People with diabetes often suffer damage to their nervous system, especially those individuals who have had difficulty controlling their blood glucose levels over time. If you have underarm pain and diabetes, this may signal that you have a complication called peripheral neuropathy.
Peripheral neuropathy, experienced by 70 per cent of people with diabetes, may cause pain in your underarm, or elsewhere in your arms, hands, legs or feet. Scientists are still researching how high blood glucose levels, and the other metabolic changes caused by diabetes, directly damage nerves. But indirectly, diabetes damages the blood vessels that nourish nerves. Conditions such as carpal tunnel syndrome and lifestyle factors (smoking and alcohol) may combine with peripheral neuropathy to contribute to pain symptoms.
You might experience underarm pain varying from sudden “lightning” sensations, to throbbing or burning. Or you may first feel minor tingling or numbness, persisting over time, and often experienced more at night. Feet and legs are usually affected by peripheral neuropathy before the arms and hands, so doctors will check your feet. Doctors diagnose peripheral neuropathy based on symptoms, the presence or absence of other contributing factors and a physical examination. This exam includes a check of your vital signs, reflexes and sensitivity to touch, especially in the feet.
To alleviate and prevent worsening of pain, keep blood glucose levels as close to normal as possible. Protect your feet by examining them visually for injuries daily or at least weekly, by yourself or with a partner’s help. Also request that your doctor give you a comprehensive re-examination at least once a year, to monitor whether there are any overall changes in the peripheral neuropathy.
Cold or hot packs can relieve underarm pain. Topical aids such as capsaicin cream, lidocaine patches, nitrate sprays, alpha-lipoic acid and evening primrose oil may also be effective. Doctors may prescribe antidepressants, anticonvulsants or opioids, if pain is severe. Researchers are also studying electrical nerve stimulation, magnetic therapy and laser or light therapy.
Underarm pain caused by diabetes may mean that nerves in other areas of the body are also damaged. Loss of sensation in the feet, especially, can lead to unnoticed injury and infection, a major but preventable cause of diabetes-related amputations.