Is Diabetic Foot Pain
Driving You Cazy?

As the prevalence of diabetes increases, diabetic foot pain becomes more common. What causes diabetic nerve pain? Can a diabetic foot sore be prevented? And, once these symptoms start, is there anything type of diabetic neuropathy treatment that is effective?




What is Diabetic Foot Pain?

Unfortunately, 25% of diabetic patients will experience foot pain. Because the incidence of diabetes is increasing, so is the incidence of diabetic foot symptoms. These symptoms can be varied and can include diabetic nerve pain including decreased sensation, increased sensation, weakness of foot muscles, and symptoms related to changes in the skin and toe nails.


Causes of Diabetic Foot Symptoms

The cause of these foot changes can be twofold: circulatory and neurological.

diabetic foot care


From a circulatory standpoint, peripheral vascular disease is the culprit. Diabetes can cause narrowing of the arteries, making it difficult for the body to deliver blood to the area. Limited blood circulation means less oxygen and nutrition makes it to the foot. Not only can this reduced circulation create symptoms, it can also reduce healing rate. This reduction in healing rate increases the risk for infection as cuts, blisters, and other foot wounds fail to heal. A diabetic foot sore or ulcer is the result of diminished healing secondary to peripheral vascular disease.


diabetic foot ulcer




Diabetic nerve pain, called peripheral neuropathy, is generally the source of foot pain related neurological changes. This condition affects the motor, sensory, and autonomic function of the nerves. Changes in nerve sensitivity can lead to both increased and decreased foot sensation. The feet can become super sensitive with even light touch, creating significant pain.

The opposite can also occur where the foot looses sensation. This can be dangerous as a simple cut or ingrown nail can go unnoticed secondary to a lack of pain. With skin changes, callus formations can occur, and nails can become thickened. Muscles of the foot can become weakened because of changes in neurological input. Such changes can affect the ability to walk and can negatively impact balance.


Prevention of Diabetic Foot Pain

What can be done to minimize the occurrence of diabetic foot pain? Here are some of the keys in foot pain prevention.

• Control your diabetes. Good blood sugar control is vital in minimizing many diabetes related conditions.

• Good nutrition helps to strengthen the immune system and fight off infection.

• Moderate exercise improves circulation and maintains muscle tone.

• Wear good shoes. Firm heel counters, wide toe boxes, and the use of orthotics can help to minimize foot stress.

• Do not wear shoes or socks that are tight or constricting.

• Avoid crossing your legs while sitting to keep blood flowing.

• Do not smoke as smoking itself reduces blood circulation.

• Limit alcohol consumption.


Diabetic Foot Treatment

Once you have started to experience the symptoms related to diabetic foot pain, there are a number of things you must do help with healing and protect against more significant issues.

• Communicate with your doctor regarding changes in sensation and structure of your foot.

• Follow your doctors’ recommendations regarding medication.

• Visually inspect your foot on a daily basis for blisters, ingrown toe nails, calluses, and other foot wounds.

• If a wound or blister does not heal within a couple of days, contact your doctor.

• Trim toe nails straight across and use a file to soothe out rough edges. If your toe nails have become thickened, do not cut them yourself. Rather, have a podiatrist cut them for you.

• Because nerve involvement can impact the strength of foot muscles, consider using orthotics to help provide support and minimize stress on problem areas.

• Keep feet clean by washing them daily with warm (not hot) water. Test the water temperature before cleaning your feet.

• Wear seamless socks to avoid the possibility of blisters.

• Wear shoes at all times to protect your feet from injury. Never go barefoot.

• Use lotion on cracked (not open) skin.


Medications and Neuropathy

Some medications can be helpful in reducing foot pain related to peripheral neuropathy. Neurontin and Lyrica can be utilized for nerve related pain. Other medications including antidepressants and anti seizure medication have also been shown to help reduce pain symptoms. Of course discuss all medications with your doctor to see if they may be effective for your nerve related foot pain.


Acupuncture

Another form of diabetic neuropathy treatment that is less utilized for diabetic neuropathy is acupuncture. Recent research has indicated that the use of acupuncture is effective in helping to reduce pain and improve function. Discuss with your doctor whether this treatment option is right for you.


Diabetic foot pain does not have to be in your future. Take measures now to keep your feet healthy. If foot symptoms consistent with diabetic foot pain do occur, contact your doctor and follow the recommendations to keep symptoms under control.




References

Int J Low Extrem Wounds. 2012 Feb 15. [Epub ahead of print]Custom-Made Orthesis and Shoes in a Structured Follow-Up Program Reduces the Incidence of Neuropathic Ulcers in High-Risk Diabetic Foot Patients.Rizzo L, Tedeschi A, Fallani E, Coppelli A, Vallini V, Iacopi E, Piaggesi A.

Diabetes Metab Res Rev. 2012 Feb;28 Suppl 1:8-14. doi: 10.1002/dmrr.2239.Advances in the epidemiology, pathogenesis and management of diabetic peripheral neuropathy.Tesfaye S, Selvarajah D.

Curr Diabetes Rev. 2011 May;7(3):208-20.Current concepts in the management of diabetic polyneuropathy.Ziegler D.

J Acupunct Meridian Stud. 2010 Jun;3(2):95-103.Fifteen-day acupuncture treatment relieves diabetic peripheral neuropathy.Tong Y, Guo H, Han B.


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