Nerves are the pathways for messages to be sent to and from the brain about pain, temperature and touch. Nerves carry messages to your muscles telling them how and when to move. Diabetes is one of the main causes of nerve damage, called diabetic peripheral neuropathy . This can cause burning, tingling, pain, numbness and/or weakness in your feet and legs leading to instability when standing or walking. Nearly 50% of people with diabetes have some degree of nerve damage. Diabetic peripheral neuropathy can progress slowly and it can take many years until it becomes debilitating. If diagnosed early, its effects can be minimized .
The following is a list of common symptoms associated with diabetic peripheral neuropathy:
- My feet tingle.
- I feel “pins and needles” in my feet.
- I have burning, stabbing or shooting pain in my feet.
- My feet are very sensitive to touch.
- My feet and legs hurt at night.
- My feet get very cold or very hot.
- My feet are numb and feel dead.
- I don’t feel pain when I get a blister or another injury to my foot.
- I can’t feel my feet when I’m walking.
- The muscles in my feet and legs are weak.
- I am unsteady when I stand or walk.
- I have trouble feeling heat or cold in my feet.
- I have open sores on my feet or legs that heal very slowly.
- It seems like my feet have changed shape.
At The Foot & Ankle Center, PC, we utilize technology called Pressure Specified Sensory Device (PSSD™) . The PSSD™ is the most accurate way of testing the lower extremity for sensory deficits. This computer-based device is able to quantify and record both specific peripheral nerve threshold levels and peripheral nerve innervation density (which reflects axonal degeneration). As a result, the PSSD™ is able to identify pathologic changes in nerves at subclinical levels and it is pain free.
For certain patients who are good candidates, nerve decompression surgery can be performed to reduce or eliminate most of the symptoms listed above. The most ideal candidate for surgery is one who is in the very early stages of neuropathy where there is less damage done to the nerves. When the procedure is performed at this time pain relief and restoration of sensation occurs very quickly. In instances of late stage neuropathy, pain relief diminishes fairly quickly but the restoration of sensation may require a period of several months. For a person with diabetes, there must be adequate circulation in the feet and legs (which we test with an A.B.I. ) and the last Hemoglobin A1c must have been at 7 or below.