Diabetes Mellitus is a medical condition in which your blood glucose, or blood sugar, levels are consistently too high. Glucose is needed to supply the body with energy. Diabetes occurs when the body does not make any insulin or does not use enough of it. It is a life-long, chronic health condition that requires ongoing maintenance and monitoring....Learn more
Diabetic neuropathy and foot pain
Diabetic Neuropathy and Foot Pain
Diabetes mellitus, more commonly referred to as diabetes, is a disease that causes high blood sugar. Usually, a hormone called insulin transports sugar from your blood into your cells to be used as energy. In patients with diabetes, their bodies either do not produce enough insulin or cannot effectively use the insulin they produce.
Continuous high blood glucose (sugar) levels, characteristic in individuals with diabetes, could lead to several complications, including painful diabetic neuropathy.
Understanding Diabetic Neuropathy
Diabetic neuropathy is a type of neuropathy that damages the nerves. This type of neuropathy relates explicitly to type 1 and type 2 diabetes and usually affects the nerves in your legs and feet, but can be diffused throughout your body. Diabetic neuropathy could start slow and go unnoticed until there has already been significant nerve damage.
Causes of Diabetic Neuropathy
The causes of diabetic neuropathy are not clear. Researchers believe that high blood glucose levels could damage nerves and small blood vessels (capillaries) over time. Capillaries supply nerves with oxygen and nutrients. Damage to either the feeding capillaries or the nerves themselves interferes with how the nerves send, receive, and interoperate signals.
Diabetic Peripheral Neuropathy vs. Autonomic Neuropathy
Diabetic peripheral neuropathy is also called distal symmetric peripheral neuropathy. It is the type of neuropathy most commonly found in individuals who have diabetes. Diabetic peripheral neuropathy affects your peripheral nervous system – all the nerves outside your brain and spine, including your sensory nerves. It starts in the feet and legs and could spread to the hands and arms. If small nerve fibers in the sensory peripheral nerves are affected, it could cause disturbances in relaying sensory information relating to feeling pain and temperature. This is often referred to as sensory neuropathy.
Autonomic neuropathy can affect the autonomic nerves found in the organs of your autonomic nervous system. This includes your heart, bladder, intestines, sex organs, eyes, and bladder.
Other types of Neuropathy
Proximal neuropathy, also referred to as diabetic amyotrophy, usually affects the nerves in your chest, abdomen, thighs, hips, buttocks, or legs. Proximal neuropathy usually affects just one side of your body. However, it could spread to the other side in rare cases. This type of neuropathy can cause extreme neuropathic pain and significant weight loss.
Focal neuropathy (mononeuropathy) refers to damage to one specific nerve. There are two types of focal neuropathy: cranial and peripheral. Focal neuropathy typically involves your hands, legs, torso, and head.
Signs and Symptoms of Diabetic Neuropathy
Symptoms of diabetic neuropathy could be mild, but it can also be extremely painful and disabling. Nerve damage could start out slow, and symptoms could only appear after considerable nerve damage has already taken place. Diabetic patients could have more than one type of neuropathy. Symptoms of neuropathy can vary depending on which nerves are affected. Because symptoms sometimes only become noticeable once considerable damage has been done, it is a good idea to pay closer attention if you have diabetes and experience any of the symptoms listed below.
The symptoms of peripheral neuropathy are usually more intense at night and could include:
- Numbness and decreased sensitivity to feeling pain and temperature changes.
- Tingling or burning sensations.
- Sharp pain or cramps in the affected areas.
- Increased sensitivity to touch. Touch could be painful.
- Foot problems like ulcers, infections, and pain in the bones and joints.
Autonomic neuropathy could manifest symptoms like:
- Not realizing when blood sugar levels are low (hypoglycemia unawareness).
- Bladder or bowel issues.
- Frequent urinary tract infections.
- Slow emptying of your stomach (gastroparesis) which could cause nausea, vomiting, and a loss of appetite.
- Sexual dysfunctions. Erectile dysfunction in men and vaginal dryness in women.
- Changes in how your eyes adjust to light and darkness.
The symptoms relating to proximal neuropathy are usually only located on one side of the body. However, it can spread to the other side. These symptoms include:
- Severe pain in your hip, thigh, or buttock.
- Muscle weakness in your thighs.
- Difficulty getting up after sitting.
- Severe stomach pain.
Mononeuropathy symptoms could manifest as:
- Difficulty focusing or having double vision.
- Throbbing or pain behind your eyes.
- Paralysis on one side of your face (Bell’s palsy).
- Numbness or tingling in your hands and fingers except for your little finger (pinkie finger).
- Weakness in your hands and the inability to hold on to objects.
Other symptoms could include:
- Urinary tract infections. Nerve damage could cause you to be unable to empty your bladder completely, leading to bacteria build up in your bladder and kidneys.
- Sharp drops in blood pressure if the nerves that control blood flow are affected; it influences your body’s ability to regulate and adjust your blood pressure.
- Digestive problems like constipation or diarrhea.
- Increased or decreased sweating if nerve damage affects your sweat glands.
Preventing Nerve Damage
There is no cure for nerve damage relating to diabetes, and treatment focuses mainly on managing the symptoms. Taking care of your body and consistently managing your blood sugar levels could lower your risk of developing neuropathy. If you have diabetes, it is a good idea to have an A1C test done at least every six months, especially when you have diabetes. The A1C test gives you an estimate of your average blood glucose level for the past two or three months. Ideally, you should have an A1C level of 7%. Anything higher than this might need you to adjust your medication or diet.
How Diabetic Neuropathy Affects Your Feet
Diabetic neuropathy in your feet could lead to ulcers and sores that do not heal. In extreme cases, it could even lead to amputation. It is recommended that you have your doctor give you a thorough foot exam at least once a year. This should be done along with practicing good foot care at home. Home foot care includes:
- Checking your feet daily to see if you have any blisters, sores, bruises, redness, swelling, or cracked and peeling skin.
- Wash your feet with lukewarm water and mild soap every day. Avoid soaking your feet and dry them thoroughly – especially between your toes.
- Moisturize your feet to prevent cracking but try to avoid moisturizer from getting in between your toes – this could cause fungal growth.
- Cut your toenails straight instead of curved. Then use a nail file to file down any sharp edges.
- Put on clean and dry socks every day. Wear socks made of cotton or material that draws moisture away from your skin. Avoid socks with thick seams or tight bands that could cause pressure, irritation, or friction.
- Wear shoes that fit well and provide comfort and support. Ensure that your shoes fit snugly but still have enough room in the toe area to avoid corns and calluses.
- Shoes that provide shock absorption or added padding, like the KURUSOLE , can also lessen diabetic neuropathy-related foot pain, especially if you have a bone or joint pain.
Diagnosing Diabetic Neuropathy and Treatment Options
Diabetic neuropathy can be diagnosed through a physical exam in combination with specific tests. A physical exam will look at your muscle tone and strength, tendon reflexes, and sensitivity to touch and vibration.
Your doctor could run some tests to establish whether you might have nerve damage. A nerve conduction study investigates your nerve conduction velocity by measuring how promptly the nerves in your arms and legs conduct electrical signals. This test is usually conducted to diagnose carpal tunnel syndrome. An electromyography (EMG) could be used to identify your blood pressure changes while you are in different positions. It could also establish whether you sweat normally and your sweat glands are functioning optimally.
Pain Management and Natural Remedies
In some cases, prescription pain medication (either on its own or in combination with over-the-counter pain medication) could help manage your diabetic nerve pain. These medications include anti-seizure drugs and certain antidepressants (tricyclic antidepressants in particular). Some people could also find relief from medicated patches.
There are several natural ideas that you can incorporate into your daily life to help manage your symptoms. Ensure that you get plenty of nutrients by eating a balanced diet that includes fresh fruit, vegetables, and whole grains.
Do moderate exercise every day. Exercise helps regulate your blood sugar and increases your blood flow and circulation, keeping your heart healthy and extremities flooded with oxygen-rich blood. It is always a good idea to consult your doctor or a physical therapist whenever you start a new exercise program – especially if you are already experiencing pain or discomfort.
Diabetes is a chronic condition that could lead to several complications. Diabetic patients could incur diabetic nerve damage that could cause significant diabetic neuropathic pain. Pain relief options include prescription medication, along with over-the-counter remedies.
Because diabetic neuropathy could affect your feet, it is vital you practice good foot care at home. Keep your feet clean and moisturized, and making sure that you wear clean socks every day. Comfortable shoes that provide enough room for your toes while giving your feet ample support will go a long way to keep your feet healthy.