Have you ever wondered how someone who had numbness could also feel pain?
Isn’t one incompatible with the other? Many diabetic people tell me that their feet hurt, but at the same time, they step on something sharp and do not feel it? The sensation is that you can’t feel much, but still get a painful “pins and needles” sensation. It’s a sensation no one enjoys, therefore it is definitely a good idea to seek out the care of a doctor to help reduce those symptoms.
Diabetic patients are at risk for many medical conditions, such as heart disease, kidney disease, eye problems, and foot problems. The disease leads to damage to the blood vessels and to the nerves over time. The foot can be painful, deformed, have balance problems, cause wounds, and even require amputation.
Nearly one in five diabetics suffer from diabetic nerve pain. The pain is often described as painful and stabbing. As time goes on, if the diabetes isn’t properly controlled, this condition usually does not go away. Pain medication doesn’t typically treat the nerves that cause pain. In some cases, Advil might be used to treat painful feet, but this medication doesn’t seem to be very effective. A few medications show promise, but they don’t always relieve the symptoms. Among them are some antidepressants, anti-seizure medications, and even a cream containing hot pepper oil (capsaicin).
As they age, patients with neuropathy may experience balance issues due to being unable to feel their feet or legs, together with pain or through deterioration of a portion of their brain, as in dementia, or through side effects from medication. Physical Therapy, bracing, and assistive walking devices such as a can or walker/Rollator may be needed to help prevent falls and injury.
Deformities of the feet can also result from neuropathy. In the case of severe nerve damage in the foot or leg, the muscles may weaken, leading to overpowering of the small muscles of the foot, resulting in hammer toe deformities. Further, patients have the possibility of developing a rare, but devastating, foot deformity called the Charcot deformity. It is estimated that 35% of diabetics suffer from the Charcot deformity. Charcot’s deformity may manifest as painful, hot, swollen feet that appear red, hot, or infected. This may result in softening of the bone in that area because of increased blood flow, which can weaken, deteriorate, and cause major deformity. In addition to casting, bracing, and non-weight bearing, healing can be helped by reconstruction to reduce the risk of ulceration, amputation, and further deterioration.
Diabetic Foot Ulcers (DFUs)
There is a possibility of foot wounds because of reduced pain and pressure sensation as well. Approximately 34% of diabetic patients develop diabetic foot ulcers (DFUs). In many cases, wounds are effectively treated by surgery, dressings, offloading devices, and specialized shoes. However, advanced treatment may sometimes be required. hospitalized. There is a very high risk that the wound will recur even after it heals because the wound is just a symptom of numbness and deformity. In some cases, surgery may be needed to rebuild the wound area because the neuropathy isn’t reversible and bracing options are limited.
The possibility of infection increases when there is a wound. Our skin protects us against infection. It keeps the good guys in and the bad guys out like a castle wall. An open wound increases the chances of germs invading and causing infection. Wound care, dressings, and antibiotics can often treat most infections in the office, but some may require hospitalization, surgery, or even amputation. When an individual has severely infected feet, they may require amputation to save their lives, remove infected tissue, or save a limb. Up to 20% of diabetic foot ulcerations may require amputation.
Considering this, how can we decrease the risk of such issues occurring?
These are some of the recommendations made by the American Diabetes Association:
- Manage your diabetes well.
- Lose weight and stop smoking as part of a lifestyle change.
- Be sure to check your cholesterol and blood pressure regularly.
- Never take a bath or a shower at too high a temperature.
- Cleanse and dry your skin regularly.
- Avoid soaking your feet.
- You should moisturize your skin after bathing (but don’t put it between your toes).
- Make sure your feet are free of cuts and sores every day.
- Think about special therapeutic shoes covered by Medicare and other insurances (e.g., broad, flat shoes that fit well).
- Before wearing your shoes, check for foreign objects.
- It is not a good idea to trim your own nails, corns, or calluses.
- You should see a podiatrist regularly if you have foot or ankle problems.
In order to reduce your risk of suffering from diabetic neuropathy, be sure to see your doctor regularly. Keep in mind the old saying: Prevention is better than cure, an ounce at a time.