What is peripheral neuropathy?
Peripheral neuropathy is damage of the peripheral nerves. Your peripheral nerves are the nerves that travel to your arms and legs. When the nerves are damaged, they don’t function properly. People with peripheral neuropathy have decreased or abnormal sensation in their toes and sometimes fingers. Sometimes they develop problems moving these parts of the body as well.
Everyone with symptoms of peripheral neuropathy of the feet should see a podiatrist. Podiatrists are doctors who are specially trained to preserve the health of the feet.
In the United States, the most common cause of peripheral neuropathy is diabetes. According to the American Diabetes Association, 60 to 70% of people with diabetes will develop neuropathy within their lifetime.
Other causes of peripheral neuropathy include:
-Certain medications including some chemotherapy drugs.
-Heredity. Some people have a family history of peripheral neuropathy
-Advanced age. Peripheral neuropathy is more common as people age
-Arthritis. Certain types of arthritis especially involving the back can cause peripheral neuropathy.
-Alcoholism. According to the US National Library of Medicine, up to half of all Long term heavy alcohol use years develop peripheral neuropathy.
-Neurological disorders. Certain neurological disorders including spina bifida and fibromyalgia are associated with peripheral neuropathy.
-Injury. Acute injury to the peripheral nerves may also cause peripheral neuropathy.
The most common symptoms of peripheral neuropathy include burning, numbness, tingling, or shooting or stabbing pain in the toes and or fingertips. Any change in sensation in the fingers or toes or feet may be a symptom of peripheral neuropathy. Be sure to report any abnormal sensations to your doctor. These sensations may be the first sign of another problem, such as diabetes.
If you have peripheral neuropathy, it is important to inspect your feet regularly. Because decreased sensation may develop gradually, you may not notice an injury or infection. Someone who has diabetes and peripheral neuropathy with loss of protective sensation, for instance, could step on a tack without noticing it. Pain is a gift. It lets us know there is a problem. Regularly inspect your feet so you can note any injuries or infections or any changes and seek appropriate medical attention immediately
If you’re unable to properly inspect your own feet, ask a family member or friend to help you, or use a large mirror on the floor in a well-lit room to see the bottoms of your feet. It’s absolutely essential that any injuries are caught and treated promptly. Otherwise, an infection can develop and progress.
People with peripheral neuropathy should wear properly fitting shoes and avoid walking barefoot to prevent injury. If you have diabetes, it’s important to control your blood sugar as well, because out of control blood sugar leads to increased nerve damage. Take your insulin or medication as prescribed and follow the recommended diet.
Diagnosis and treatment
A podiatrist, family physician, internist, or physician who specializes in diabetes can diagnose peripheral neuropathy. The diagnosis is made on the basis of a physical exam, health history, and your reporting of symptoms. The doctor may order a blood test to check your blood sugar level because high blood sugar levels and diabetes are an important cause of peripheral neuropathy.
There is no known cure for peripheral neuropathy. The goal of treatment is to slow the progression of the disease, to maintain foot health, and to decrease pain (if present) and improve the quality of life.
Your podiatrist may prescribe oral medication to help with symptoms. He or she will also perform a thorough foot check to look for any injuries or infections and will teach you how to do the same. Your podiatrist will also show you how to take care of your feet at home. People who have peripheral neuropathy should have their feet examined by a podiatrist at least once every year.
Prevention and parting advice
The most important thing any medical professional will tell you is to control your blood sugar. A healthy diet increased physical activity, and well-controlled blood sugars, along with regular visits to your podiatrist and a diabetic doctor may help to avoid complications of diabetes such as peripheral neuropathy.
If you or someone you know may have peripheral neuropathy, get them evaluated including a good foot and lower extremity exam. We can help.
Walter G. Warren, DPM, CPed