Diabetes and Your Feet

Why Do People With Diabetes Need to Check Their Feet?

Diabetes Blue CirclePeople with long-standing diabetes have an increased risk of developing certain conditions that may affect their feet.  Without proper care, these conditions may lead to severe complications such as foot ulcers, infections, and amputations.  In fact, diabetes is the leading cause of non-traumatic amputations in the world.

Neuropathy

Neuropathy is a loss of nerve function that typically begins in your hands and feet.  With poorly controlled diabetes, affected nerves can cause sensations of burning, tingling, and numbness.  Because of these abnormal sensations, you are more susceptible to foot injuries.  You may unknowingly stub your toe or step on something sharp.  Even excess pressure from your shoes can lead to an injury.

Blood Vessel Damage

The small and large blood vessels in your feet and legs can also be damage with prolonged diabetes.  This results in limited blood flow and poor healing.  If your foot is injured or develops an ulcer or an infection, it will be more difficult to heal due to the inadequate blood supply.

Check Your Feet Daily!

In addition to routine foot evaluations by a podiatrist, it is very important for everyone with diabetes to examine their bare feet at least once a day.  If you cannot see the bottoms of your feet, use a mirror.  Check for any cuts, sores, blisters, or pressure spots.  Also, examine the insides of your shoes for any sharp rocks or other debris, and make sure your shoes fit properly.

If you notice any changes to your feet, notify your podiatrist immediately.

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Treatments for Neuromas

The treatments for neuromas depend on how severe and how long the condition has lasted.  If started early, conservative treatments typically work well.  The first thing is to modify your shoes with padding or an insert (orthotic).  A small cortisone injection around the affected nerve can provide good relief.  Ice, massage, and physical therapy can help as well.

More aggressive treatments for neuromas, such as surgery, may be needed for severe cases.  However, a good alternative to neuroma surgery is a treatment with alcohol.  This procedure chemically destroys the affected nerve.  It requires a series of 4 to 6 injections around the neuroma every week.  This has a high success rate and is well tolerated.  There will be some numbness in the toes following either the alcohol injections or surgery, but this will diminish over time.

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What is a Neuroma?

Plantar Nerves - NeuromaDo you have a neuroma?  Do your toes burn or feel numb when standing or walking?  Does it seem as if you are walking on a marble or a rolled up sock?  If you have any of these symptoms, you may have a neuroma which is a painful, inflamed nerve in your foot.

This condition is also known as Morton’s neuroma after being described in 1876 by Thomas Morton, a surgeon from Philadelphia.  He suspected that a nerve was being compressed by the bones in the foot.  The most frequent location for this to occur is between the third and fourth toes.

Neuromas more commonly affect women (5:1 ratio) especially those who frequently wear high heels with narrow, pointed toes.  It can also occur in athletes who run on hard surfaces or place a lot of force on the front of their feet.  If not treated properly, the symptoms will become more persistent and gradually worsen.

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