1 What is neuropathy?
Neuropathy is the gradual loss of nerve function due to diabetes. The most common and significant change is loss of feeling, or touch sensation in the feet and legs. With neuropathy you may not feel touch or pain. Occasionally patients may present with symptoms and signs of neuropathy and investigation show that they are diabetic. The most dangerous thing about neuropathy is the absence of feeling, because this allows any injury to go unrecognised.
2 How do I know if I have neuropathy?
Neuropathy comes on slowly. It is sometimes hard to be aware of something you cannot feel. A clinical examination by your orthopaedic foot and ankle surgeon will be able to quantify and neuropathy. This is usually done using a special filament called a Semmes Weinstein filament, which is pressed against the skin to see if you can feel it. Occasionally other investigations may be initiated.
3 If neuropathy causes loss of feeling, why do my feet sometimes hurt or tingle?
Neuropathy can cause the nerves to “go haywire”, or transmit impulses that you experience as numbness, tingling, shooting pains, burning sensations, pins and needles, electric shock sensations or any combination of the above. In other words the nerves are all messed up.
4 Do all diabetics get neuropathy?
The likelihood of getting neuropathy increases with age and the longer you have diabetes, the increased chance you have of developing neuropathy. The severity of any neuropathy does not necessarily correspond to the severity of the diabetes. So even if you have very mild diabetes that you think is well controlled you are not immune from developing a neuropathy.
5 What can happen to my feet if I have neuropathy?
You can injure your feet without knowing it. So, for example you may let a cut or a sore of the foot get out of hand because you are unable to feel it and may not appreciate the extent of it or even recognise that you have it in the first place. A severe infection could then develop which could be limb threatening in the worst case scenario.
6 What other ways can neuropathy hurt my feet?
If you wear a pair of poorly fitting shoes, blisters or open sores (ulcers) can develop. At first these can cause small problems but they can progress to become much more severe. Walking barefoot is dangerous with decreased foot sensation.
7 Does this mean that I should seek medical attention if I have a small foot injury or minor infection?
Yes you should be checked out. A small area of swelling or redness may seem very minor and may not hurt at all because of the neuropathy. It can however represent a significant problem or injury that requires treatment to prevent a serious complication developing.