Experiencing chronic pain in your feet? Blame diabetes

By Dr Sujeet Jha

People suffering from high blood sugar for a substantial period are at a higher risk of developing neuropathy. Apart from changing sugar levels, various other factors like high blood pressure, high lipid levels, smoking, and consuming alcohol can also result in nerve damage.

A recent study conducted on diabetic patients showed that about 50-70 per cent of them developed some form of neuropathy in their lifetime. The study also pointed out that one in three diabetic patients show evidence of diabetes-related nerve damage during their first visit to the doctor. Further, nerve damage results in around 50-75 per cent of non-traumatic leg amputations.

However, this is a preventable complication. It can be controlled by monitoring the blood sugar, which, in turn, will prevent the onset or progression of nerve damage.


One in three diabetic patients show evidence of diabetes-related nerve damage during their first visit to the doctor. (Image: Getty)

Diabetic neuropathy can be classified into four sub-segments:

Peripheral neuropathy

This condition affects the nerves of the patient's toes, feet, legs, hands and arms, leading to numbness, loss of sensation and pain.

Autonomic neuropathy

In this condition, the nerves that regulate autonomic function such as digestion, bowel and bladder function, regulation of vision, sexual response, perspiration, heart rate and blood pressure are affected. In the long run, the patient experiences symptoms like constipation, diarrhea, nausea, low appetite, dizziness, blood pressure changes and urinary incontinence.

Focal neuropathy

Focal neuropathy occurs in any peripheral nerve. The onset of the pain or numbness may be severe and sudden, most often in the torso, head or leg. However, it can also occur in the nerves in the eye, causing sudden vision changes.

Proximal neuropathy

Proximal neuropathy affects nerves in the thighs, hips or buttocks causing pain or numbness. It can lead to weakness in the legs.


One needs to observe the chronic pain (Image: Thinkstock)

Symptoms: Detecting the problem

To detect the condition, one needs to observe the chronic pain in their feet/soles and immediate medical help should be sought. Mostly, the affected patients often have a progressive build-up of unpleasant sensory symptoms. The symptoms include burning pain; shooting pain down the legs (like 'electric shocks'); pain (like being stabbed with a knife); contact pain (often with day-time clothes and bedsheets); pain while walking (like 'walking barefoot on marbles or hot sand'); persistent achy feeling in the feet; and cramp-like sensations in the legs.

Other symptoms include tingling and sensations of heat or cold in the feet.

In most cases, the pain can extend above the feet and may involve the whole of the legs when the disease advances. In such a scenario, often the upper limb is involved. The affected patient experiences pain during night which later transforms into tiredness throughout the day. This further affects the quality of life and performance at work.


The best way to prevent neuropathy is to keep your blood glucose levels normal (Image: Thinkstock)

Prevention is better than cure

The best way to prevent neuropathy is to keep your blood glucose levels as close to normal as possible. People who suffer neuropathy need to work with their healthcare experts for maximum relief and benefits.

(The author is an endocrinologist at Max Healthcare Hospital, New Delhi)