroids after your first injection.  If you require more than one pain treatment injection the doctor may choose to modify the steroid dose or eliminate steroids from the treatment plan.

Your Pain Doctor will care for you in the best possible manner.  Please consult with the Pain Doctor.

PainDoc4u.com provides Pain Medicine, Chiropractic, Physical Therapy, Acupuncture since 1987!


Related Articles and Links

Aquos Hygiene

Platelet-rich plasma

Platelet-rich plasma (PRP) is blood plasma that has been enriched with platelets.

As a concentrated source of autologous platelets, PRP contains (and releases through degranulation) several different growth factors and other cytokines that stimulate healing of bone and soft tissue. The efficacy of certain growth factors in healing various injuries and the concentrations of these growth factors found within PRP are the theoretical basis for the use of PRP in tissue repair.[1] The platelets collected in PRP are activated by the addition of thrombin and calcium chloride, which induces the release of these factors from alpha granules. The growth factors and other cytokines present in PRP include:[1][2]

  • Platelet-derived growth factor
  • Transforming growth factor beta
  • Fibroblast growth factor
  • Insulin-like growth factor 1
  • Insulin-like growth factor 2
  • Vascular endothelial growth factor
  • Epidermal growth factor
  • Interleukin 8
  • Keratinocyte growth factor
  • Connective tissue growth factor

There are, at present, two methods of PRP preparation approved by the U.S. Food and Drug Administration. Both processes involve the collection of whole blood that is anticoagulated (with citrate dextrose) before undergoing two stages of centrifugation designed to separate the PRP aliquot from platelet-poor plasma and red blood cells. In humans, the typical baseline blood platelet count is approximately 200,000 per µL; therapeutic PRP concentrates the platelets by roughly five-fold. There is however broad variability in the production of PRP by various concentrating equipment and techniques.

Please ask questions and get informed.

Our Doctors and staff will always do their best for you!

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