Changes within the central nervous system, including the brain and spinal cord, can be a key reason for pain in people with diabetes, and future treatments could focus on restoring the brain’s pain blocking systems, according to new research.
More than 50% of people with diabetes develop diabetic peripheral neuropathy. In about one-third of cases, nerve damage results in painful sensations such as burning, tingling, or shooting sensations in the feet. Pain often worsens at night and disrupts sleep and ultimately reduces a person's ability to work, or to carry out everyday activities.
Dr Di Ye from Murdoch University’s School of Psychology said that pain management is a big issue for people with diabetic and nerve pain, and that the new findings will help to spur the development of future treatments.
“Our research shows that the pain that people experience is not just caused by damaged nerves in the feet, but that the brain and spinal cord can also play a big role,” Dr Ye said.
"In healthy people, the brain sends signals down the spinal cord to calm pain signals coming from the body, but in people with diabetes and nerve pain, this calming system is less effective, so pain signals get amplified instead of reduced."
The findings also show that being overweight or obese and their associated chronic inflammation may contribute to chronic pain in diabetes.
Co-author of the study Murdoch University Professor of Psychology Peter Drummond said that the findings have pleasingly given insights into some possible next steps to help with the pain that diabetes can bring.
“Future treatments might look at restoring the brain’s pain blocking systems and reducing inflammation in the nervous system, looking beyond blood sugar, to overall metabolic health,” Professor Drummond said.
“Further research could determine whether impaired pain modulation can serve as an early indicator of painful diabetic peripheral neuropathy, which may also enable us to intervene and help people earlier.”
The full research Pain Modulation and Central Sensitization in Painful Diabetic Peripheral Neuropathy: Updated Narrative Review and Future Directions is now available in the Journal of Diabetes .
Journal of Diabetes
Meta-analysis
Not applicable
Pain Modulation and Central Sensitization in Painful Diabetic Peripheral Neuropathy: Updated Narrative Review and Future Directions
3-Apr-2026
The authors declare no conflicts of interest.