March 14, 2013

Peripheral neuropathy – the silent stalker

Peripheral neuropathy is a condition where there is damage to the nerve endings of the extremities. It tends to cause a range of symptoms, such as;

  • a progressive absence of sensation starting from the toes and extending slowly up into the leg (most common)
  • painless wounds and ulcers under the foot and between toes
  • severe burning pains in the feet (uncommon)
  • changes to the small muscles in the foot which creates toe and forefoot deformities
  • changes to gait and walking, leading to postural instability

The most common cause of peripheral neuropathy in the western world is diabetes – and both Type 1 and Type 2 patients are both at risk of developing this complication. The risk of diabetic peripheral neuropathy increases with age, duration of diabetes, and the degree of blood glucose control over extended periods.

A painless ulcer developing under the big toe joint due to peripheral neuropathy

A painless ulcer developing under the big toe joint due to peripheral neuropathy

However, many other conditions may also cause peripheral neuropathy. These include such varied causes as vitamin B12 deficiency, exposure to certain neurotoxic chemicals and drugs, hereditary conditions such as Charcot-Marie-Tooth disease, and chronic alcohol dependence.

From a podiatry perspective, once there is irreversible damage to the nerves of the foot, there is a high liklihood of painless injury of trauma occurring that can pass by completely un-noticed by the patient. In some instances this can lead to severe foot infections, chronic ulcerations and even bone and joint deformities. It is quite common to have to wear special protective footwear and orthotics to reduce high pressure areas under the foot, or even require extended periods of localised wound care if a wound breakdown occurs.

The team at The Podiatry Practice in Brisbane are highly experienced in the assessment and management of peripheral neuropathy and the complications it may cause. If you feel you are losing feeling in your feet (particularly if you have diabetes), make sure come and see us to have it assessed as soon as possible.

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