Classifications of Peripheral Neuropathy • Mononeuropathies are neuropathies that involve only one nerve and can be very painful. If you have more than one mononeuropathy, it may be called mononeuropathy multiplex or multifocal mononeuropathy. • Peripheral Polyneuropathies involve a number of nerves and are typically distributed in a "stocking and glove" distribution bilaterally - meaning they affect both feet, both legs and/or both hands. These can be classified in a number of ways. • Sensory neuropathy is neuropathy of the nerves that control your ability to feel pain, temperature, position and touch. These nerves can become "hypersensitive" and can cause significant pain. Damage to sensory nerves may also make your feet feel numb or like you are walking on cushions or blocks of wood and can affect your ability to feel an injury and your ability to keep your balance. • Motor neuropathy is neuropathy of the nerves that control your ability to move your muscles, your coordination and your ability to walk. • Sensory-motor neuropathy means that both sensory and motor nerves are impaired. • Autonomic Polyneuropathies involve the nerves that regulate biological activities that you do not control consciously, such as digesting food, sweating and heart and gland functions. If you have peripheral neuropathy, your feet and hands may not sweat and can become cracked and dry, putting you at risk of other complications. Symptoms of Peripheral Neuropathy Symptoms of neuropathy depend on the types of nerves affected and can affect people in many different ways. • Sensory neuropathy symptoms include: • Pain – Neuropathic pain is often described as burning, shooting, stabbing, like electrical shocks, pins and needles and throbbing. Painful symptoms are often more com Continue reading >>
Diabetic Neuropathy—the Agony Of Da Feet
[Editor’s note: In recognition of American Diabetes Month, Harvard Health Publications is collaborating with MSN.com on its Stop Diabetes initiative. Today’s post, published on World Diabetes Day, is the first of several focusing on this all-too-common disorder.] People tend to think of diabetes as a silent, painless condition. Don’t tell that to the millions of folks with diabetes-induced tingling toes or painful feet. This problem, called diabetic neuropathy, can range from merely aggravating to disabling or even life threatening. It’s something I have first-hand (or, more appropriately, first-foot) knowledge about. High blood sugar, the hallmark of diabetes, injures nerves and blood vessels throughout the body. The first nerves to be affected tend to be the smallest ones furthest from the spinal cord—those that stretch to the toes and feet. Diabetic neuropathy affects different people in different ways. I feel it as a tingling in my toes. Moving my feet and wiggling my toes helps the tingling disappear for a while. Others have it much worse. Diabetic neuropathy can cause a constant burning feeling in the feet; sharp pain that may be worse at night; and extreme sensitivity to touch, making the weight of a sheet unbearable. It can be sneaky, too, and completely rob the feet of their ability to sense pain. The truly scary thing about diabetic neuropathy is a 10-letter word we usually associate with horrific accidents or Civil War battlefields—amputation. When sensory nerves in the feet become damaged, a blister, cut, or sore can go unnoticed, allowing time for the wound to become infected. Infections that cause tissue to die (gangrene) and that spread to the bone may be impossible to treat with cleansing and antibiotics. Diabetes accounts for about 70,000 lo Continue reading >>
Diabetes And Foot Problems
Foot problems are common in people with diabetes. You might be afraid you’ll lose a toe, foot, or leg to diabetes, or know someone who has, but you can lower your chances of having diabetes-related foot problems by taking care of your feet every day. Managing your blood glucose levels, also called blood sugar, can also help keep your feet healthy. How can diabetes affect my feet? Over time, diabetes may cause nerve damage, also called diabetic neuropathy, that can cause tingling and pain, and can make you lose feeling in your feet. When you lose feeling in your feet, you may not feel a pebble inside your sock or a blister on your foot, which can lead to cuts and sores. Cuts and sores can become infected. Diabetes also can lower the amount of blood flow in your feet. Not having enough blood flowing to your legs and feet can make it hard for a sore or an infection to heal. Sometimes, a bad infection never heals. The infection might lead to gangrene. Gangrene and foot ulcers that do not get better with treatment can lead to an amputation of your toe, foot, or part of your leg. A surgeon may perform an amputation to prevent a bad infection from spreading to the rest of your body, and to save your life. Good foot care is very important to prevent serious infections and gangrene. Although rare, nerve damage from diabetes can lead to changes in the shape of your feet, such as Charcot’s foot. Charcot’s foot may start with redness, warmth, and swelling. Later, bones in your feet and toes can shift or break, which can cause your feet to have an odd shape, such as a “rocker bottom.” What can I do to keep my feet healthy? Work with your health care team to make a diabetes self-care plan, which is an action plan for how you will manage your diabetes. Your plan should inclu Continue reading >>
Why Do Your Feet Hurt?
In the days before modern medicine, someone who lived long enough with diabetes may have had one or both legs amputated. I assumed it did not happen anymore, until I read about people with diabetes who have ignored high blood sugar levels and developed complications requiring amputations. It seemed impossible that this could still be happening. Then the pain and numbness in my own feet sent me looking for answers. What caused it, and what could I do about it? I learned that the path from high blood sugar to foot ulcers and amputations often goes through a condition called peripheral neuropathy, the medical term for nerve damage in the hands, feet, arms, and legs that often causes pain and numbness. Diabetes and nerve damage High blood sugar damages blood vessels. One doctor described the extra glucose floating in the blood of someone with diabetes as similar to bits of glass scraping along the walls of veins and arteries. The tiniest blood vessels are easily damaged. That is why eyes, feet, and kidneys are so vulnerable, showing signs of blood vessel damage, sometimes even before a person is aware he has diabetes. Fingers and toes can become numb or overly sensitive when the blood vessels that supply the nerves are hurt. The longest nerves in your body run down your spine into your feet, ending at your toes. This makes feet an easy target for damage from peripheral neuropathy. Feet with nerve damage Because of diabetes we must care more about issues like foot ulcers, infections, ingrown nails, toenail fungus, and sores. The greatest enemy to our feet is numbness, because pain is the thing that warns us something is wrong. Peripheral neuropathy may make your feet more sensitive to touch while at the same time the numbness it may cause can mask problems like hot spots tha Continue reading >>
Diabetic neuropathy can cause the following symptoms: Numbness (loss of feeling) or painful tingling and burning in parts of the body, especially your feet, legs, and toes. Muscle weakness and difficulty walking. Your feet heal slowly when you get cuts, sores, or blisters on them. Also, they don’t hurt as much as you would expect. Diabetes causes the level of sugar in your blood to be higher than normal. Over time, high blood sugar levels damage your blood vessels and nerves. That’s why people who don’t (or can’t) control their blood sugar very well seem more likely to get diabetic neuropathy. Men are more likely to have diabetic neuropathy than women. High cholesterol levels and smoking also increase your risk. The most important thing is to keep your blood sugar under control. Take your medicines and/or insulin exactly as your doctor prescribes. Eat a healthy diet. If you are overweight, ask your doctor to help you lose weight. Get plenty of exercise. What can I do to prevent foot problems from diabetic neuropathy? Keep your blood sugar level as close to normal as possible. Also, follow your doctor’s advice on diet and exercise. Take your insulin or medicine exactly as prescribed. Here are some other ways to protect your feet: Wash your feet every day with lukewarm (not hot) water and mild soap. Dry your feet well, especially between the toes. Use a soft towel and pat gently; don’t rub. Keep the skin of your feet smooth by applying a small amount of cream or lotion, especially on the heels. If the skin is cracked, talk to your doctor about how to treat it. Check your feet every day. You may need a mirror to look at the bottoms of your feet. Call your doctor if you have redness, swelling, pain that doesn’t go away, numbness, or tingling in any part of you Continue reading >>
What Can I Do For Numb, Painful Feet And Legs?
My husband was diagnosed with diabetes almost a year ago. At first he was experiencing numbness in his feet. Over the past few months, he began having pain as well, sometimes as far up his leg as his calf. What can we do to help these symptoms? I have read that vitamin E and even flaxseed oil are good for the circulation. Would those be helpful? Continue reading >>
Diabetic Nerve Pain And What You Can Do About It
One of the saddest statistics about diabetes is that, at the time of their diagnosis, fully 48% of those newly diagnosed with diabetes already have signs of diabetic nerve damage. You can see this documented in this table where "impaired foot sensitivity" is a diagnostic sign of neuropathy: Prevalence of microvascular complications at the time of diagnosis in diabetic patients identified by screening and in general practice which is taken from this study: Microvascular Complications at Time of Diagnosis of Type 2 Diabetes Are Similar Among Diabetic Patients Detected by Targeted Screening and Patients Newly Diagnosed in General Practice: The Hoorn Screening Study It is known from studies of people with Type 1 diabetes that it takes a decade of exposure to elevated blood sugars to produce neuropathy. But high blood sugars creep up on people with Type 2 diabetes, and it turns out that even blood sugars in the "prediabetic" range can cause it. You can read more about the research that documents the relationship of high post-meal blood sugars to neuropathy HERE. Doctors miss the early diagnosis of Type 2 diabetes in these people because they rely on the fasting glucose test, or perhaps the A1c test, to screen for diabetes. Unfortunately, neurologists who have researched the topic have found that the incidence of neuropathy correlates entirely to rising post-meal blood sugars, not fasting glucose or A1c. As soon as post-meal blood sugars (or GTT blood sugars) go over 140 mg/dl (7.7 mmol/L) the incidence of neuropathy starts to rise. It starts with small nerve fibers and with extended exposure to high blood sugars, extends to the thicker fibers. But even after they diagnose people with Type 2 diabetes, the treatment that doctors give their patients ensures that even those who Continue reading >>
Common Diabetes Foot Problems And How To Prevent Them
Foot problems in diabetes can be caused by damage to both large and small blood vessels, which is much more common in diabetes. Foot problems, including nerve damage or peripheral neuropathy, usually begin with vascular disease. Damage to small blood vessels, in particular, appears to be the major cause of nerve damage that results in loss of feeling, or worse pain and burning sensations that bother the feel and legs. Once nerve damage progresses, it triggers loss of motor control and the abnormal gait that results in ulcers and amputations. Preventing foot problems in diabetes begins by preventing the loss of circulation that will result in serious nerve damage. This is relatively easy today if the risks for circulatory problems are recognized early. Keeping the blood pressure below 130/80 is essential for reducing damage to blood vessel walls. Preventing placque formation is also critical. This is done with medications the lower triglycerides and raise HDL, such as gemfibrozil and niacin, and those that lower LDL and make it lighter, such as the statins. Blood vessels walls can also be protected with certain blood pressure meds called ACE inhibitors. Blood flow may be improved with high dose vitamin E, although 1200 mg to 1500 mg a day are usually required for this effect. absence of foot pulses a pale color of the foot when it is raised feet that feel cold pain at rest pain at night relieved by hanging the feet over the side of the bed thin appearing skin loss hair from the toes and feet shiny skin a blue color of the toes reddish color of the feet ulcers that don't heal a foot infection that is hard to heal Although amputations are 15 times as common with diabetes, about half can be prevented with simple steps that protect the feet: Unfortunately, about 60 to 70 per Continue reading >>
When you have diabetes you need to take care of your feet every day Having diabetes can increase your risk of foot ulcers and amputations Daily care can prevent serious complications Check your feet daily for changes or problems Visit a podiatrist annually for a check up or more frequently if your feet are at high risk Your feet are at risk because diabetes can cause damage to the nerves in your feet, blood circulation and infection. Having diabetes can increase your risk of foot ulcers and amputations. This damage is more likely if: You have had diabetes for a long time Your blood glucose levels have been too high for an extended period You smoke – smoking causes a reduced blood flow to your feet, wounds heal slowly You are inactive. It's important to check your feet every day. If you see any of the following- get medical treatment that *day * Ulcer Unusual swelling Redness Blisters Ingrown nail Bruising or cuts If you see any of the following- get medical treatment within 7 days Broken skin between toes Callus Corn Foot shape changes Cracked skin Nail colour changes Poor blood glucose control can cause nerve damage to feet. Symptoms include: Numbness Coldness of the legs A tingling, pins and needles sensation in the feet Burning pains in the legs and feet, usually more noticeable in bed at night. These symptoms can result in a loss of sensation in the feet which increases the risk of accidental damage because you can’t feel any pain. An injury to the feet can develop into an ulcer on the bottom of a foot which can penetrate to the bone. This could lead to infection of the bone (osteomyelitis) and a chronic infection in the bones and joints. If an infection isn’t treated at the earliest signs, this could result in ulceration (an infected open sore) and eventually Continue reading >>
Numbness, Burning Or Tingling In The Feet Can Be The Sign Of Something More Serious
There are many reasons for numbness and tingling in the feet. Sometimes the cause originates in the feet and other times it a systemic cause meaning there is a disease process in the body that manifests in the feet. The number one cause of burning/numbness/tingling/pins and needles sensation in the foot in the US is diabetes. Other common causes are alcoholism, vitamin B12 deficiency, hypothyroidism, HIV, and multiple sclerosis. Occasionally patients have “idiopathic peripheral neuropathy” which means there is no clear cause for the burning, numbness or tingling in their feet. Systemic causes usually result in burning, tingling or numbness in BOTH feet and often in a symmetric distribution (like the toes, ball of the foot, or entire bottom surface). A systemic cause of nerve sensations frequently occurs while at rest, especially in the evening and can even wake you from sleep. & If the burning or tingling sensation is in just one foot or leg, you may have a compressed nerve in the lower back (specifically L4, L5, S1). When the problem is higher up then treating the foot is only for symptomatic relief and the problem is not truly being addressed. If you have a known back problem (compressed vertebrae, slipped disc, etc), it is important to inform your podiatrist during your appointment. & Sometimes tight shoes (especially laced shoes) can cause numbness in the foot, particularly during exercise when our feet swell. Occasionally patients have a bone spur on top of the foot in an unfortunate position where the nerve is pinched between the bone and shoes. This can be relieved by skipping eyelets in the shoe so the laces do not contact that area of the foot, applying a pad around (but not on) the spur, or surgically removing the spur. & If you are going to see a podiatri Continue reading >>
What Natural Remedies Could Help Neuropathy?
Neuropathy (pain, numbness or tingling, usually in the feet or hands) is caused by a malfunction of the nerves in the skin. We need such nerves to tell us about the world around us, and when they stop working properly the pain and the disorientation from the loss of function are both horrible. What can be done to help neuropathy? Natural Remedies to Help Neuropathy: Q. Numbness and tingling in my feet have been increasing rapidly for the past few months. I have had diabetes for over 12 years. My blood glucose level has been under control and the A1C has consistently been around 5.5. The neuropathy started before I was even diagnosed with diabetes. Some physicians have expressed doubt it is related to diabetes. I heard one of your radio listeners claim he got rid of nerve pain by taking curcumin. It has not helped me after a month. I would like to know what other remedies your listeners have tried or used successfully to help neuropathy. I have been taking alpha-lipoic acid and Neurontin for years. My goal is to arrest its progression. I am terrified, as my mother became paralyzed from the waist down with neuropathy that began in the feet due to diabetes. Consider Benfotiamine: A. You might want to add benfotiamine to your regimen along with the alpha-lipoic acid you already take. This variant of the B vitamin thiamine prevents damage to blood vessels (Diabetes, Obesity & Metabolism, Dec., 2015). It has also shown promise against neuropathy (Pharmacological Research, June, 2010). Capsaicin Could Be Helpful: You might also want to consider topical capsaicin, which can sometimes be helpful for easing nerve pain caused by diabetes (Journal of Pain, online, Oct. 13, 2016). As you may know, capsaicin is what makes hot peppers hot. To relieve pain it must be applied several ti Continue reading >>
Caring For Diabetes-related Nerve Disorders (neuropathy)
What is diabetic neuropathy? Some diseases consume the body like wildfire. Others are more like a slow burn. Diabetes is a malady that takes its time. If not controlled, diabetes slowly eats away at the body's cells, especially nerve cells. Doctors call the gradual breakdown of nerve cells "neuropathy." At first, nobody misses a few dead cells here and there. But after a decade or two, the damage can be impossible to ignore. Many patients suffer numbness or the opposite, extreme pain. As a result of decreased sensation, many people with diabetes may not be aware when they've broken the skin or suffered a cut or scrape on one of their feet. Bacteria can then set up housekeeping -- an invasion aided by impaired circulation and small vessel disease caused by diabetes. In some cases, these unnoticed infections can lead to raging infections and loss of the limb. Despite many recent advances in diabetes treatment, neuropathy remains frighteningly common. About 60 to 70 percent of people with either type 1 or type 2 diabetes will eventually develop nerve damage, though not all of them will have symptoms. But if you have diabetes, remember this: the key to avoiding nerve damage is prevention. By carefully controlling your blood sugar, you can help keep your nerve cells out of harm's way. What causes diabetic neuropathy? When people with diabetes experience pain, tingling, numbness or other sensory symptoms, typically in the feet, high blood sugar seems to be the real culprit. In general, nerve cells only start dying when blood sugar stays too high over a long period of time. Nobody knows why extra sugar is so toxic. Perhaps it upsets the chemical balance in the nerves. Or perhaps the sugar slows down blood circulation and cuts off the oxygen supply to the nervous system. Expert Continue reading >>
Preventing The Effects Of Diabetes On Your Feet
When you think of diabetes, you probably think about avoiding sugar and taking blood tests. If you’ve been diagnosed with Diabetes, however, you should also be thinking about your feet and ankles. Diabetes affects every area of your health, requiring constant monitoring. In fact, good diabetic foot care can be crucial for preventing severe, painful complications that could deteriorate into life-threatening infections or limb amputations. Foot Complications from Diabetes People with Diabetes can develop many different foot problems. Even ordinary problems can get worse and lead to serious complications. Your feet are highly sensitive to changes from Diabetes. Some people even experience symptoms in their feet before the condition is noticed elsewhere. Elevated sugar levels compromise your blood vessels, allowing fluid to leak into your tissues and damage them. Your immune system is weakened, so any issues that develop are harder to heal and have much higher odds of incurring complications. Infections are more dangerous, too. Allowed to progress too far, they could threaten your entire foot with amputation. Poor circulation (blood flow) can make your feet less able to fight infection and to heal. Diabetes causes blood vessels of the foot and leg to narrow and harden. Peripheral Arterial Disease Peripheral Arterial Disease (PAD) is a problem that can appear from compromised blood vessels. The problem is with narrowed, blocked up blood vessels traveling into your feet and ankles. Diabetic Peripheral Neuropathy Diabetes is often accompanied by a condition called neuropathy. Damaged nerves may misfire and cause aching, burning, or shooting pains. You may have numb patches, too. Being diagnosed with neuropathy does not mean that there is no hope. At Next Step Foot & Ankle Cl Continue reading >>
Dr. Wiley is Professor, Internal Medicine and Director, Michigan Clinical Research Unit, and Dr. Towns is Research Assistant Professor, Department of Internal Medicine, Division of Gastroenterology, University of Michigan Medical School, Ann Arbor, MI. Diabetes, formally known as diabetes mellitus, affects 171 million people worldwide, according to the World Health Organization. Type I diabetes usually starts in childhood or early adulthood, while the onset of type 2 diabetes is typically much later, often in middle-age. Diabetes affects many of the body’s systems and functions, not the least of which may be the nervous system. When the nervous system is affected, diabetic neuropathy can result. This occurs when too much sugar (hyperglycemia) circulates in the blood stream over a long period of time. Some people with neuropathy may not have any symptoms at all, while others will experience pain, tingling, or numbness in their hands, arms, feet, or legs. Many patients will first notice numbness, tingling, or pain in the feet. These symptoms are usually mild in the beginning but may worsen over the years, and then actually decrease in later years, as the nerve damage gets worse. It is thought that 60-70% of people with diabetes will develop some form of neuropathy over their lifetimes. While it is still somewhat unclear, diabetic neuropathy tends to occur after about five years of high blood sugar, and it usually peaks after about 25 years. Some people with neuropathy may not have any symptoms at all, while others will experience pain, tingling, or numbness in their hands, arms, feet, or legs. Diabetic neuropathy can also affect different organ systems, including the cardiovascular, genital-urinary, digestive, and vision. Though the origin of type 1 and type 2 diabetes Continue reading >>
What Causes Feet Pain And Purple Blue Coloring In A Diabetic?
Hi dear readers, Today I wanted to share the history of one of my patients asking guidance over the pain and changing in color of his legs. This patient was a type 2 diabetic for long time (over 10 years) and on medications (Metformin, and insulin shots at bedtime). He was overweight with belly fat. Back Pain Relief Surgery - You Could Save Thousands Ad Act Now. IntelliSpine℠: More Precise, Faster Recovery. Medicare Not Accepted. NorthAmericanSpine.com Learn more Recently, he is experiencing pain in his feet, particularly located around the ankles. He is also noticing that his feet turn purple and sometimes get dark in color. He is telling that has performed several Doppler ultra sounds on his legs with the final result as “Normal”. I may understand that each of you has his/her own history. However, sharing and/or reading to other’s history would help you understand better your current situation and/or to take proper actions for further future steps. As the ankle of this patient has shown to be swollen, the very first thought is directed to arthritis. During the arthritis attack, patients do feel pain and swelling of the joints. At this point, it is good to do the erythrocyte sedimentation rate (ESR) testing together with measuring the levels of C-reactive protein (CRP), antistreptolysin and rheumatoid factor and fibrinogen levels. All these tests are good enough to determine the presence of inflammation, its current degree and if it has to do with inflammation. Another explanation could be because of diabetes, especially when not controlled well. As it can damage the nerves, the patient might experience pain in the feet and legs. Furthermore, when the damages are so severe, it is difficult to feel pain while hurting or any injury or trauma or giving problems to Continue reading >>