Diabetes and Neuropathy

Do you have numbness and/or tingling in your feet? You may be suffering from peripheral neuropathy. Other phrases or terms describing this are, neuropathy of the foot, numb foot, peripheral neuropathy, diabetic neuropathy, idiopathic neuropathy, insensitivity, the neuropathic foot,  or extremity neuropathy, loss of protective sensation or LOPS.

Neuropathy is commonly associated with people with diabetes, however you can have neuropathy without having diabetes.  Comfort Shoe Specialists of St. Louis have extensive experience and are considered the “go to” facility for preventive and corrective care of Diabetic and Neuropathic Patients.

Neuropathy describes the pathological changes of the peripheral nerves, common to the lower extremities. Neuropathy can leave the feet insensitive to pain. Without warning signals of pain, the feet are in danger of cuts, blisters, or thickened calluses that can lead to ulcers.  This is called LOPS or Loss of Protective Sensation.  Because of the loss of protective sensation or LOPS, a person will continue to ambulate, unaware of an ulcer or developing sore. This is dangerous since an open wound can be a portal for bacteria, leading to infection.

According to the Center for Diseases, 15% of all people with neuropathic feet will develop foot ulcers.  These neuropathic foot ulcers can become infected. Complications from infections may lead to amputations.  Aggressive intervention from qualified physicians is important to save the foot and limb.

IMPORTANT to healing is reduction in pressure.  Either complete non-weight bearing or walking casts applied by specialists in diabetic wound healing is generally the course of treatment combined with medications.  AFTER the wound is healed, pedorthic modalities are needed to prevent re-ulceration, callus, and sores.

Comfort Shoe Specialists of St. Louis are experts at preventing reulceration with these Pedorthic Problem Foot Solutions:

  • Properly fitted footwear, respecting the shape of the Diabetic Feet
  • Accommodative or functional orthoses, depending on the activity and risk level
  • Custom molded footwear, generally boots covering the ankles, or chukka height
  • Diabetic Socks such as Thorlo Medds or Aetrex Copper socks
  • Anastasia Cream

Employing these modalities as soon as possible is KEY TO STAYING HEALED.  This may be a lifetime strategy since there is a propensity for reoccurence.  At Comfort Shoe Specialists, footwear for every need is available and fitted properly.  From slippers with support to walking to dress wear, Comfort Shoe Specialists can fit from the extensive inventory of more than 30 comfort shoe lines:  Finn Comfort from Germany, Aetrex, Dunham, New Balance, Brooks, Saucony, PW Minor, Aravon, MBT, Ryn, Haflinger, Kumfs Ziera, Drew, Soft Spots are some of the brands available.

80% of all amputations can be prevented with foot care and properly fitted shoes and orthotics.  Pedorthists are the shoe fitting experts of the medical field.  If you have neuropathy, pedorthic care is KEY to foot health.  Every diabetic should have a pedorthist on their foot care team.

Insurance companies will sometimes repay a portion of the cost of shoes and orthotics if you have diabetes and neuropathy.  Unfortunately Medicare coverage has low reimbursements and seldom covers footwear that is truly appropriate.

Who to see for help:

  • Primary physician
  • Endocrinologist
  • Orthopedist
  • Neurologist
  • Podiatrist
  • Diabetic educator
  • Certified pedorthists at Comfort Shoe Specialists in St. Louis
  • Neuropathy support groups

A simple daily routine will lessen the possibility of foot ulcers and amputations.  Daily foot care is quick and easy:

Wash and dry your feet thoroughly including between your toes every day. Inspect your feet every morning and evening.
If you have trouble seeing the bottom of your feet, put a mirror on the floor near your bed, or have someone else check your feet.

Look for cuts, blisters, or redness.

Calluses are a warning sign that an excessive amount of pressure is being put upon that area of your foot. The majority of ulcers begin as a callus.  The most common sites are the hallux (big toe), or metatarsal heads (ball of the foot).  Consult with a pedorthist to find ways to reduce this pressure. If there are any openings or blood under the skin surface, see your physician immediately.

Wear white socks as much as possible and avoid socks with large seams. Socks with seams can be worn inside out.
Wear shoes with lots of room. Tight shoes can cause pressure that can lead to an ulcer.  Have a Certified Pedorthist check the fit of your shoes. Look for foreign objects before putting your shoes on.

The do not’s:

  • Do not smoke, smoking constricts small blood vessels and decreases blood flow.
  • Do not drink alcohol in excess.
  • Do not go barefoot.
  • Do not soak your feet.
  • Do not use adhesive tape directly on skin.
  • Do not wear shoes without socks, socks are the first barrier for the feet. Therapeutic socks are available that help protect your feet.
  • Do not wear thongs.
  • Do not sleep with your ankles crossed.
  • Do not cut calluses or corns, have foot care specialists take care of them.
  • Do not trim your own toe nails, see a podiatrist or pedicurist.
  • Do not walk barefoot on hot surfaces like sand or concrete around pools.
  • Do not wear slip on shoes.

The Do’s: Great things for your feet!

  • Take a daily walk, walking increases the blood flow to your feet, which lessens the risk of ulcers and infections. However, if you have an ulcer, stay off your feet.
  • Stretch twice a day, stretching increases the circulation to your feet and feels good too!
  • Touch both of your feet, if one feels “HOT”, see your physician immediately. This could be a sign of infection or broken bones.