Nerve Pain at Night

Tingling, burning, stinging, and dull aches. Somehow, whatever nerve pain you may feel during the day seems intensified at night, which of course is just when you want to be free of any and all discomforts so you can drift off to sleep.

"Nerve pain at night is very common in people with diabetes," says Michael Bergman, MD, clinical assistant professor of medicine at NYU Langone Medical Center in New York City. But all nocturnal nerve pain doesn't happen for the same reason.

With diabetic neuropathy, which some 30 to 40 percent of diabetics have after about 10 years, the pain tends to be more of a stinging or tingling sensation and to occur in the hands and feet. It often feels better if you get up out of bed and walk around.

Vascular disease, also common in diabetics, causes a different type of pain. It's more like a deep pain, and it tends to be present in the calves, thighs, and buttocks, rather than the hands and feet. If your nighttime pain is due to vascular disease, it not only doesn't feel better when you get up and move around, it actually feels worse. And this type of pain is aggravated by having covers-sheets, comforters, blankets-on top of the affected area.

If you are experiencing nerve pain at night, don't automatically assume it's from neuropathy or vascular disease. "Look for other causes," advises Bergman. "It could also be due to other problems, and you don't want to miss something."

Once you know where your pain is coming from, a variety of therapies is available. "There are many different things to try," Bergman says. "If there was one thing that helped, we wouldn't have multiple treatments."

Here are some therapies that are likely to bring relief:

• First and foremost, get your blood sugar under control.
• Both antidepressants and anticonvulsants can be helpful at controlling pain, Bergman says. "And pain patches and creams can be effective, too," he adds.
• Some patients find that therapy such as TENS (transcutaneous electrical nerve stimulation) can help get rid of the pain. Ask your doctor for a referral to a professional who can administer this.
• Over the counter pain relievers can help, too. If they don't work, you can always get a prescription-strength pain reliever, but keep in mind that these can be habit-forming.
• If the pain is due to neuropathy, moving around helps. If you wake up in pain, stretch, move around your bedroom, walk up and down the hall, and see if these simple measures can help you feel better right away.

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