by Olivia Getty
(Belfast)
Question from Olivia:
How do I deal with severe pains in my legs and feet? I was diagnosed with diabetes in May and since then I have been in constant pain, unable to sleep, walk any length of time, or work. I am also feeling sick because of the length of time I have been taking ibuprofen.
Olivia, severe leg and foot pain that stops you from sleeping, walking, or working needs medical review urgently. It should not be treated only with long-term ibuprofen or home remedies.
In diabetes, severe pain may come from nerve damage, poor blood flow, infection, foot ulcers, inflammation, a back or spine problem, vitamin B12 deficiency, kidney disease, or another condition.
Please contact your doctor, diabetes clinic, podiatrist, or urgent care service. If one foot is cold, blue, black, very swollen, infected, or you have a wound, fever, or sudden worsening pain, seek urgent care now.
Answer by Dr. Albana Greca, MD, MMedSc
Dear Olivia,
I am sorry you are going through this. Constant severe leg and foot pain after a diabetes diagnosis should be taken seriously. It is not enough to assume that this is “just diabetes pain.” You need an examination to find the cause and choose the right treatment.
Diabetes can affect the feet in more than one way. Burning, tingling, stabbing pain, numbness, or electric-shock sensations may suggest diabetic neuropathy. Pain that appears while walking and improves after resting may suggest poor circulation, also called peripheral artery disease.
Other causes must also be considered, including infection, a hidden foot wound, pressure from shoes, arthritis, gout, blood clot, spinal nerve compression, vitamin B12 deficiency, thyroid disease, kidney disease, or medication-related problems. Our guide to diabetes leg pain explains why the pattern of pain matters.
A proper exam should check the skin, toenails, foot temperature, pulses, sensation, vibration, reflexes, walking ability, and whether there are ulcers, calluses, pressure areas, or signs of infection.
If poor blood flow is suspected, your doctor may order tests such as ankle-brachial index, toe pressures, Doppler ultrasound, or referral to a vascular specialist. If nerve pain is suspected, treatment is different. You can compare symptoms with diabetic neuropathy symptoms.
Ibuprofen may help short-term pain, but it is not a safe long-term plan without medical supervision. It can irritate the stomach, raise bleeding risk, worsen blood pressure, and affect kidney function, especially in people with diabetes, high blood pressure, kidney disease, dehydration, or older age.
Because you are already feeling sick from ibuprofen, contact your doctor promptly. You may need kidney tests, stomach-safety review, a different pain medicine, or treatment for the real cause
If your doctor confirms diabetic nerve pain, medicines such as duloxetine, pregabalin, gabapentin, or other options may be considered. These medicines work differently from ibuprofen and must be chosen based on your symptoms, kidney function, age, and other medicines.
If the main problem is poor circulation, nerve-pain medicines alone may not solve it. Circulation treatment may include supervised walking therapy, cholesterol treatment, blood pressure control, smoking cessation if relevant, antiplatelet medicine when appropriate, and sometimes vascular procedures. Our page on diabetic nerve pain explains this in more detail.
Daily foot checks and protective footwear are central to diabetic foot safety. See our diabetic foot care guide for practical steps.
Seek urgent medical care if you notice a foot ulcer, spreading redness, pus, fever, sudden swelling, a cold or blue foot, black skin, sudden severe pain, new numbness or weakness, chest pain, shortness of breath, or calf swelling with tenderness.
A diabetic foot wound can worsen quickly, especially when neuropathy and poor circulation are present. If you have any sore or open area, review diabetic foot ulcers and arrange medical care promptly.
Seek urgent medical care now if your foot is cold, blue, black, very swollen, infected, draining pus, has an ulcer, or if pain is sudden and severe. Also seek urgent help for fever, vomiting, confusion, chest pain, shortness of breath, severe weakness, or high blood sugar with ketones.
Olivia, the priority is to identify the cause of your pain. Diabetic neuropathy, poor circulation, infection, and medication side effects are treated differently. Long-term ibuprofen is not enough and may create new risks. Please arrange a foot, nerve, circulation, and medication review as soon as possible.
Educational safety note: This answer is for general diabetes education only. It does not replace personal medical advice, diagnosis, or treatment. Do not start, stop, or change pain medicines, diabetes medicines, foot creams, supplements, or wound treatments without speaking with your healthcare provider.
Last reviewed: July 2026.
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