pain in arms & legs

pain in legs & hand. she is 29y. old and diabitic.  at present sweling in right hand and also pain in both legs its continius last three days. she can't sleep last  night cause of legs pain.still it is paining. fasting diabitic is 205. plz. what type of medicine she take.

[Christopher R Newey, DO]

Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with a doctor.

Without the ability to examine and obtain a history, I can not tell you what the exact cause of the symptoms is. However I will try to provide you with some useful information.

There are 2 types of nerves in our body, large and small. When they are injured, it is called a neuropathy. With small fiber neuropathies, symptoms including burning or buzzing or other vague symptoms starting in the feet and hands then in some cases spreading to other parts of the body. The other type of sensory neuropathy is called a large fiber neuropathy. These symptoms includesensory loss and if motor nerves are involved ,weakness. Some types of sensory neuropathies occur and progress very slowly, others sort of wax and wane (with flare-ups) and some are progressive. One of the most common causes of neuropathy is diabetes. There are many other causes including endocrinological, rheumatological, genetic, metabolic, etc.

In addition to laboratory testing (as indicated), the diagnosis will include an EMG/NCS. This test will evaluate for large fiber neuropathies.

Treatment for neuropathic pain includes medications such as gabapentin and pregabalin, and medications such as elavil (which is an antidepressant but has actually been found to be helpful with neuropathic pain as well). These medications must be prescribed by a physician and titrated slowly. Before starting any medication, the risks must be weighed against the benefits of the medication.

Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.