Treating Numbness Tingling and Burning Caused by Neuropathy
My name is David Northcutt. I'm oneof the podiatrists here at Dallas Podiatry Works. Today I want to discuss diabetic peripheralneuropathy. There are several reasons for the development of peripheral neuropathy,but diabetic peripheral neuropathy is one of the most common. Diabetic peripheral neuropathy simply meansnerve damage that is caused from having diabetes. This is not something that develops rapidly,but is a slowly worsening and progressive condition which happens over the period ofseveral years. The loss of sensation that occurs with nerve damage from diabetes makesthe patient more prone to developing open
sores or ulcers. Patients often do not know that they havea sore or wound, due to this lack of sensation. This can lead to significant complicationsincluding amputations. Diabetic peripheral neuropathy usually occurs in patients whodo not maintain their blood sugar well, however it can occur in anyone with diabetes. The symptoms of neuropathy include numbness,tingling, pain, burning in the feet which can progress up to the legs, there's oftenloss of muscle tone, loss of balance, and changes to foot structure. To determine whetheryou have diabetic peripheral neuropathy, a
history and physical will be performed. Simple,in office, noninvasive testing helps to diagnose the problem. Neurologic tests sometimes areordered. Sometimes a biopsy of the peripheral nerves in the skin may also be performed.Treatment of diabetic peripheral neuropathy begins with good control of your blood sugar.There are oral medications as well as topical medications that may reduce your symptoms.Prevention of diabetic peripheral neuropathy includes maintaining good blood sugar levels. If you have any symptoms of numbness, burning,tingling in your feet or legs, please give us a call at Dallas Podiatry Works. We willwork to get the correct diagnosis to help
relieve your symptoms.
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.