Foot pain and other foot conditions may be a daily part of life for those living with diabetes. It is important to understand how to recognize the signs of foot troubles so that they can be treated effectively. Here are the most common foot pain conditions associated with diabetes and their treatments.
Diabetic peripheral neuropathy is a condition in which the peripheral nerves in the body (those leading to the extremities like hands and feet) have suffered damage and even death. This can lead to foot injuries that go undetected, such as blisters or sprains. Nerve damage may be so severe that you could even step on something sharp like glass or a tack and not realize that it is embedded in your foot. These injuries can lead to infections that can be very dangerous for a person with diabetes.
Neuropathy can change the shape of your feet, and forcing them into shoes that don’t fit can further damage them.
Treatment: Check your feet daily for punctures, bruises, or other injuries that you may not have felt occur during the day. Additionally, talk to your doctor about custom orthotics or specially designed shoes to help conform to the shape of your foot (instead of forcing your foot into a shoe that no longer fits). Special shoes may not seem necessary, but with oxygen and blood flow already restricted in the feet, it is even more important to give feet proper space.
Changes to skin
The decrease in blood and oxygen circulation to the feet can cause unexpected changes to the skin. Nerve damage means that the nerves controlling levels of moisture in the feet no longer work. This can result in painfully dry and cracked skin on the feet.
Treatment: In this case, an ounce of prevention is truly worth a pound of cure. Along with inspecting your feet daily, there are a few ways you can prevent foot pain due to cracked and peeling skin. After bathing, dry your feet and inspect them carefully. Look for any splits or cracks that may need treatment (such as an antibiotic ointment).
When your feet are fully dry, moisturize with a thin layer of petroleum jelly, unscented hand lotion, or other moisturizing salve. Cover feet with thin cotton socks to allow them to breathe. This will keep the moisturizer from rubbing off. When moisturizing, avoid putting too much (if any) moisturizer between the toes. This is a naturally damp area of the foot, and added moisture may cause infection. If there is dry skin or cracks, treat with antibiotic cream and a bit of moisturizer as needed, but there is no need to moisturize routinely.
A foot ulcer is a deep, open sore or skin wound. While they occur most often on the underside of the big toe or on the balls of the feet, ill-fitting shoes can cause ulcers on the sides of the feet as well. It is important to seek medical attention for any ulcer on the foot. For people with diabetes, any wound can be very slow to heal, and this can cause complications that can be serious.
Treatment: The treatment varies depending on the type of ulcer. Your doctors may perform an X-ray to make sure there is no involvement with the bone. They will then clean out any dead or infected tissue and prescribe an antibiotic cream. It is important to stay off the affected foot as much as possible while it is healing. Any pressure on an ulcer can make it worse. The doctor may provide you with a splint or special boot.
If the foot ulcer is not healing properly, you may be referred to a vascular surgeon. Proper circulation is essential to wound healing, and circulation is generally an issue for people with diabetes.
Once the foot ulcer is healed, you may need to wear special shoes to keep the pressure off the area. Scar tissue under an old wound is easily broken down, especially for those with diabetes.
Foot pain due to poor circulation
Poor circulation can cause foot pain in a number of different ways. Poor circulation may cause nerve damage, which means that feet feel constantly cold. Warming the feet with a heating pad or hot water can cause burns, as the feet may not be able to feel the sensation of heat.
Those with poor circulation may also feel intermittent claudication, which is pain in the calves that occurs when walking up a hill, on a hard surface, or when walking fast.
The most dangerous side effect of poor circulation is dry gangrene, a foot condition that causes tissue to die and rot, necessitating amputation.
Treatment: There are two main treatments for foot pain due to poor circulation. The first is to limit any activities that make circulation worse, like smoking. Smoking hardens arteries, limiting blood flow and restricting the flow of oxygen in the body.
The second treatment is to get regular exercise. Exercise increases circulation, lowers cholesterol, and helps maintain a healthy body weight, all important factors in managing diabetes and diabetic foot pain. You should not put pressure on your feet if they have ulcers, but otherwise, daily exercise is an excellent option!
Our feet support the weight of our bodies every day, and this can cause a build-up of calluses. For those without diabetes, this tough, dead skin that is a result of too much pressure on certain areas of the foot is not really a cause for concern. For those with diabetes, these calluses can get overly thick and break down to become a foot ulcer. Once this happens, foot ulcers can be very difficult to heal.
Treatment: Looking for thick calluses should be part of the daily foot inspection. Wash your feet in warm water to soften the calluses a bit, then use a pumice stone daily to gently remove the callus. It may take several days of use to remove any thick callus.
Do not use harsh chemicals, and do not cut your calluses. If the calluses do not respond or get smaller when using a daily pumice scrub, ask your doctor if he or she can remove them for you.
After using the pumice stone, pat feet completely dry and moisturize immediately.
At the extreme end of foot pain is amputation, the most common and single most costly procedure for diabetic patients, many times prompted by a foot ulcer that goes undetected due to loss of lower limb sensation. The average cost for a lower limb amputation is $70,000, and in 2013, approximately 73,000 people in the U.S. required this procedure.
Foot care is an important part of preventative treatment for diabetes. Make it a part of your daily regimen!