Article reviewed by Dr. Emily Splichal, DPM

Neuropathy in the Feet

Neuropathy, also referred to as peripheral neuropathy, is the malfunction or impairment of the peripheral nervous system that transmits signals from the body to the brain and back. This usually starts to affect the extremities such as the feet and hands but is not limited to these body parts. Neuropathy is a common condition in the United States with approximately 25-30% of the population affected. Most often, neuropathy is associate with diabetes, but there are instances when it can present itself because of other causes.

Symptoms of Neuropathy

What someone with neuropathy experiences is directly correlated to the damaged cells involved and where it is the body. Listed below are symptoms relating to the feet that can occur because of neuropathy.

  • Loss of sensation and feeling.
  • Tingling or “pins and needles” feeling.
  • Muscle weakness.
  • Imbalance and lack of coordination.
  • Sharp, stabbing pain.
  • Extreme changes in sensation from not being able to feel anything to intense pain.
  • Moisture control issue such as excessive sweating or not sweating at all.
  • Feeling as if the hands and feet are covered when they are bare.
  • Not being able to tolerate heat and cold.
  • Low muscle tone or motoric paralysis.
About Neuropathy

Neuropathy Causes

  • Diabetes is the main cause of neuropathy causing pain and burning in the extremities such as the feet and hands.
  • Loss of sensation in the hands and feet.
  • Nerve damage can occur because of injuries or intense physical activities that compress the nerves.
  • Autoimmune disorders such as Guillain-Barré syndrome, lupus, rheumatoid arthritis and Sjogren’s syndrome.
  • While medication and antibiotics are essential to treating many medical conditions, they can sometimes cause harm and trigger neuropathy. In addition, chemotherapy and radiation also provoke the condition.
  • Properly functioning nerves require normal oxygen levels. Vascular disorders that reduce blood flow to the extremities can damage the nerves and lead to neuropathy.
  • Someone who consumes alcohol excessively will have low levels of thiamine which is essential for properly functioning nerves.
  • Vitamin deficiency in vitamin E, B1, B6, B12, and niacin can impair nerve function.
  • Genetic conditions such as Charcot-Marie-Tooth, Familial amyloidosis, Fabry disease and metachromatic leukodystrophy can lead to weakness is the extremities.
  • Additional diseases such as kidney and liver disorders, tumors, myeloma, and lymphoma can trigger neuropathy.
  • Unfortunately, there are instances when we do not know the cause of the neuropathy.

Prevention of Neuropathy

The good news is that neuropathy can be treated and even eliminated and in cases that are more severe, the symptoms can be greatly minimized so that one can continue living a pain free life.

  • Physical therapy can help if you experience low muscles tone and limited mobility. The physical therapist will work on strengthening muscles while keeping pain to a minimum.
  • Non-steroidal anti-inflammatory medication can help with reducing pain, swelling and inflammation.
  • Surgery can remove a tumor that is pressing on the nerves and affecting their function.
  • Topical creams, lotions or ointments when applied to the affected painful area can act as a numbing agent. There are many types, some use natural ingredients while others use capsaicin as an effective pain killer.
  • If your neuropathy is due to reduced vitamin levels of E, B1, B6, B12, and niacin, taking over the counter vitamin supplements can help.
  • Transcutaneous electrical nerve stimulation can be used to stimulate damaged nerves and provide pain relief. Low voltage electrical currents are administered on and around the affected nerves. Consult with your medical care provider to see if this is right for you.
  • Since neuropathy interferes with the brain’s ability to feel pain, sometimes taking anti-depressants can help change the chemical process in the brain and modify your pain perception.

Shoes for Neuropathy

If you have peripheral neuropathy and it has affected your feet, it is recommended you only wear neuropathy shoes as they are designed with special features that help comfort and protect the sensitive foot. Below is a list of important features you should look for when shopping for the best neuropathy footwear.

  • Extra depth design – shoes designed with added depth from the heel to the toe promote a pressure free environment and can accommodate foot swelling. There is also enough room to insert a custom orthotic or brace if needed. If you wear padded socks for extra protection, they will also fit comfortably in your shoes. Wide toe-box – a round & tall forefoot area is ideal for maximum toe movement and prevent the toes from overlapping or rubbing against each other. It is also the best for feet with bunions and hammertoes that require a wider area.
  • Non-binding stretch uppers – the neuropathic foot is sensitive and can get swollen often. It is imperative not to add any extra pressure or stress that may constrain already compromised circulation. Shoes for neuropathy are designed with fabric uppers that expand and contract are able to conform to the specific shape of the foot at any given time and offer a comfortable fit.
  • Wide widths – often the neuropathic foot expands which necessitates wide width footwear. Orthopedic companies have the best selection and offer widths from medium up to extra extra wide. For the best fit, try on shoes during times when they are most swollen which is usually towards the end of the day.
  • Orthotic insole – shoes for neuropathy with built in orthotics are even better since they support the arch, align the body and prevent excessive pronation which can lead to injuries and other foot problems. The insoles are usually constructed with shock absorbing materials that cushion the foot and protect it from the daily pounding.
  • Seam free interior– the loss of sensation will not allow someone with a neuropathic foot to feel even a little thread! A seamless interior prevents rubbing and skin irritation.
  • Padded linings– thick cushioning all around the foot protects it from injury.