by Dr. Richard Jackson, Endocrinologist
What is Neuropathy?
Neuropathy is the term doctors use to describe nerve damage. It occurs when the nerve endings in the body begin to malfunction. Sometimes just a single nerve can be affected, but most commonly in diabetes there is involvement of multiple nerves, usually starting in the feet. This nerve damage can causing cause pain, numbness, and and occasionally weakness.
What causes neuropathy?
Neuropathy can be caused by a number of things including trauma, other medical conditions, and sometimes it is caused by diabetes due to high A1Cs over a long period of time.
How do you know if your neuropathy is caused by diabetes?
There are a number of tests that can be done to determine the cause of neuropathy. When neuropathy is caused by diabetes, it is usually first felt in the feet because that is where the body’s longest nerves are. You can ask a doctor to run specific tests to find out if your neuropathy is related to diabetes.
Does neuropathy affect everyone the same way?
Neuropathy affects everyone differently. Some people have a little bit of nerve damage and feel a lot of discomfort, while others have a lot of nerve damage but hardly notice it, not realizing that their feet are numb. However, this lack of discomfort can be dangerous, as people may not realize that their feet are susceptible to damage from the neuropathy.
How is neuropathy pain treated?
Usually, people find that neuropathy is worse when they’re not doing anything. For many people, it’s often most noticeable when they are resting or in bed. Medications to help ease neuropathy pain are also available, but unfortunately they only help some people some of the time—talk to your doctor to figure out if this is a good option for you.
Can rubbing your feet help with discomfort from neuropathy?
Rubbing your feet can sometimes help with the pain related to neuropathy but generally it does not. If you find that rubbing your feet makes a big difference, the cause of your pain may be something other than neuropathy. Talk with your doctor about the pain you are experiencing.
Does the pain of neuropathy continue to get worse?
Here’s some good news– —the pain from neuropathy is NOT something that gets worse and worse. Pain related to neuropathy often fluctuates. Unfortunately, there is no way to know how long the pain will last because every case is different. However, it is important to know that the pain can get better over time.
What are the most important things for people with neuropathy to do?
There are a couple of important things people with neuropathy can do:
Stop smoking. Smoking constricts the blood vessels that supply nutrients to the nerves throughout the body and can worsen neuropathy pain and symptoms.
Look at your feet every night. Having neuropathy often means that a person doesn’t have sensation in their feet and pain can often alert us to potential problems. A person with neuropathy can develop cuts, sore spots, and infections on their feet but not feel it, which can be dangerous. Checking your feet each night is the most effective way to avoid complications.
Lowering A1C, if it is high, can help to slow the progression of neuropathy, and can sometimes bring about the return of some nerve function.
Helpful Hint: If checking the bottom of your feet each night is difficult to do, there are mirrors available designed to specifically help. Asking a loved one to assist you is also a good idea… just be sure to do something nice for them in return!
Dr. Richard Jackson is an Endocrinologist who worked for more than 30 years with the Joslin Diabetes Center in Boston, MA.