Causes

There are many causes of Peripheral Neuropathy including diabetes, genetic, alcohol abuse, exposure to certain chemicals or toxins and “idiopathic.” Idiopathic means a specific cause cannot be identified.

Symptoms

One or more of the following symptoms may occur with Peripheral Neuropathy: Numbness, tingling, burning pain, shooting pains, and muscle weakness. Some people have no pain; however, for most people, pain is the main complaint. Sometimes Peripheral Neuropathy is not discovered until an injury of the foot has occurred.

Foot Problems Associated with Peripheral Neuropathy

Problems with the feet generally occur after the loss of protective sensation. Protective sensation is the amount of feeling that you need to realize that your foot has been injured. The most common foot problems that occur with peripheral neuropathy are unrecognized trauma and a destructive arthritis called neuroarthropathy (nur-o-are-throp-athy). Unrecognized injury such as a blister, a cut, or an abrasion is preventable with proper shoes and foot care. The problems with neuroarthropathy are minimized if it is diagnosed and treated promptly.

Prevention of Unrecognized Trauma

After protective sensation has been lost, the feet need special attention so that minor injuries are recognized quickly and treated appropriately. Following the recommendations below will help you prevent and discover unrecognized trauma. If minor injuries are not cared for appropriately, infection, additional injury, or a non healing wound may result.

Special Foot Care that Helps Prevent Major Problems

  • Protect your feet by wearing shoes and socks all the time, even inside your home.
  • Check your feet twice a day for blisters, cuts, sores, bruises, swelling, and discolored calluses, all of which require special attention. If they do not get better quickly, evaluation by your doctor is necessary.
  • Proper shoe fit is essential for proper support and protection of your feet. Review the “12 Points of Proper Shoe Fit”.
  • Trim toenails straight across and keep them short enough that they do not rub a sore on the adjacent toe.
  • Trim calluses with a pumice stone or foot file so that they do not become thick and hard. Thick, hard calluses put you at risk for developing a blister or ulcer under the callus.
  • Good skin care is a must. Apply moisturizer (Crisco shortening is an inexpensive, best alternative) to the heels, soles and tops of the feet, but avoid putting it between the toes.

Neuroarthropathy (Charcot Arthropathy)

Neuroarthropathy is a destructive arthritis that occurs either spontaneously or after what is perceived as minor trauma. As neuroarthropathy develops, the joints begin to disintegrate. The foot becomes swollen, red, warm, and it may or may not be painful. Frequently the problem is mistaken for infection or a blood clot. If x-rays are taken early in the process, they may be normal, but as the process continues, especially if the foot is not protected, broken bones and dislocated joints are seen. The end result is a deformed foot that is prone to pressure sores and non healing wounds. Treatment of a Charcot (shar-co) Joint requires protection and control of swelling. This is accomplished by use of a Total Contact Cast followed by a specially made custom brace called a Custom Restraint Orthotic Walker (CROWalker).

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