The Gift of Pain
I first heard this phrase spoken by one of my professors in medical school. My first thought may be similar to yours: gifts are pleasant, things we would like. Who wants pain? Discomfort is not a gift!
A diagnosis of diabetes can change that perspective quickly. If you are a diabetic survivor, the ability to feel your feet or the discomfort that injuring them provides can be a lifesaving matter. Not feeling pain in your feet, or ‘a little bit of numbness’, can lead to wounds, infection, and surgical intervention or amputation.
Studies have shown that almost 50% of individuals who have diabetes for many years will develop peripheral neuropathy, or problems with the nerves in your arms and legs. Most individuals who have mild neuropathy are unaware of it due to the subtlety of the symptoms.
The nerves in your body have two main jobs:
- Relay information to your brain (sensory nerves),
- Relay information from your brain to your muscles (motor nerves).
Those that sense or feel send signals for pain, hot or cold, and light touch among others. It is the nerves that react to light touch that are most susceptible to damage from diabetes and uncontrolled blood sugar. Because some sensation is still present, it is easy to be fooled into thinking everything is fine. Many times small scrapes or injuries that are not noticed can become infected or increase in size before you notice.
One of the most common secondary symptoms people experience with late stages of the disease are numbness, tingling, or burning sensations in their fingers and toes. These sensations may not persist or only occur occasionally, but they are classic finding for peripheral neuropathy. The nerves in the outermost part of your body, fingers and toes, contain the smallest of nerves. These tiny nerves are the first ones to be damaged by diabetes and elevated sugars. Nerves are very slow to heal and often damage to them is so significant that it is irreversible. When your nerves are not able to detect pain, the chances of you injuring your feet are greatly increased. It is important for anyone with neuropathy to examine your feet daily for any problems or injuries.
The best way to prevent neuropathy from occurring is to keep your blood sugars under control. With the help of your family physician, endocrinologist, diabetes educator, dietician, and podiatrist, good sugar control can prevent, and sometime reverse symptoms of neuropathy (if not longstanding). Early intervention can keep symptoms from becoming worse. In advanced cases of neuropathy, constant burning or tingling sensations can become unbearable and may require special medication or other treatments to manage.
As foot specialists, we see to many individuals who don’t seek out treatment until irreversible damage has been done. Early loss of light touch can be easily detected through a routine podiatric examination. If this is elicited from your examination, we will discuss the daily foot exams you should do at home to detect what your nerves no longer can and regular follow ups with your podiatrist. We can identify problems early this way and prevent limb loss or death, the worst of diabetic complications.