Neuropathy

What is neuropathy?

In podiatry, neuropathy refers to nerve damage or dysfunction specifically affecting the feet and lower extremities. It's a condition commonly encountered by podiatrists due to the high prevalence of foot-related complications in individuals with neuropathy.

Neuropathy in podiatry often involves damage to the peripheral nerves, leading to a range of symptoms primarily localized in the feet and legs. These symptoms can include:

How to know that I have a neuropathy?

Neuropathy can present with various symptoms, and its manifestation may differ from person to person. Here are some signs that might indicate the presence of neuropathy:

1. Numbness or Reduced Sensation: You might experience a lack of sensation or reduced feeling in your feet or hands. This could make it challenging to feel pain, temperature changes, or touch.
2. Tingling or Burning Sensations: Some individuals with neuropathy describe sensations of tingling, pins and needles, or a burning feeling in the affected areas.
3. Sharp or Shooting Pain: You might experience sharp, stabbing, or shooting pains in the feet or hands, even without an apparent cause or injury.
4. Loss of Coordination or Balance: Neuropathy can impact proprioception, leading to difficulty in maintaining balance and coordination, increasing the risk of falls.
5. Muscle Weakness: Some people may notice muscle weakness or difficulty moving their feet or hands properly.
6. Foot Problems: Neuropathy in the feet might cause foot problems like ulcers, infections, or slow-healing wounds due to decreased sensation and compromised circulation.

‍

What causes neuropathy? 

Neuropathy can have various causes, and it often results from damage or dysfunction of the peripheral nerves. Some common causes include:

1. Diabetes: Diabetic neuropathy is a prevalent form of neuropathy, occurring due to prolonged high blood sugar levels damaging nerves over time.
2. Trauma or Injury: Accidents, falls, or traumatic injuries can directly damage nerves, leading to neuropathy.
3. Autoimmune Diseases: Conditions like rheumatoid arthritis, lupus, or Guillain-Barré syndrome can cause the immune system to attack nerves, resulting in neuropathy.
4. Infections: Certain infections, such as Lyme disease, shingles (herpes zoster), HIV/AIDS, hepatitis C, and other bacterial or viral infections, can lead to nerve damage and neuropathy.
5. Toxins or Chemicals: Exposure to toxins like heavy metals, certain medications (chemotherapy drugs, antiretrovirals, certain antibiotics), or excessive alcohol consumption can cause nerve damage leading to neuropathy.
6. Nutritional Deficiencies: Deficiencies in vitamins (particularly B vitamins like B12), minerals, or nutrients crucial for nerve health can contribute to neuropathy.
7. Heredity: Some forms of neuropathy are inherited and run in families, indicating a genetic predisposition to nerve damage.
8. Other Medical Conditions: Conditions such as kidney disease, liver disease, thyroid disorders, and certain cancers can lead to neuropathy as a secondary complication.

‍

‍

How is neuropathy treated?

Neuropathy is managed to prevent complications, relieve symptoms, and maintain foot health. Here are some approaches commonly used in podiatry to address neuropathy:

1. Foot Care Education: Podiatrists provide education on proper foot care techniques, including daily inspection of the feet for any injuries, ulcers, or infections that might go unnoticed due to reduced sensation.
2. Footwear Recommendations: Proper footwear with adequate support and cushioning is recommended to prevent injuries and protect sensitive feet.
3. Management of Foot Complications: Podiatrists help manage foot complications associated with neuropathy, such as ulcers or wounds, by providing wound care, applying dressings, and suggesting offloading techniques to promote healing.
4. Orthotic Devices: Customized orthotic devices, such as shoe inserts or braces, may be prescribed to provide support, improve gait, and reduce pressure on vulnerable areas of the foot.
5. Pain Management: Medications, topical treatments, or nerve pain medications prescribed by podiatrists can help alleviate neuropathic pain symptoms.
6. Physical Therapy: Podiatrists may recommend exercises to improve strength, flexibility, and balance in the feet and lower limbs.
7. Monitoring and Prevention: Regular follow-ups with podiatrists are crucial to monitor foot health, detect any developing issues early, and prevent complications like infections or foot deformities.
8. Collaboration with other Specialists: Podiatrists often work collaboratively with other healthcare professionals, such as neurologists, endocrinologists (for diabetes-related neuropathy), and wound care specialists, to provide comprehensive care for individuals with neuropathy.

‍

The goal of treating neuropathy in podiatry is to maintain foot health, prevent injuries, and manage symptoms effectively. Individualized care plans are tailored to each patient's specific symptoms, needs, and underlying causes of neuropathy to optimize foot function and overall quality of life.