Peripheral neuropathy in feet is when peripheral nerves that travel to your feet are damaged. It is a common problem in people over 55 years of age.
In this blog, our podiatrist Clare Rushmer explains the symptoms and causes of peripheral neuropathy as well as how to protect numb feet and treatments for heightened sensitivity or painful neuropathy symptoms.
What is peripheral neuropathy?
Peripheral neuropathy is a nerve condition which occurs when nerves are damaged at the extremities of your hands and feet.
It is so-called as it affects your peripheral nervous system. This is a network of nerves located outside your central nervous system (brain and spinal cord).
Peripheral nerves can be sensory (pain and touch), motor (muscle controlling), and autonomic nerves (regulate functions such as blood pressure and bladder). Peripheral neuropathy symptoms depend on which nerves are affected.
What are the symptoms of peripheral neuropathy?
Peripheral neuropathy causes 3 main sets of symptoms:
- Numbness – which you will not be aware you have.
- Heightened or overexaggerated responses to stimuli – such as jumping and feeling pain when something very light touches your skin.
- Abnormal sensations – are often described as something stuck under your foot, cotton wool between your toes, a sock rucked up under your toes, tingling, and pins and needles. These occur because the misbehaving nerve is firing off impulses to your brain, and your brain interprets it in the best way it is able. They are often worse at night because you are no longer applying stimuli (pressure when standing and walking) to your feet and have no distractions.
You may have one, two or all three symptoms. The symptoms normally start at your toes and can progress further up your foot and leg if it worsens.
What causes peripheral neuropathy?
Common causes for this problem include:
- Rheumatoid arthritis and other long-term chronic diseases
- Vitamin B12 deficiency (called pernicious anaemia)
- Drug side effects, particularly statins.
If you have blood tests for all these and nothing is discovered, it may be termed idiopathic neuropathy, which means there is no known cause. A surprising number of people with neuropathy have no known cause.
If you have other symptoms in keeping with a neurological condition, your GP may want to refer you for further tests such as nerve conduction studies.
Why is peripheral neuropathy numbness a problem?
Numbness is risky because you are no longer able to rely on your sense of pain to tell you when something is wrong. It is easy to then damage your feet without knowing it.
Can peripheral neuropathy be cured?
There is no known cure for peripheral neuropathy. Treatments aim to slow its progression, maintain foot health, reduce any pain (if present) and improve your quality of life.
Steps you can take to protect numb feet:
Build into your daily routine some safety checks
This is important to keep your feet in tip-top shape. Please look at your feet daily. Rely on your eyes rather than your ability (or not) to feel pain to tell you there is something wrong. You are looking for anything stuck in your foot, any cuts, changes of colour or bleeding. If you see anything wrong, contact your podiatrist immediately.
Check the water temperature before immersing your foot or hand
When you are having a bath or footbath, or any time you would immerse your feet in water, check the temperature of the water with your elbow, not your hand or foot.
Check clothes and footwear for foreign bodies
When you are dressing and when you go to put on your shoes or slippers, have a quick check inside them to make sure there are no foreign bodies inside and no nails poking through the bottom.
Maintain your balance
It is important to maintain your balance as much as possible to keep upright, safe and continue exercising. You may benefit from seeing a physiotherapist who can give you balance retraining exercises.
Treatments for heightened sensitivity or painful neuropathy symptoms
If you have heightened sensitivity or painful neuropathy symptoms, you could benefit from the following:
- Neurobion – this is a vitamin complex including B1, B6 and B12. These vitamins are known to help nerves. However, there are some medications it is not advisable to take this with, and some potential side effects, so do check with your GP or pharmacist first.
- OpSite Flexifit tape – this is a very fine adhesive film which you can cut to size and stick over the area which is causing you symptoms. It is great for larger areas but not really suitable for around your toes. It works by providing a real stimulus to the nerves which are misfiring. You can purchase this online or order it through your local pharmacy.
- Capsaicin cream – this is available only on prescription. It is a foot cream containing chilli. It works in the same way as the film. Please ensure you wash your hands after applying and don’t touch your eyes!
- Neuropathy Hemp Extra – this is a cream available from Sera Organics online. It has a similar action to the topical treatments above.
- Tablets – if you have tried the topical treatments and nothing is working, it is possible to take medications. Normal painkillers do not work for these kinds of symptoms. Instead, there are medications which help change how your brain perceives the stimuli. Options include nortriptyline, gabapentin and pregabalin. These are all prescription only, so please speak to your GP, prescribing nurse or pharmacist to see if you are suitable.
The most important treatment is if there is an underlying cause to get it sorted. This could include vitamin B12 injections for pernicious anaemia, better glucose control in diabetes, or changing your cholesterol medication for one which is not a statin.
How can podiatrists help with peripheral neuropathy in feet?
A podiatrist is able to perform a number of simple tests on your feet in the clinic to check if you have neuropathy.
If peripheral neuropathy in feet is discovered, a podiatrist can contact your GP to request blood tests to help discover the cause. They can also ask for referrals for further investigations such as nerve conduction studies if these seem appropriate.
Neuropathy can be categorised into low, medium or high risk, depending on other factors to do with your health. If you are considered low risk, it is sensible to have a check-up annually to see if the neuropathy is progressing, check there are no complications, and reinforce the importance of safety checks. If you are medium or high risk, it is better to have assessments more regularly. You may also prefer to have basic foot care such as nail cutting carried out by a podiatrist or podiatry assistant, to help prevent potential accidents at home.
How do Randell’s Footcare podiatrists help with peripheral neuropathy?
The qualified and experienced podiatrists at Randell’s Footcare can help in a number of ways with peripheral neuropathy.
Our podiatrists can help to diagnose the condition and request tests to help find its cause.
They can offer annual or more regular check-ups depending on your neuropathy risk. Our podiatrists can also perform foot care including nail cutting to help prevent home accidents.
Book your appointment with one of our qualified podiatrists
If you have peripheral neuropathy symptoms, then you can book an appointment with a Randell’s Footcare HCPC-qualified podiatrist by calling 01603 737 188. They can offer tailored advice and treatments to manage your symptoms.
Our highly trained reception team offer a free mini-consult to ensure your appointment is with the most appropriate podiatrist for your needs.
We also offer routine appointments which can bring to light common conditions such as peripheral neuropathy.