Neuropathy
NEUROPATHY is a general term describing functional disturbances and/or pathological changes in the peripheral nervous system. The etiology may be known or unknown.
Cause: One of the most common complications of diabetes is diabetic neuropathy. Neuropathy means damage to the nerves that run throughout the body, connecting the spinal cord to muscles, skin, blood vessels, and other organs. |
Neuropathy can be prevented, at least in some cases. The Diabetes Control and Complications Trial studied complications in people on tight glucose control, and those people using regular diabetes treatment. Only one-third as many people in the tight-control group got neuropathy as in the standard-treatment group. In addition, avoiding alcohol and cigarettes will probably help protect your nerves from damage and prevent against neuropathy.
People with diabetes should be aware that other diseases can also cause neuropathy. There are at least 50 other causes of neuropathy. These include disorders of the immune system, infectious diseases, and poor nutrition.
Treatment:
Researchers are still looking for a way to heal nerves damaged by neuropathy. Right now, treatment aims to make the symptoms of neuropathy better. And tight blood glucose control may heal early neuropathy.
Most doctors say that people with neuropathy should do three things. They should reach an ideal weight, follow a regular exercise program, and control their blood sugar levels. Recent research suggests that no one therapy works best for everyone. Instead, treatment should be tailored to the location of the pain and what kind of pain it is.
Once neuropathy has started, it is important to head off injuries and further complications. For example, when you lose feeling in your feet and toes, it is easy to injure your foot without ever feeling it. For this reason, you should check your feet every day. Also check your shoes to make sure they contain no stones, staples, rough spots, or other sharp or lumpy objects that could hurt your feet.
Loss of feeling is why electric blankets and heating pads carry warning labels that say people with diabetes should not use them without talking to their doctors first. You can be seriously burned by an electric blanket or heating pad because you cannot feel how hot it really is.
Treatment for Charcot's Joint attempts to prevent joint damage. Two ways to prevent damage are keeping the joint from moving and avoiding bearing any weight on the joint while it heals. The foot is usually put into a cast or a special brace. This preserves joint function and limits the damage. Later, as the foot heals, the person wears special shoes. In people whose joints have already healed into a deformed shape, surgery may help restore the joint.
Be on the alert for urinary infections. These tend to happen again and again when your bladder is affected by autonomic neuropathy. Tell your doctor if you have cloudy or bloody urine, painful urination, low back pain, and fever. One way to prevent these infections is to urinate every 3-4 hours when you are awake, even if you don't feel as if you need to. There are drugs that can treat faintness or diarrhea caused by autonomic neuropathy.
A major goal of treatment for neuropathy is relieving pain. Pain medicines can help, but they are best used regularly throughout the day before pain becomes severe. Once the pain becomes overwhelming, pain medicines do not work as well. Narcotics can relieve pain, but they are used only as a last resort. Neuropathy can hurt for months. Use of narcotics for that long can lead to addiction.
Several other therapies are available for distal symmetric polyneuropathy. Capsaicin creams, which contain hot pepper extract, can be rubbed on the skin over the pain. These creams block pain signals. Imipramine is an antidepressant that can relieve nerve pain. Antidepressants also help people with the depression, anxiety, and insomnia that neuropathy sometimes causes. Gabapentin is a medication used to treat seizures (epilepsy). This drug has been shown to reduce pain from diabetic neuropathy. A new class of drugs called aldose reductase inhibitors is being tested as a possible treatment.
Seek physician advice for your specific treatment options.
Make an appointment with our Board-Certified Pedorthist for a consultation for properly fitted footwear and/or orthotics which can aid in the pain or discomfort of Neuropathic feet.
People with diabetes should be aware that other diseases can also cause neuropathy. There are at least 50 other causes of neuropathy. These include disorders of the immune system, infectious diseases, and poor nutrition.
Treatment:
Researchers are still looking for a way to heal nerves damaged by neuropathy. Right now, treatment aims to make the symptoms of neuropathy better. And tight blood glucose control may heal early neuropathy.
Most doctors say that people with neuropathy should do three things. They should reach an ideal weight, follow a regular exercise program, and control their blood sugar levels. Recent research suggests that no one therapy works best for everyone. Instead, treatment should be tailored to the location of the pain and what kind of pain it is.
Once neuropathy has started, it is important to head off injuries and further complications. For example, when you lose feeling in your feet and toes, it is easy to injure your foot without ever feeling it. For this reason, you should check your feet every day. Also check your shoes to make sure they contain no stones, staples, rough spots, or other sharp or lumpy objects that could hurt your feet.
Loss of feeling is why electric blankets and heating pads carry warning labels that say people with diabetes should not use them without talking to their doctors first. You can be seriously burned by an electric blanket or heating pad because you cannot feel how hot it really is.
Treatment for Charcot's Joint attempts to prevent joint damage. Two ways to prevent damage are keeping the joint from moving and avoiding bearing any weight on the joint while it heals. The foot is usually put into a cast or a special brace. This preserves joint function and limits the damage. Later, as the foot heals, the person wears special shoes. In people whose joints have already healed into a deformed shape, surgery may help restore the joint.
Be on the alert for urinary infections. These tend to happen again and again when your bladder is affected by autonomic neuropathy. Tell your doctor if you have cloudy or bloody urine, painful urination, low back pain, and fever. One way to prevent these infections is to urinate every 3-4 hours when you are awake, even if you don't feel as if you need to. There are drugs that can treat faintness or diarrhea caused by autonomic neuropathy.
A major goal of treatment for neuropathy is relieving pain. Pain medicines can help, but they are best used regularly throughout the day before pain becomes severe. Once the pain becomes overwhelming, pain medicines do not work as well. Narcotics can relieve pain, but they are used only as a last resort. Neuropathy can hurt for months. Use of narcotics for that long can lead to addiction.
Several other therapies are available for distal symmetric polyneuropathy. Capsaicin creams, which contain hot pepper extract, can be rubbed on the skin over the pain. These creams block pain signals. Imipramine is an antidepressant that can relieve nerve pain. Antidepressants also help people with the depression, anxiety, and insomnia that neuropathy sometimes causes. Gabapentin is a medication used to treat seizures (epilepsy). This drug has been shown to reduce pain from diabetic neuropathy. A new class of drugs called aldose reductase inhibitors is being tested as a possible treatment.
Seek physician advice for your specific treatment options.
Make an appointment with our Board-Certified Pedorthist for a consultation for properly fitted footwear and/or orthotics which can aid in the pain or discomfort of Neuropathic feet.