Nerve Damage and Foot Problems

     Nerve damage is a contributing factor in foot problems as well as many other problems.  How and why do the nerves play such an important role?
     Nerve damage (Neuropathy) in the feet or poor blood flow increases the risk of various foot problems.  You ignore your feet and it will lead to serious complications, even amputation of the foot, for diabetics, as well as non-diabetics.  Excess sugar can injure the walls of tiny blood vessels (capillaries) that nourish your nerves, especially in the legs.  This can cause numbness, tingling and/or burning pain which usually begins at the tips of your toes or fingers and gradually spreads upward.  Poorly controlled blood sugar will eventually cause you to lose all sense of feeling in affected areas.  Damage to the nerves affect every area of your body.
     We are going to discuss only foot problems and how the nerves affect your feet in this diabetic newsletter.  The most common foot complication come from what we call Peripheral Neuropathy.  This is where the nerves are directly affected by the disease process.  A large percentage of complaints, by diabetics, is due to Sensory neuropathy.  There are three types of pheriphal neuropathy: sensory, motor, autonomic).
     Sensory neuropathy can show up as "sensitive pain" when covering up your feet while in bed and at the same time your feet may feel numb, cold yet burning, tingling or even a stabbing pain.  Relief is foremost in your mind.  The first thing you need to know is what your last few HbA1c tests readings have been.  Persistent high blood sugar will contribute to this type of pain.  The longer you have diabetes the greater chance you will have one or all three types of pheriphial neuropathy.  To get some relief from the pain you might want to massage the foot with a diabetic foot cream or use a foot roller.  When using any foot creams, of any knid, do not rub it between the toes!  They say Vitamin B preparations help.  You may have to consult with your doctor about it.  There are several prescription drugs that can help.
     Motor neuropathy contributes to another painful diabetic condition.  Nerve damage to the muscles can cause them to feel weak and achy.  The first muscles to be affected are usually in the thigh, other areas include the skin and small muscles of the feet.  This condition can cause walking imbalance which can lead to inflammation, rubbing to different areas of the foot by your shoes, callouses, and so forth; all causing pain.  You might want to get some supportive shoes with foot support inserts.  Try doing foot exercises, massage the foot and you may try some foot rolling devices to help keep those muscles and joints from becoming stiff.
     Autonomic neuropathy affects nerves that are not under our conscious control.  With this condition, the sweating mechanism is altered.  Thickened dry cuticles and nails, as well as dry, stiff cracked skin can lead to a buildup of thicker callouses and more pain.  You are more likely to have bacterial and fungal infection.  You could try toenail oil and foot conditioning creams - that often helps.  The longer you have diabetes the more likely you will have all three types of neuropathy.  Take it from someone who knows because I have all three types and it is immensely painful.
     Circulation problems in the foot of a diabetic are caused by the affect of high blood sugars on the arteries, capillaries, and veins.  Arteries take fresh blood from the heart.  This fresh blood nourishes and provides oxygen to the tissues.  The blood enters and leaves the tissues through capillaries and goes back to the heart to get refreshed with oxygen and nourishment by way of the veins.  Capillaries are known to get thick and stiff becoming inefficient in delivering the oxygen and nutrients to and from the tissues.  The veins can get swollen, causing pain.  When the arteries cannot handle the blood flow little channels are created to direct the blood over to the veins instead of trying to push the blood through closed arteries.  When there is more blood flow than the veins can handle they become full and the valves become broken.  When this happens, blood pools in the feet and legs and can leak out into the skin, creating ulcerations (open sore, other than a wound); very painful.  When blood flow to the feet is partially or totally blocked, for whatever reason, the tissues start to starve for oxygen and proper nourishment - leading to diabetic complication.
     Anytime there is a break in the skin bacteria, fungi, and other pathogens can enter and cause an infection.  Your feet provides an ideal environment for bacteria and microorganisms to grow when you are wearing shoes because the foot is kept warm and often moist.

Take Care of Your Feet

1.  Inspect the tops, sides and bottom and between the toes of your foot daily
2.  Check for changes and/or breaks in the skin.
3.  Look for redness, swelling, broken skin, sores or bleeding
4.  Check for any pus-like discharge.
5.  Is the skin pale or blue looking?
6.  Are there changes in foot temperature?
7.  Do you have tingling or numbness?
8.  Keep your feet clean and dry, especially if you have sweaty feet.

     When checking your feet, you may need a mirror to see the bottom.  Any time you notice an injury, wound, ulcer, or sore on your feet, treat it immediately to prevent infection.  Untreated ulcers can take months to heal, causing infection and can lead to amputation.
    There are millions of diabetics and a good portion of them will develop foot problems.  The risk of an amputation is greater if you have diabetic neuropathy or circulatory problems.  Always consult with your doctor when you have foot problems.
     I have kept my blood sugar under control for over fifty years, but time takes its toll on your body eventually, not matter what you do.  You may say to yourself, "why bother" if it is going to happen anyway.  Keeping your blood sugar under control will delay and/or prevent many diabetic complications.  You may not mind being sick and/or being in pain because it gets you a lot of attention, but I hate it.  As I always say "It is your choice" to do something or ignore the problem.  Whatever you decide to do just remember it was your choice so blame yourself and not everything or everyone else! I know this sounds rather rough and I don't mean to hurt anyones feelingsbut sometimes truth hurts.