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Have leg pain, headache. Duzela, Betacap not helping. Please advise

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Practicing since : 1981
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i am suffering from leg pain- both legs - pain in the ankle,calf and also i get severe headache - bodyache sometimes, My doctor has given me duzela 20mg, betacap tr in the morning and duzela 40mg with zapiz 0.5mg in the night, But I am not getting any benefit. I also take transdol 50mg this tab gives relaxation. Please advise I am having this pain since last eight to nine months.
Posted Sat, 25 Aug 2012 in Bones, Muscles and Joints
Answered by Dr. Anil Grover 3 hours later
Thanks for wriiting in.
I am a medical specialist with an additional degree in sub specialty of cardiology. Indian population is very susceptible to Diabetes. In fact 70% of cardiac patients I manage have diabetes too. I read your mail with diligence.
What I gather from medical history is with metformin 500 mg twice a day with glimepride 2 mg twice a day your diabetes is well controlled 100 mg Fasting 120 mg post prandial. Still you have developed diabetic neuropathy which needs drugs like duloxitene (Duzela is a brand name of the salt) and pamanxiolytic drug like clonazepam (Zapiez) and transdol (tramadol). Diabetic Neuropathy develops in almost all patients only severity may vary patient to patient. Your case plenty of drugs are not helpful in contolling pain. Here are the following suggestions, which may help you further:
1. Please keep your diabetes under control always. You ought to monitor it by 3
montly value of glycated hemoglobin measurement (HbA1c), it should never cross
8.5; preferrably kept below 8. (<7 very good control, 7-8 Good Contol, 8-8.5 Fair
control, >9 Poor control of blood sugar of preceding 12 weeks)
2. Because exercise improves blood flow to legand foot nerves. A regular exercise
program of regular walking prevents progression of neurpathy. All this with the
assumption that there is no involvement foot. As you had not mentioned it.
3. Warm water treatment of Diabetic Neuropathy. Regular warm water in bath
provides relief at least in early cases of diabeticneropathy. In any case, warm
water improves circulation and it is relaxing too. Please check the temperature
of water with fingers of hand before puttkng foot in it.
4. Vitamin B: 25 mg of thiamine(vitaminms B1), 500 micrograms of B 12, 25 mg of
vitamin B 6 and at least 1 mg of Folic Acid is recommended daily intake as
supplement in patients with Diabetes amd neuropathy.
5. I am sure this would have been done in your case to tab paracetamol, Aspirin,
Ibuprofen and Naproxen ought to be tried first before going to drugs you are
6. Capsaicin (the hot chilli pepper) cream rubbed on the skin affected by Diabetic
Nerve does help.
7. Abstinence from alcohol. Alcohol is toxic to nerves. Avoid it.
8. Evening Primerose Oil extracted from the plant of the same name has been
found effective in Diabetic Neuropathy. There are clinical trials in support of
9. Other botanical oils like geranium oil, lavender oils have been used on the skin
and have benefitted some.
10. Alpha Lipoic Acid a potent antioxidant, given orally 600-1200 mg, has been
shown to reduce pain (anecdotal reports).

I hope some of these will be of help to you for you are taking too many of medicines for pain. If you have a supplementary question, I will be most happy to answer it at the soonest. Good Luck.
With Best Wishes,

Dr Anil Grover
MBBS, MD (Internal Medicine) DM (Cardiology)
Cardiologist & Internist
Above answer was peer-reviewed by
Follow-up: Have leg pain, headache. Duzela, Betacap not helping. Please advise 11 hours later
sir please let me know the brand name of alpha lipoic acid tablet
Answered by Dr. Anil Grover 5 hours later


I looked the answer from internet and I found this site, as it comes under food supplement no prescription is needed (I will advise to search more brand names)

With best wishes.

Dr Anil Grover
MBBS, MD (Internal Medicine) DM (Cardiology)
Cardiologist & Internist
Above answer was peer-reviewed by
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