Pain associated with PAD and Diabetic Neuropathy
In vascular patients such as those with PAD or Diabetic Neuropathy, the pain is generally associated with what is known as Ischaemia or Critical Limb Ischaemia (CLI), which occurs when there is restricted blood supply to tissues. This, in turn, limits the oxygen necessary for the tissues to remain healthy. As a result, tissue damage occurs and neuropathic pain develops which can limit walking, exercise and generally any physical activity if PAD is not addressed.
Keep in mind that individuals with diabetes or who smoke are at higher risk for PAD and these conditions can increase the impact on vessel constriction and tissue damage, thus increase the severity of pain. It is essential that all underlying causes of PAD are addressed to mitigate the potential for severe pain.
Treating PAD associated neuropathic pain
Opioids are generally not recommended as a first line of treatment for PAD associated neuropathic pain, generally caused by the narrowing of the arteries and constricted blood flow. PAD associated pain can be severe and nearly 25% of all those with PAD are at risk for addiction when being prescribed opioids to treat chronic neuropathic pain. Opioids should only be used as a second-line of treatment for those with PAD associated neuropathic pain. Currently, there are no known treatments for PAD or Diabetic Neuropathy, thus many live long-term with the resulting neuropathic pain. But, the pain can be alleviated with diet and other lifestyle changes as well as non-opioid based treatments such as:
- Amitriptyline – also used for treatment of headaches and depression
- Suloxetine – also used for treatment of bladder problems and depression
- Pregabalin and gabapentin – also used to treat epilepsy, headaches or anxiety
Only your doctor can determine the best way to treat PAD associated neuropathic pain but the use of opioids should be avoided. At JanOne, the premise of JAN101, the PAD treatment currently in our pipeline, is the use of nitrites to reverse constriction of the arteries, repair damaged arterial tissues and increase blood flow to near normal function. This, in turn, has the potential to remediate PAD neuropathic pain. That means less risk for opioid abuse at the prescription pad.