There are numerous causes of leg pain, particularly for individuals with diabetes. Burning feet and numbness, tingling or shooting pain down the leg are commonly thought of as diabetes complications. That might be correct but not always.

Dr. RajaRajan Balasubramanian, FIPP, DABRM, the first dual board certified pain specialist in Singaperumal Koil, is a frequent evaluator of diabetic patients who have been told that their leg pain is “just because of sugar.” In fact, a large number of diabetic patients who complain of leg pain also have a coexisting compression of the sciatic nerve, and that is treatable and very treatable, irrespective of diabetes.

It's vital to know this because the treatments for diabetic nerve damage and spinal nerve compression are not the same. When the wrong condition is treated, poor diabetes control may result in pain.



What is Diabetic Peripheral Neuropathy?

Diabetic peripheral neuropathy (DPN) is a common chronic complication of diabetes. Over a long time, high blood sugar can slowly begin to weaken the nerves, especially in the feet and legs.

Symptoms often gradually develop, starting in the feet and gradually working up the legs in both legs.

Common Symptoms

  • A burning sensation in the feet.

  • Tingling or "pins and needles"

  • Numbness

  • Separate the objects from the bed.

  • Night time pain that increases in intensity.

A lot of patients also complain of not being able to feel heat or cold or walk comfortably without shoes.

Diabetic neuropathy typically progresses over a period of time and is somewhat symmetrical, involving both sides of the body.

Before looking for treatment for nerve pain in the leg due to diabetes, it is important to determine if such symptoms are actually due to diabetic neuropathy.

Sciatica: What is that, and why are diabetic patients at risk for it as well?

Sciatica is the irritation or compression of one of the nerves that branch out from the lower spine. A slipped (herniated) disc is the most common cause, but spinal arthritis or narrowing of the spinal canal can also be the cause.

Diabetes is not a preventative measure for sciatica. In fact, diabetic patients often have some age-related changes at the spine, which can compress the sciatic nerve.

Typical symptoms include:

  • Sudden, stabbing pain from the lower back down into the leg of one side.

  • Tightness down the leg to calf or foot

  • Tingling in one leg

  • Weakness while walking

  • Worsening pain after sitting for extended periods of time

Many people wonder:

“Could my leg pain be due to diabetes or a disc issue?”

One of the best indications is that sciatica typically impacts just one leg, travels in a straight line down the leg and alters by posture or motion. Diabetic neuropathy tends to affect both feet and legs equally and is not as body position dependent.

It is important to keep in mind that diabetic patients with low back pain should not conclude that the symptoms are solely due to blood sugar fluctuations. Both can occur simultaneously.

Side by Side: Diabetic Neuropathy vs Sciatica


Feature

Diabetic Neuropathy

Sciatica

Where Is the Pan?

Two feet/legs

One leg pathway

Where the pain is felt

Burning/Tingling

Sharp/Shooting

The number of students getting better/worse with walking

Symptoms may stay the same or gradually worsen 

Pain may improve or worsen with walking depending on the cause 

Spine Imaging Relevant?

Not usually/not often

Often yes

Patients with diabetes and nerve problems

Spine treatment

Diabetes + nerve care treatment


In simple terms:

  • Diabetic neuropathy is due to nerve damage from diabetes.

  • Sciatica is a condition that's brought on by a spinal nerve being compressed or irritated.

  • Both can give tingling or burning feelings, but the cause and hence also the treatment of the two are different.

Knowing the cause of your symptoms can prevent wasted time and the wrong course of treatment being started.

Is it possible to have both? (Very Common — Here's Why):

Yes. In fact, many adults over 50 years old suffer from diabetic neuropathy and sciatica. This is one of the primary reasons for the fact that leg pain can be confusing, and why some people may still have pain after they've got their diabetes under control.

Over time the peripheral nerves can become damaged, or changes in the spine, like a herniated disc or spinal degeneration, can compress the sciatic nerve. These conditions can involve various regions of the nervous system so they may occur simultaneously.

A frequent question patients ask is: "Can diabetics have sciatica simultaneously? The answer is yes. A diabetic patient may suffer from both burning or tingling in both feet because of diabetic neuropathy, and shooting or stabbing pain down one leg because of sciatica.

Your symptoms can be helped by a detailed examination of your clinical condition, along with the right imaging if needed, that can help determine if one condition—or both—is causing them.

If so, why is it that getting this wrong translates to under-treatment?

Diabetic patients often complain that every time they experience pain in their legs, the cause is solely blamed on diabetes.

Receiving a diagnosis of a treatable spine condition might be delayed if the assumption is that all nerve pains are "due to the sugar.

For instance, if a compressed sciatic nerve is misdiagnosed as diabetic neuropathy, only blood sugar control and nerve medications will be used, and the spinal issue will be left untreated.

Likewise, if neuropathy is not diagnosed and treated in the spine, then burning or numbness may remain.

Not just to relieve pain, but to find the source of the pain. Correct diagnosis ensures your treatment plan is tailored to each condition, enabling you to be more comfortable, mobile and enjoy your life.

But if you have ever wondered how to tell the difference between the two, the most recommended way to determine the difference between the diabetic nerve pain and sciatica is to get an expert evaluation.

Dr. RRB Pain Care performs a thorough evaluation of your leg pain including a complete evaluation of diabetic neuropathy, sciatica and more.

Specialists from Tambaram, Chengalpattu and Kattankulathur make regular visits to the clinic for specialised assessment and customised treatment for patients. The Kancheepuram district corridor has a considerable number of diabetic patients that are treated at Dr.RRB Pain Care they are able to find out if they have diabetes, or if their pain is a result of spinal nerve compression or if they have both.

Approximate travel times:

  • Tambaram: 25–30 minutes

  • Chengalpattu: 30–35 minutes

  • Kattankulathur: 10–15 minutes

Clinic Address

Dr. RRB Pain Care

GST Road No.1/164, Singaperumal Koil, Tamilnadu 603204

The first step to effective treatment is to get an accurate diagnosis of the condition, whether it be diabetic neuropathy treatment in Tamil Nadu, evaluation for sciatica in diabetic patients or neuropathic pain treatment at GST Road.

You can find these resources helpful as well:

  • Sciatica → /conditions-treated/sciatica

  • LBP is treated in this manner.

  • Diabetic Frozen Shoulder Blog → /blog/frozen-shoulder-diabetic-patients-treatment

📲 WhatsApp us today to schedule your consultation.

Frequently Asked Questions

1.What is the difference between leg pain due to diabetes vs spine?

Typically, diabetic neuropathy causes a burning, tingling or numbness in the feet and legs. A common symptom of sciatica is a sudden, intense pain that radiates down one leg from the lower back. A physical exam aids in identifying the cause.

2.Do diabetics get sciatica?

Yes. Diabetes does not stop any spinal problems. Sciatica is a common condition among diabetic patients that can be caused by disk herniation or spinal deterioration that is associated with aging.

3.Can diabetic neuropathy be cured?

Although damage to the nerves may not fully heal, many people get a great deal of relief from blood sugar control, medications, lifestyle changes and pain management.

4.So who is the doctor for the diabetic leg pain in Tambaram?

Call a pain specialist who specializes in the diagnosis of diabetic and spinal nerve disease if you are experiencing burning, tingling, numbness and/or a shooting pain in your leg. Dr. RRB Pain Care is frequently visited by patients from Tambaram, Chengalpattu and Kattankulathur for assessment.

5.Are there any similarities between the two disorders that may make the same treatment appropriate?

Not always. Treatment for diabetic neuropathy and sciatica are different and should be done based on the proper diagnosis. In some cases, these patients need to be treated for one disease at a time.

Conclusion

Not every time you experience pain in your legs is a result of diabetic neuropathy. Many patients suffer from both sciatica and diabetic nerve damage and these can give similar symptoms.

To avoid needless delays in recovery, the first step is to understand what is causing your symptoms, so you can select the right treatment for diabetic neuropathy leg pain.

When you're unsure why your leg hurts, there may be a number of different issues at play. For patients with diabetes mellitus and leg pain solely due to neuropathy, an evaluation of the contribution from the spine is worth considering in consultation with a specialist at

Dr.Rajarajan Balasubaramanian, MBBS, MD, DNB, FNB (WIP, USA, DABRM (USA)

INTERNATIONAL PAIN & SPAIE SPECIALIST
India's First National Board and American Board Certified Specialist Dedicated to restoring quality of life through precision interventional pain management.