Dr. Bill Cihak, Internist, Olean Medical Group
Neuropathy is a result of damage to your peripheral nerves, often causing weakness, numbness, and pain, usually in your hands and feet. It can also affect other areas of your body.
If you are experiencing cracks, ulcers, drainage, or other signs of infection in your feet, please see your primary care provider, podiatrist, or endocrinologist as soon as possible. Neuropathy is caused by poor blood sugar control that persists over a long period of time and can indicate that you are pre-diabetic or that you already have Type 2 Diabetes.
Your chances of developing neuropathy in your feet are great if your blood sugars have remained high for a long period. The nerves that go from your spine to your feet are long and they are affected well before the nerves in your arms and hands. If your blood sugars remain high, complications will arise in both feet.
Neuropathy in your feet can cause numbness and pain and it can lead to injuries as well. Without the feeling in your feet, you can trip and fall or stub and break your toes - and because of the numbness, you may not even realize that you have sustained a cut or a break, which could lead to infection and possibly, amputation, if not properly cared for. However, most amputations are preventable when your blood sugars are managed and you take care of your feet. Just a note here, the American Diabetes Association reported that in 2010, there were about 73,000 non-traumatic lower-limb amputations, performed on adults (20 years or older) diagnosed with diabetes.
A proper diet, with a good balance of protein, vegetables, grains, and fruit, is critical for sustaining a normal blood sugar. Also, managing your weight can make a significant difference because individuals who are overweight or obese tend to develop more neuropathy and arthritic problems and pain in their feet due to the extra weight. Shedding pounds will help to normalize your blood sugars and maintaining a healthy weight will address your overall cardiovascular and cholesterol health.
Along with a healthy diet, exercise is very important. If you have been stagnant and on the sofa most of the winter, now is the time to begin an exercise regimen - but always check with your healthcare provider before beginning any exercise program.
Flexibility exercises, also called stretching, help keep your joints flexible and reduce your chances of injury during other activities. Gentle stretching for 5 to 10 minutes helps your body warm up and get ready for aerobic activities such as walking or swimming, if you are able to do them. Although walking is probably the best exercise for most, with neuropathy in your feet, exercises like flexibility stretches and squats are far safer. There are other exercise for people with neuropathy but here are a few you can do right at home:
Seated Hamstring Stretch - sitting on the front half of a firm chair, place one leg out straight with the foot pointing up. Bend the opposite knee so that your foot is flat on the floor. Center your chest over the straight leg, and slowly straighten your back until you feel a muscle stretch in the back of your leg. Hold 15-20 seconds on each leg and repeat twice a day, 3 repetitions each leg.
Calf Stretch - place one leg far behind you with the toe pointed slightly inward. Take a large step forward with the opposite foot. With the front knee slightly bent lean forward keeping your back heel on the floor. You should feel a muscle stretch in the calf of your back leg. Hold it for 15-20 seconds on each leg, three times, twice a day.
Squats are also safe and good exercise. Try a chair squat, using a firm chair with armrests, position your feet in a split stance with one foot at the base of the chair and the other foot placed comfortably in front and slightly out to the side. Slowly transfer your weight forward until your legs are supporting your body weight. Slowly press up with your legs to standing. To lower yourself, slowly reach for the chair with your hips. Touch the chair with your hips and press back up for your next repetition. Repeat 2 repetitions, 10 -15 times, twice a day.
Kitchen Counter Calf Raises - while standing at the kitchen counter, place two finger tips on the counter. Stand on one foot lifting the other heel off the floor, standing on your toes (as you strengthen your muscles, try to alternate your heels as shown in the picture below). Slowly lower yourself to the floor and repeat. Once you are on your toes control yourself. Do not just drop down to the floor. Repeat 2 repetitions, 10 -15 times on each leg, twice a day.
While maintaining good blood sugar control can help prevent or delay neuropathy, there is no cure once the nerves are damaged for a long period of time; the medications that are available only treat symptoms and slow the progression of the disease. However, researchers have seen some promising results in recent studies so be sure to get regular check ups with your healthcare provider and keep exercising. With earlier diagnosis, better treatments, and patients working with their doctors to take charge of the disease, individuals with diabetes are doing much better.
If you’re concerned you may have neuropathy in your feet or if you experience any redness, cracks, drainage, ulcers, or other signs of infection in your feet, you should see your healthcare provider immediately.
Dr. Cihak is an Internist at the Olean Medical Group, with offices in Olean and Ellicottville. He has been practicing at the Group since 1999.