diabetes numbness toes
Painful diabetic neuropathy
The toes burn and tingle and sharp shooting pains in the legs. The bed linen uncomfortable on your feet and you roll back and forth, hoping to drift off into a pleasant sleep. But the "fire-like" feeling in the toes keeps you awake. They switch positions, wiggle your toes, prop seems a pillow under the legs, but nothing to help. You can only lie in bed and watch the hours pass on the clock.
Background
Burning, numbness, tingling, cold or heat, shooting and electrical pain are common sensations felt in the feet in patients with painful diabetic peripheral neuropathy (PDN). Neuropathy is a disorder of the nervous system. Diabetic neuropathy, nerve damage caused by diabetes and is described as a loss the sensation that starts in the tips of the toes and gradually works its legs. Diabetic neuropathy is sometimes referred to as a stocking-glove neuropathy because it progresses as if you pull on a sock. Diabetic neuropathy, both the hands and feet.
There are three types of nerves in diabetic peripheral neuropathy, affected sensory, motor and autonomic. Sensory nerves allow people to perception, emotion, such as pain, hot or cold or touch. Motor nerve control the muscles and enable movement. Autonomic nerves control bodily functions without our awareness or control. In the feet, would be a reaction of the autonomic be nervous sweating. Neuropathy may be to group all these types of nerves, but sensory nerves are usually the first and most commonly involved.
Statistics
Fast twenty-one million Americans suffer from diabetes. About sixty to seventy percent of diabetics have some form of nerve damage, and about thirty percent of diabetics over forty years, a diabetic peripheral neuropathy (CDC, 2005). Five percent of diabetics experience painful diabetic neuropathy and the incidence increases with age. About forty five percent of people who have been ill for over twenty-five years will experience some symptoms of PDN.
The cause
The exact cause of diabetic neuropathy is not clearly understood. Many theories exist, but the general school of thought is that high blood sugar chemical changes in nerves and damages blood vessels with oxygen and nutrients to the nerves that caused nerve function impairment. A not so new theory, which always popular will is the idea that diabetics are more prone to compression of nerves. The sensitivity is assumed that due to the increase in the nerve from the abnormal glucose metabolism in the nerve. In legal terms this is as if the nerve swelling and the surrounding tissue and ribbons on the nerves, which merge to a loss of function.
Treatments
There is currently no treatment for diabetic neuropathy reversed and there are no treatments to remove the numbness is. However, there are many treatments to reduce of the symptoms associated with PDN.
Drugs
There was hope of reversing or significantly improve neuropathy with drugs such as aldose reductase inhibitors, myoinositol, Protein kinase C inhibitors, C-peptide, vasodilators and nerve growth factors. Unfortunately, the research did not show consistent or effective results.
The main support of medical treatment for diabetic peripheral neuropathy is to manage the symptoms with drugs. For those who may be persons with painful diabetic neuropathy prescription medications are needed to manage the pain. Classic drugs are used to treat amitriptyline, desipramine and nortriptyline. These were used to help to reduce pain and sleep. Fluoxetine, paroxetine, and citalopram Sertral usually better tolerated, but also tend to be less effective in relieving of pain.
In September 2004 the FDA approved Cymbalta duloxetine as known. This was the first drug specifically approved for the treatment of PDN. Gabapentin, also known as Neurontin known, was a successful treatment of painful diabetic neuropathy. Originally approved as an anti-seizure drug, was it a popular treatment of painful diabetic Neuropathy. There was a controversy surrounding this drug if the manufacturer of this drug for marketing PDN, which is to be treated launched an off-label use. Many doctors still this drug as a treatment. A newer drug called pregabalin has arisen, also known as Lyrica. Pregabalin has been approved by the FDA are caused by nerve damage pain and many feel pregabalin is superior in efficacy and has fewer side effects than Neurontin. Tegretol and Dilantin, common seizure medications can, in severe cases be used.
Therapy
Anodyne infrared therapy uses light energy to increase the circulation of the small vessels in the feet. Diodes are fit into flexible pads that can be applied directly to the skin over several areas of the foot. The theory is that light energy to the blood flow again Function of increasing injured nerve helps. Originally released in 1994, Anodyne was met with mixed reviews, but has gained in popularity in the recent years. Some studies have shown excellent results with a reduction in pain and symptom relief of a total of neuropathy. Anodyne has also to treatment used by diabetic ulcers, has been encouraging with some results.
Surgical
Nerve decompression has increased in popularity in recent years as Treatment for diabetic peripheral neuropathy. This surgical treatment was initially not with much enthusiasm. Previous studies have shown poor operating results and many surgeons were reluctant to undergo elective surgery performed on diabetics. A new surgical technique and improved surgical approach introduced success rate dramatically. The theory that diabetics vulnerable to compression of nerves, may justify decompression of nerves on the alleviation of the symptoms of diabetic neuropathy provide.
Natural Alternatives
There are many natural alternative treatments for diabetic neuropathy. Many diabetics have had success with their use, but studies have not given consistent results showing its effectiveness. For painful diabetic neuropathy may help decrease the red pepper pain occurs at night. Capsaicin is the active ingredient in chili peppers. If the feet applied it acts as a counter irritant and can help decrease neuropathic pain. Capsaicin can be purchased at your local drugstore be. Alpha lipoic acid is an effective anti-oxidant that has been shown in some studies, pain relief with neuropathy. Gamma-linolenic acid is an essential fatty acid, typically sold in the form of evening primrose oil. Most studies have shown modest results, but the possibilities are still encouraging. Side effects of long-term use at higher doses can inflammation, thrombosis (blood clots), or decreased function of the immune system. It is important to note that even if a product labeled "natural" it does not necessarily mean that it is safe. Always consult your physician before beginning any new supplements.
Prevention
As with all diabetic complications, prevention is the best treatment. Keep blood glucose levels within the normal range is the most important tool in the treatment and prevention of peripheral neuropathy. Even with tight control, most diabetics develop some degree of neuropathy. Given the severity of the complications with neuropathy (ulcers, infections and amputations), is the associated pain in PDN, tight blood glucose control is of paramount importance. Along with a healthy Diet, exercise for 30 minutes per day will also help improve circulation and stimulate the growth of new blood vessels that help the progression of neuropathy can.
The treatment of painful diabetic peripheral neuropathy is very difficult and many of the above therapies should be tried and combined. Expect no "cure" and give us all therapy a chance to work. It is recommended that you speak with your doctor or podiatrist to discuss these treatment options.
About the Author
Christine Dobrowolski, DPM is a podiatrist and owner of Northcoast footcare, Inc an online resource for foot care products and foot health information.
To learn more about diabetic foot care and peripheral neuropathy, visit
NorthcoastFootcare.com/PDN
Foot Neuroma – Podiatrist in Bountiful, UT
