By Dr. Mayhar Okhovat, M.D.
Although foot pain may seem like a simple symptom, for people with diabetes it could be an alarming sign indicating significant nerve damage. Foot pain and numbness are the most common symptoms of diabetic neuropathy – a nerve disorder associated with diabetes. People who have diabetes are at risk of developing nerve damage because high levels of blood sugar can impair small arteries in the feet, preventing oxygen and nutrients from reaching the far ends of the nerves. If blood glucose levels are not controlled appropriately, they can overtime lead to a progressive degeneration of the nerves.
Early symptoms of diabetic foot pain are a feeling of burning, tingling, and numbness in the feet and legs. If these symptoms are neglected, the nerve damage can progress and lead to advanced complications, such as loss of coordination and muscle weakness. Subsequently, loss of coordination further complicates the condition, by increasing the risk of falling, which could lead to fractures.
An additional complication from diabetic neuropathy derives from infections originating from simple cuts or scrapes, that might go unnoticed for long periods of time. Individuals with diabetic nerve damage experience loss of sensation in the feet, and may not feel the initial injury. If the infection is not treated properly and in a timely manner, it could set in, and propagate. Once infections become established, there is a higher likelihood of gangrene (tissue death) development, and the need for surgical treatment to stop the spread of the infection.
The good news is that all of these complications can be prevented! If a person has diabetes, it is very important to routinely visit a doctor for an evaluation and management of blood sugar levels. If any symptoms of diabetic neuropathy are identified, a neurologist should be consulted immediately for proper diagnosis, and to develop a customized pain management treatment.
As a neurologist, I pursue a full diagnosis that includes a simple blood test, to rule-out any other possible factors such as B-12 deficiencies, and thyroid disorders. I also perform a nerve conduction test to formally evaluate the extent of the nerve damage.
The treatment I recommend is comprehensive, but requiring simple steps:
- Adopt a healthy diet to control blood glucose levels. This is a crucial to preventing further nerve damage.
- Start a daily physical routine. A quick 30-minute walk helps increase blood circulation, aiding in transportation of essential nutrients and oxygen to the nerves.
- Start a pain management treatment. For patients to whom medication is not recommended, we provide other effective therapies for pain relief, such as Spinal Cord Stimulation.
- Work closely with a podiatrist. This will guarantee proper feet care, while preventing any severe infections from happening.
- In cases of loss of coordination, I refer to a physical therapist for gait-training exercises. These help them regain balance.
Fortunately, diabetic neuropathy can be prevented and managed with these simple steps. It is fundamental that people with diabetes work closely with their doctors to control blood glucose levels, maintain proper care of their feet, exercise and manage their pain in order to keep a healthy and active lifestyle.
Dr. Mahyar Okhovat, M.D., is a neurologist and pain management specialist at Pain Management and Injury Relief (PMIR). Practicing since 2003, Dr. Okhovat specializes in diagnosing and treating nerve damage and pain disorders related to nerve conditions.