Our nervous system includes the brain, spinal cord and a complex network of nerves. When these nerves become damaged, it can lead to dysfunction, such as neuropathy, which can cause pain, numbness, tingling, swelling, or muscle weakness. While neuropathy can have various causes ranging from injury to autoimmune disorders, one of the most common is diabetic neuropathy, which affects about 60% to 70% of people with diabetes.
While some patients experience numbness, painful diabetic neuropathy occurs when the nerves aren’t completely numb. Imagine an exposed electrical wire sending impulses into soft tissue, causing sharp, shooting pain throughout the foot and up the leg.
While there is risk for anyone with diabetes to develop painful diabetic neuropathy, it most commonly develops in those who struggle to control their blood sugar, have high levels of blood fat and blood pressure, or are overweight.
Podiatry: A Step Ahead
Since the feet have lots of nerve endings and are extremities in the body’s blood circulation, they can be important indicators when dysfunction starts to occur. For this reason, podiatrists are often the first to discover and treat many ailments, including diabetes. According to Dr. Christos Kyrou, a board-certified podiatrist at Premier Medical Group, he and his colleagues are trained to identify and care for potential issues early on.
“People always worry about, [losing a] toe, but to get to that point where the circulation is that poor, takes a while when you’re diabetic,” Dr. Kyrou said. “Typically what rears its ugly head initially is neuropathy.”
Dr. Kyrou explains that patients who experience numbness from their diabetic neuropathy risk stepping on something without realizing it, which can lead to calluses and eventually ulcers.
“We’re at the forefront of finding these things and then treating them accordingly,” he said.
With painful neuropathy, much of the focus for treatment is on pain management since ongoing discomfort can lead to additional health issues. Dr. Kyrou says many patients will experience the worst symptoms of painful neuropathy when they’re trying to rest.
“Patients come in and they say ‘I can’t sleep at night’ or ‘Watching T.V. or reading a book, my feet kill me’,” he said. “It keeps them awake. They have poor sleep habits, which leads to depression, and it is just a spiral.”
Hopeful Treatments
Luckily, when it comes to painful neuropathy, there are a number of different options that specialists like Dr. Kyrou can recommend depending on patient needs and health history. Oral medications and cortisone injections are options that can help alleviate pain in the short term. In some cases, surgery can free up the nerves. A recent breakthrough, Qutenza®, an 8% capsaicin topical cream, shows great promise.
“Basically, you wrap the patient’s feet and it burns the tops of the nerves, kind of like burning crops and the new crops grow back stronger,” Dr. Kyrou said. “Similarly, Qutenza® affects the superficial nerves and allows them to come back stronger after a few treatments.”
Dr. Kyrou says that while patients who are treated with Qutenza® typically need a few rounds of application, care plans differ from person to person and are solidified after evaluating the results from the initial 3 to 4 months of treatment. In general, he says patients have responded well to the topical approach.
“There’s not a lot of options out there,” he said. “That’s why people are very excited about Qutenza®. I’ve had some good success with it already.”
A Holistic Approach
Although they do help with many of the symptoms, medication and surgery aren’t the only things that can help bring patients relief. There are several things you can do in the long and short term to help improve your diabetic neuropathy.
Tip #1—Control Your Diabetes
Take control of your diabetes now. If it’s been out of control for a while and then you manage it, it can take the nerves a long time to heal. Reducing your sugar intake, eating healthy fruits and vegetables, monitoring your blood sugar levels throughout the day, and losing any extra weight, can all help improve your diabetic health and set you on the path to pain relief.
Tip #2—Diabetic Shoes and Inserts
Invest in diabetic inserts and/or shoes to help distribute pressure evenly across the sole of the foot. The cushioning helps reduce painful, high-pressure points by preventing foot strain. It also minimizes the risk of pressure sores, ulcers, or calluses forming and going unnoticed.
Tip #3—Exercise Three Times a Week
Regular exercise, such as walking three times a week, can lower neuropathy pain, improve muscle strength, and help control blood sugar levels. It’s a win-win for diabetic neuropathy. If your painful neuropathy prevents you from putting pressure on your lower extremities, consider a pool-based exercise like swimming.
Connected Care Working for You
Another key to managing diabetic neuropathy is connecting with specialists who can work in tandem with your podiatrist to treat any comorbidities. Premier Medical Group, for instance, offers 12 specialties under one roof.
With diabetes, there may be concerns about renal function. If you have an infection, a full dose of antibiotics might be necessary. Your podiatrist will collaborate with a nephrologist to develop a tailored treatment plan. They will also work with internal medicine specialists.
“We often identify issues first and then refer the patient to the appropriate specialty within our group that works in conjunction with podiatry,” Dr. Kyrou said.
This collaborative approach benefits the patient, podiatrist, and specialists, all working towards a positive outcome.
To learn more about Premier Medical Group’s podiatry specialty or diabetic neuropathy, visit our website https://www.premiermedicalhv.com/specialties/podiatry/ or contact Dr. Kyrou at (845) 231-0310.