Diabetic Neuropathy Assessment

Small Fiber Neuropathy Symptoms Diagnosis and Treatment

Small fiber neuropathy is really an interestingcondition because it consists typically of just burning, numbness, pain of the feet,sometimes the hands later on without necessarily having any abnormalities on your EMG or nerveconduction study. So what I tell patients and actually residents or students who trainunder us is that a normal nerve conduction study does not exclude a neuropathy. And wewill confirm this by doing additional testing, specifically the nervous the the examinationat the bedside asking patients about their symptoms, for example, loss of sensation tocool or or hot temperatures, loss of pain sensation and also doing skin biopsies wherewe look at nerve densities in the skin both

from the calf and the thigh as well as doinga special test that looks at sweat function both in your foot in in the legs as well asthe feet to gauge the level of small fiber nerve damage. Small fiber neuropathy typicallywill progress unless the underlying cause is identified and reversed. Diabetes of coursebeing the most common cause is always screened for. But once the more common causes are excludedand the focus becomes on excluding any underlying secondary disease process but also controllingpain because if patients' symptoms of pain are generally controlled they tend to do prettywell and really have no other major functional deficits. I've really become interested overthe years is how interconnected neurology

and rheumatology are and one thing I oftendo on patients who have unexplained small fiber even autonomic neuropathy is have themsee rheumatology or get evaluated for connective tissue disorders like lupus or Sjogren's orsarcoid and sometimes even if we are not directly involved in treating the patients, this canbe the first sign of an underlying connective tissue disorder that can then be brought tothe attention of rheumatology and addressed from their standpoint.

Diabetes Foot Exam

we know that one in four people withdiabetes will develop foot complications. These complications can be serious and can limit you and what you want to do with your life the Joslin al guidelinesrecommend that you have a thorough foot exam by your physician atleast once a year one of the things that can cause foot problems: in people with diabetes they result from twomajor problems. The first is neuropathy. diabetes can affect the nerves over time

and as the nerves are affected you may lose the sensation in your feet this may not cause you any discomfort,your feet may feel fine, but not being able to sense problems in your feet puts them at risk. A second problem is circulation diabetes can affect circulation in thehead in the heart but also affects circulation in your feet. With the circulation decreased, any problem that occurs in your feet

will resolve more slowly; infections heal more slowly and you are prone to more complications. this combination of neuropathy and circulation problems are why your physician needs to carefully examine you feet at least once a year when he or she examines your footthey're going to look at three different things they'll visually inspect your foot tosee if there's any deformities,

they'll look carefully the skin to see if there's any cuts, any sore spots, any lesions thatshould need attention between your toes as wellas the top of the bottom of your feet the physician will also take a look atyour circulation by feeling for pulses at certain spots in your feet where we know the the pulsesshould be strong and last, they'll check for signs of neuropathy by using either tuning fork or something called a ten gram fibersmall wis

you should be able to sense and if youcan't it means you're especially high risk for problems with yourdiabetes smoking is obviously a problem for anyone's health if you have diabetes smoking isespecially damaging so he can affect the circulation inparticular the circulation to your feet we know that the majority of ourpatients with diabetes who have foot problems have had smoking intheir past

so what can you do to keep your feethealthy? we just talked about stopping smoking ifyou're doing that if you have neuropathy or have had foot problems, examining your feet by yourself everyday looking at the skin is very important keeping your A1c, your blood pressure,your cholesterol in control will also decrease your chance of complications. And remember,

Category: Neuropathic Pain

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