Treatment for the burning, aching, or electric-shock type pain associated with diabetic neuropathy involves a multidisciplinary approach focused on managing blood sugar and alleviating symptoms, as there is currently no cure for the underlying nerve damage. The most crucial aspect of care is rigorous glycemic control through diet, exercise, and medication, which helps to slow or halt the progression of further nerve damage. For existing pain, physicians typically prescribe specific medications that have proven effective for neuropathic pain, even if not originally intended for it. Common first-line oral options include anticonvulsants such as pregabalin and gabapentin, which work by calming overactive nerve signals, and certain types of antidepressants, specifically serotonin-norepinephrine reuptake inhibitors (SNRIs) like duloxetine and venlafaxine, or older tricyclic antidepressants (TCAs) like amitriptyline. These medications modify pain perception pathways in the brain. For localized relief with fewer systemic side effects, topical treatments like over-the-counter capsaicin cream or prescription-strength lidocaine patches are often recommended. A comprehensive management plan also incorporates non-pharmacological approaches, including physical therapy to improve strength and mobility, transcutaneous electrical nerve stimulation (TENS), acupuncture, and certain dietary supplements. In cases of severe, refractory pain, advanced interventions such as high-frequency spinal cord stimulation may be considered by specialists. Patients often need to try several medications or a combination of therapies to find the most effective pain relief strategy, requiring close collaboration with their healthcare team to manage side effects and optimize outcomes, ultimately improving their quality of life.