Back of two feet and ankles with a highlighted red area over the Achilles tendinopathy showing pain

What Is Neuropathy?

Neuropathy describes damage to your nervous system - your body’s command centre, where an extensive network of nerves connect our brain with the rest of the body, and control our ability to feel and move, alongside our breathing, vision, thoughts and much more. 

While the nervous system is also responsible involuntary actions such as our digestion and heart rate, as podiatrists, we work extensively with patients whose nerves have been affected in two key ways: either their sensory nerves have been damaged and their ability to feel pain and other sensations has become interrupted, or their motor nerves are involved and their ability to produce voluntary muscle movements, like lift their foot up off the ground, is affected.

What Are The Symptoms Of Neuropathy In Feet?

As the network of nerves in the body is very extensive, the symptoms you feel can vary greatly and will depend on which nerves have been damaged and how severe the damage is. Many non-traumatic, underlying causes of nerve damage progress over time, so symptoms can change and worsen. Examples of symptoms of neuropathy in the feet include:

  • Pins and needles
  • Numbness or tingling
  • A reduced ability to feel pain or changes in temperature, making it more difficult for you to detect when the ground you’re walking on is too hot and may be burning your feet, for example
  • Burning or sharp pains
  • Feeling pain from gentle or typically non-painful sensations
  • Loss of balance and coordination
  • Diminished proprioception (the ability to detect where your feet are in space - like when you close your eyes and be able to lift your foot up, and be able to tell where the ground approximately is to lower your foot back down) 
  • Muscle weakness or paralysis, which can lead to conditions like foot drop
  • Reduction in muscle size (muscle wastage)

What Causes Neuropathy In Feet?

In Australia, the most common cause of neuropathy in the feet is diabetes, with diabetic neuropathy being a precursor to a range of foot problems and complications. Aside from diabetes, it can also be caused by: 

  • Being exposed to toxic substances, ranging from excessive alcohol consumption to chemotherapy medications
  • Surgery, where the nerves have been unintentionally damaged as part of the procedure
  • Vitamin deficiencies, such as B12
  • Having a physical injury, like having a ball kicked hard against your leg during sports
  • Having an unmanaged, underactive thyroid gland
  • Hereditary conditions such as Charcot-Marie-Tooth disease
  • Certain infections can lead to nerve damage, such as Lyme disease or shingles
  • Health conditions such as liver or kidney disease
  • Autoimmune diseases such as rheumatoid arthritis and lupus

Common Risk Factors

The most common risk factor for neuropathy is having diabetes. This risk factor is also somewhat controllable, though the extent of this can vary from person to person. Depending on how well you manage your blood sugars and control your diabetes, a person can often slow the progression of their neuropathy or delay its onset.

How Is Peripheral Neuropathy Diagnosed?

For our patients with diabetes, diagnosing neuropathy and getting an insight into its severity is a routine and important part of their annual diabetes foot health check, and is done by running some simple tests during your appointment to detect whether the feeling in their feet has become diminished or disrupted. If it is, this indicates that you are experiencing some level of neuropathy, though it is also important to understand why.

If you do not have diabetes, your podiatrist will review your medical history to see if there is anything obvious that matches your clinical signs and symptoms - like a recent injury to the area, or a surgery. In the absence of any obvious explanations for the changes in sensation or motor control you’re experiencing, your doctor may want to run blood tests, nerve conduction tests, or other tests. Understanding what is causing your neuropathy gives you the opportunity to address the cause, and where possible, to help slow or halt its progression.  

Treatment Options For Foot-Related Peripheral Neuropathy

The best way to manage peripheral neuropathy depends on what is causing it. If the cause is a vitamin deficiency or diabetes, the goal is to effectively manage this underlying problem, while also managing any symptoms and risk factors that the neuropathy creates - such as putting you at risk for unnoticed wounds if you cannot appropriately detect feeling in your feet, or putting you at risk for regular tripping and falling if muscle weakness in your foot results in a foot drop.

If the cause of your neuropathy is unknown, or it is permanent such as from after surgery, the goal is also to help manage your symptoms and reduce your risk of complications. Part of this may involve pain medications from your GP, if you are experiencing sharp or severe pain.

Podiatrist Treatment For Neuropathy

Your podiatrist can be a valuable asset when it comes to managing the symptoms of neuropathy on your feet. We’re proud to offer the ASA laser, a low-level laser that is safe, painless and proven to be effective in significantly reducing neuropathic pain while also improving the microcirculation of the skin.,

By working with a podiatrist, you can expect to:

  • Feel fully informed about what neuropathy is, how it is currently affecting your feet, and what you can be doing to help protect your foot health
  • Undergo annual foot health checks that mean that you have up-to-date information about your foot health status, given that the symptoms of neuropathy can change over time, so you can continue to take the best steps to protect your feet
  • Get the right care for the symptoms of muscle weakness on your feet, such as using the EXO-UP brace for foot drop, as well as an exercise program
  • Receive timely care for the effects of diminished sensation on your feet, such as wound care, to reduce the risk of further complications such as foot ulcers
  • Know which shoes and socks you should be wearing for both your foot type, and to help best support and protect your feet
  • Have all of your questions answered and feel well supported along the way

We may also recommend using capsaicin creams or ointments, which are shown to reduce pain from a range of neuropathies by working as an analgesic and desensitising the local pain nerves. 

At-Home Treatment

If you have peripheral neuropathy, the best thing you can do is to help reduce your risk of injury to your feet when you’re at home and out and about. This includes:

  • Wearing good, supportive shoes that both protect your feet and promote optimal movement
  • Checking your feet daily for any changes to their integrity or condition, specifically looking out for redness, swelling, cuts, splinters, and blisters.
  • Washing and thoroughly drying your feet daily, especially between your toes. 
  • Moisturising your feet daily to avoid dry skin (but not between the toes)
  • Wearing any braces or splints prescribed by your podiatrist
  • Completing any stretching or strengthening exercises prescribed by your podiatrist
  • Avoiding walking barefoot
  • Avoiding using over-the-counter corn pads or razors — it may cause marked maceration to the skin.
  • Cutting your toenails straight across, with good quality nail clippers, and filing the corners and edges. 
  • Wearing ‘diabetic’ socks - these have benefits like being seamless which helps protect the integrity of your feet
  • Avoiding having your feet in close contact with direct heat including: heaters, hot water bottles & electric blankets

Preventing Peripheral Neuropathy In Feet

While it’s not always possible to prevent neuropathy due to the variety of causes, many of which are outside of our control, you can take steps to help support your foot health, slow the progression of symptoms, and help prevent complications together with your podiatrist. This focuses on helping manage the underlying causes of your neuropathy, which your podiatrist will discuss with you.

You can book in with one of our podiatrists in Brisbane City or Newmarket here.


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