Peripheral Neuropathy

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Symptoms of peripheral neuropathy

Look at the list below and make a note about any symptom you have. Bring this list to your next office visit.

Tingling

• My feet tingle.
• I feel "pins and needles" in my feet.

Pain or increased sensitivity

• I have burning, stabbing or shooting pains in my feet.
• My feet are very sensitive to touch. For example, sometimes it hurts to have the bed covers touch my feet.
• Sometimes I feel like I have socks or gloves on when I don't.
• My feet hurt at night.
• My feet and hands get very cold or very hot.

Numbness or weakness

• My feet are numb and feel dead.
• I don't feel pain in my feet, even when I have blisters or injuries.
• I can't feel my feet when I'm walking.
• The muscles in my feet and legs are weak.
• I'm unsteady when I stand or walk.
• I have trouble feeling heat or cold in my feet or hands.

Other

• It seems like the muscles and bones in my feet have changed shape.
• I have open sores (also called ulcers) on my feet and legs. These sores heal very slowly.

Diagnosis

Foot exams. Your health care provider should look at your feet at each office visit to check for injuries, sores, blisters or other problems. As a reminder, take off your shoes and socks when you're in the exam room.

Have a complete foot exam once a year. If you already have foot problems, have your feet checked more often. A complete foot exam includes a check of the skin on your feet, your foot muscles and bones, and your blood flow. Your provider will also check for numbness in your feet by touching your foot with a monofilament. It looks like a stiff piece of nylon fishing line or a bristle in a hairbrush.

Other ways to check your nerves include using a tuning fork. It may be touched to your foot to see if you can feel it moving.

Nerve conduction studies and electromyography (EMG). If the doctor thinks you might have nerve damage, you may have tests that look at how well the nerves in your arms and legs are working. Nerve conduction studies check the speed with which nerves send messages. An EMG checks how your nerves and muscles work together.

Treatment

To treat nerve damage, you will need to keep your blood glucose levels in your target range, manage your pain and protect your feet. Many people get depressed when they have nerve damage and may need medication for depression as well as counseling.

Medications. Medications to relieve pain and reduce burning, numbness and tingling are available. Some of these are known for their use in other conditions but they still seem to help those with nerve damage. Choices include medications also used for:

• seizure prevention
• depression
• pain

Other treatments for pain. There are a number of other ways to help with the pain:

• Capsaicin (cap-SAY-sin) cream made from hot peppers can be rubbed on the skin
• A TENS unit blocks pain signals
• Relaxation training, hypnosis or biofeedback
• Acupuncture
• Photo energy therapy