Tips Search Results
- Why do my feet burn at night when I'm trying to go to sleep?
- Why do I have leg pains when I walk?
- What will help heal the ulcers on my feet?
- Since I don't want to end up with foot problems, how do I know whether my athletic shoes are okay?
- Since I can't reach or see my toes very well, how can I adequately care for my feet?
- Should I be concerned about a small red blister on my foot from walking in new shoes?
- If my feet don't hurt, should I still check them every day?
- I've had a lot of trouble with my feet. They used to hurt and burn, but now I hardly feel them at all. Are things getting better?
- I'm worried about this sore on my foot that the doctor called a foot ulcer. What is a foot ulcer?
- How can I check my feet every night like I am supposed to when my eyesight is so bad?
Why do my feet burn at night when I'm trying to go to sleep?
The nerves in your feet have been affected by your diabetes. "Painful neuropathy" is a term used to describe diabetic feet that are painful without an obvious cause. People with painful neuropathy usually describe a "pins and needles" sensation or a dull burning in the feet and legs that is more apparent at night (when there are few other things to distract you). You may also experience frequent leg cramps. Because painful neuropathy is difficult to cure once it is established, the best treatment is to prevent it by controlling your blood glucose. These nerve problems occur more frequently in men and in people who have had diabetes for many years, are tall, smoke, or have poor blood glucose control.
If you already have painful neuropathy, there are treatments available that provide some relief for about 50% of people. These treatments include the use of antidepressant medicines, certain heart medications, and creams made from chili peppers (capsaicin). These creams are rubbed on the feet to desensitize them. If you do not get relief from one of these treatments, the good news is that the pain from this neuropathy often lessens over time.
Why do I have leg pains when I walk?
Sore muscles can hurt when you walk, but pain can also be a symptom of poor circulation. If you have diabetes or other cardiovascular risk factors such as high blood pressure, your doctor should evaluate the pain. You may have intermittent claudication or poor blood flow. Intermittent claudication feels like cramping or aching. The pain occurs because the blood vessels leading to the lower leg have narrowed, and the muscles cannot get enough blood. The pain usually occurs after you walk a short distance. Your physician may recommend that you walk until you begin to feel pain, stop to rest, and walk some more. You gradually increase the distance walked and improve circulation to your leg, relieving the pain.
Leg pain can also be due to sore muscles. If you are out of condition and try to walk quickly, you may feel discomfort in your legs. You may be stretching muscles that are not used to stretching. If you run or exercise vigorously, you can get shin splints, or tendonitis on the front of the lower leg. Walk more slowly or do a different activity for a few days until the soreness goes away.
What will help heal the ulcers on my feet?
Healing requires good foot care from your health provider including antibiotics and removal of the dead tissue. You do your part by not walking on the foot, keeping it clean and dry, and following your health care team's guidance.
A new medication called Regranex gel (becaplermin) has recently been approved by the FDA for use on foot ulcers that have adequate blood vessels going to them. This medication enhances new blood vessel formation and healing of your ulcer. It is made by recombinant gene technology and not directly from blood products and, therefore, is probably safer than if it were made directly from blood.
If you use this medication, there are several steps you should consider. First, before applying the gel, your ulcer must be clean and all nonliving tissue removed by your physician or podiatrist. Healing may begin within 2 weeks and be completed in 10 weeks.
Studies in patients with diabetes show that Regranex is better than using good ulcer care alone. Regranex healed approximately 50% of the ulcers compared to 30–40% healed with standard care alone.
Unfortunately, this medication is very expensive. Hopefully, the price will drop in the future. This medication may give you the extra assist you need, but your foot still requires careful care and close follow-up with your physician.
Since I don't want to end up with foot problems, how do I know whether my athletic shoes are okay?
It is best to buy shoes from a store that has experienced personnel who know how to measure your feet and fit your shoes correctly. A "certified pedorthist" is a specialist in fitting shoes and inserts for a proper fit with no pressure points. When you get new shoes, wear them for only a few hours, and then check your feet for any red areas or sore places where the shoes might be rubbing.
Even well-fitted shoes may have a seam or area that rubs on your foot. Get padded athletic socks that protect your feet from blisters. Athletic shoes have become very high-tech these days and have different features depending on the exercise you are planning to do. It is a good idea to get the ones with extra cushion because this reduces the wear and tear on your joints. Look in the Yellow Pages for stores that specialize in athletic shoes or have a pedorthist on staff.
Since I can't reach or see my toes very well, how can I adequately care for my feet?
Many people with diabetes have difficulty seeing their feet well and trimming their toenails. The reasons for this problem are many, including poor eyesight, obesity, arthritis, back pain, and other medical conditions that may prevent you from leaning over toward the floor. Have a member of your family examine your feet once a day for sores and nail problems. We recommend that most people with diabetes do not try to cut their own toenails, but go regularly to a podiatrist for routine foot care.
Podiatrists are trained to provide good foot hygiene and nail care. They can be located in the Yellow Pages under Physicians & Surgeons, DPM (Podiatric), or ask your health care team for a referral. Good foot care is extremely important to your good health. It may save your feet.
Should I be concerned about a small red blister on my foot from walking in new shoes?
Yes! You may look at a small blister and think that it is nothing serious, but it can be. If it breaks, this blister in the skin can allow germs into your foot. These germs can cause not only an infection in your foot, but also in the bone. Infections in the bone are very difficult to treat and often are the cause of amputations.
What you should do right now is to wash your feet carefully in gentle soap and water and dry them thoroughly. Then put a small amount of antibiotic ointment on a dressing and cover the wound. Next, call your health care team and let them know that you have a sore on your foot. Your health care team will want to see your foot to decide whether you need to get started on an antibiotic medication.
Finally, quit wearing the shoes that caused the blister. Purchasing a comfortable pair of shoes is one of the best investments you can make. The shoes you wear must fit your feet. Careful attention can prevent future problems.
If my feet don't hurt, should I still check them every day?
You should examine your feet at the end of each day to be certain that there are no sores, cuts, or areas where your shoe is rubbing against your foot. People with diabetes may lose pain sensation in their feet, so they may develop ulcers and open sores and not notice it because they can't feel the pain.
Without medical attention, sores may continue to be irritated and not heal properly. Although your health care team should examine your feet at each visit, you need to be on the lookout for any small areas of redness or bleeding. It is essential that your shoes are comfortable and fit well.
Special shoes can be made for you if your feet are difficult to fit. Always wear socks or stockings to provide padding between your feet and your shoes. The longer a patient has diabetes, the more common foot problems are. Preventing foot sores is much easier than trying to heal them.
I've had a lot of trouble with my feet. They used to hurt and burn, but now I hardly feel them at all. Are things getting better?
It sounds as if you have neuropathy, or nerve damage, which is common in people who have had diabetes for many years. As nerve damage gets worse, people often notice the very symptoms you describe: lots of burning and pain at first, but then much less as time goes on. Many times people say they no longer feel their feet at all. While pain can be awful, when you lose feeling in your feet you also lose an important warning sign. Pain has a purpose. If your foot hurts when you step on a tack, for instance, you will quickly remove the tack and treat the wound. But when you don't feel pain you lose the protection it provides. You don't feel anything when you step on the tack, so unless you frequently check your feet, it can take a long time for you to realize you're in trouble and to take action. That delay can lead to infections, and infections can be especially hard to clear up when you have diabetes. So going from painful feet to feet you can't feel is not a good thing. Your feet hurt less, but that means you need to find other ways to protect them.
I'm worried about this sore on my foot that the doctor called a foot ulcer. What is a foot ulcer?
An ulcer is an open sore. People with diabetes are more likely to get foot ulcers for three reasons. First, many people with diabetes have lost some feeling in their feet because of nerve damage, so they might not notice tiny cuts or cracks in the skin that could lead to serious problems. Second, many people with diabetes also have circulation problems, so it is hard to get oxygen, white blood cells, and antibiotics to the wound to help it heal. That's why many people with diabetes find that any wound, even the smallest one, can take a really long time to heal. In fact, without an adequate blood supply, foot ulcers may never heal. Finally, high blood glucose levels also hinder healing.
Foot ulcers can appear any place on your feet, though most often they are on the bottom or side of your big toe and on the ball of the foot. Prevention is essential. Pamper your feet. Keep them clean, dry, and protected from injury. Watch them like a hawk. If you see any sign of an open cut or sore, no matter how small, contact your health care provider immediately. You might also ask for a referral to a podiatrist, someone who specializes in treating foot problems.
How can I check my feet every night like I am supposed to when my eyesight is so bad?
Unfortunately, you are not alone. As important as it is to check your feet every day, especially if you have any loss of feeling, many people have trouble checking themselves because of back, vision, or other problems. You may be able to rig up a system that lets you see your feet. Shining a flashlight on your feet or placing a lamp on the floor right by your feet while you check them could help. If you have trouble seeing the bottom of your feet, place a mirror on the floor and hold your foot over it.
If you still aren't able to check your feet yourself, ask family members or friends to help. It's hard to ask for help, but if there are people in your life who love you and have the time, it's worth asking. They might even appreciate the chance to do it. Talk to your health care provider about other ways to help your feet last a lifetime.
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