Integrated Pain Management


Diabetic Proximal Neuropathy

Diabetic Proximal Neuropathy or femoral neurophagy, diabetic amytrophy, or lumbosacral radioplexus is a nerve disorder that is a complication of diabetes mellitus.

Diabetic Proximal Neuropathy

This disorder affects the buttocks, thighs, hips and legs. Proximal diabetic neuropathy is a peripheral nerve disease characterized by pain, muscle wasting and weakness.

Diabetic neuropathy is common and is a complication associated with diabetes.This disorder is defined as the sensory nerve damage.

There are different ways which are suggested through which diabetes will damage the nerves that allow people to feel pain. All the various ways are related to the increase in blood sugar lever over a long duration of time.

Diabetic proximal neuropathy is one of the 4 types of diabetic neuropathies. Diabetic proximal neuropathy can occur in type 1 and type 2 diabetes mellitus but it is also found in type 2 diabetes patients. This is the second most common diabetic neuropathy and can be managed over time and with treatment.

Signs and Symptoms

Diabetic proximal neuropathy signs and symptoms will depend on the affected nerves. The first pain that is reported by most patients is the pain in the hips, buttocks, thighs and legs.

This pain will mostly affect one side of the body and will either start gradually seeming mild at first and can come as a sudden occurrence.

The pain is usually followed by intense weakness in the proximal muscles in the lower limb and this can lead to the patient being unable to stand from a sitting position without any assistance.  This kind of weakness will start in a unilateral manner but can later spread bilaterally.

Diabetic proximal neuropathy will mostly be accompanied by peripheral nerve malfunction, musclefasciculation, and small but involuntary twitches of muscles and in some cases there may be contractions visible under the skin.


The nerve damage associated with diabetic proximal neuropathy was initially believed to be as a result of metabolic changes such as pericytes degeneration caused by hyperglycemia.

There are studies that have provided evidence supporting the immune mechanism theory. Albeit diabetic proximal neuropathy will occur in patients that are not diabetic, the condition is more prevalent in diabetic patients, which indicates that diabetes has a big role to play in this condition’s development.


Diabetic proximal neuropathy is quite difficult to diagnose because it has symptoms that are similar to other conditions and diseases.

The diagnostic procedure that will effectively confirm the disorder involves Electrodiagnostic testing.

Nerve conduction testing and electromyography can be used in supporting the diagnosis and eliminating the possibility of other conditions that might have the same symptoms.



Diabetic proximal neuropathy can be prevented by the proper management of diabetes mellitus.

This condition is reversible and can be done through the control of blood sugar levels, proper diet, physical exercise, medication, good mental health and avoiding smoking and drinking.

Physical therapy is used to restore the nerves in the legs and this will bring back the feelings in the limbs.

Most doctors will recommend oral medications to relieve pain such as opiates, and antidepressants. The duration of the treatment method selected will depend on the nerve damage extent.

In all measures, the control of the diabetes has been found to improve the symptoms and give the patient back their function and consequently improve the quality of life.

The use of corticosteroid injections or immunosuppressant will assist in alleviating the pain which causes discomfort and agony.

The treatment should involve the expertise of a physical therapist or an occupational therapist to ensure that the patient gains muscle strength which will assist in the recovery.