Peripheral neuropathy is a condition that commonly affects the legs and arms. Neuropathy in your feet occurs when the nerves that carry pain signals to your brain get damaged. This can cause pain, numbness or tingling in your feet. You may feel even when there is no injury or trauma causing it. The nerves in your feet can begin malfunctioning and your brain can begin receiving incorrect pain signals. Neuropathy in your feet can prevent you from standing, walking or running. It can limit daily use of your legs and ultimately affect your wellbeing.
The symptoms of neuropathy in the feet may slightly differ from person to person. The symptoms one person experiences may be different from the symptoms another person experiences. Common symptoms include:
The most common causes of neuropathic pain in the feet include:
Cancer treatments: Cancer treatment may cause neuropathic pain. Cancer treatments such as chemotherapy and radiation can impact the nervous system and cause unusual pain signals.
Injuries: Injuries to tissue, muscles or joints are uncommon causes of neuropathy pain. Back, leg and hip problems or injuries can damage the nerves leading to pain.
Infection: Infections, though not a common cause of neuropathic pain, can lead to nerve damage. Infections such as shingles can trigger several weeks of neuropathic pain along a nerve. Postherpetic neuralgia is a rare complication of shingles that involves persistent neuropathic pain. Syphilis infection can lead to burning and stinging pain. Certain bacteria and viruses directly attack the nerve tissues in the body. Examples are Epstein-Barr virus, hepatitis B and C, leprosy, diphtheria, and HIV.
Autoimmune diseases: Autoimmune diseases like rheumatoid arthritis, lupus, Guillain-Barre syndrome, chronic inflammatory demyelinating polyneuropathy and vasculitis affect the peripheral nervous system in various ways. Chronic inflammation and damage to tissues, as well as pressure caused by inflammation, can all lead to severe nerve pain.
Bone marrow disorders: Bone marrow disorders such as an abnormal protein in the blood (monoclonal gammopathies), a form of bone cancer (myeloma), lymphoma and the rare disease amyloidosis can affect the nerves and cause neuropathy.
Diseases: Diseases such as kidney disease, liver disease, connective tissue disorders and an underactive thyroid can cause nerve damages.
Alcoholism: Alcohol can have a toxic effect on nerve tissues. Alcoholism can lead to vitamin deficiencies. People who take excess alcohol are at a higher risk of peripheral neuropathy.
Toxic chemicals: Exposure to toxic chemicals like glue, solvents or insecticides can also cause nerve damage. Exposure to heavy metals such as lead and mercury can also cause nerve damage.
Diabetes: Most people with diabetes develop some type of neuropathy. Diabetes is one of the most common causes of nerve damage.
Inherited disorders: People with a family history of neuropathy are more likely to develop the disorder.
Tumors: Cancerous and noncancerous growths and tumors can develop on the nerves causing neuropathy.
Exposure to poisons: Exposure to poisonous substances and chemicals can cause peripheral neuropathy.
Medications: Certain medications such as anticonvulsants, drugs for bacterial infections, medications for cancer treatment, and some blood pressure medications can cause peripheral neuropathy.
Injury or trauma: Injury or trauma from motor vehicle accidents, fractures, falls or sports injuries are common causes of nerve damage.
Inactivity: Holding still for too long or physical inactivity can cause neuropathy.
Increased pressure: Increased pressure on the inside of the ankle or knees can lead to nerve compression or entrapment, which can lead to peripheral neuropathy.
Vitamin deficiencies: When the body lacks B vitamins such as B-1, B-6 and B-12, vitamin E and niacin, it can lead to peripheral neuropathy.
Some diagnostic modalities during the first visit include foot and ankle evaluation, gait evaluation, X-ray, ultrasound, nerve and blood flow studies, basic and advanced lab work to get a baseline. Therapy will be targeted towards the areas of most concern but work towards full resolution of symptoms. We may recommend a Sudoscan test to measure the amount of nerve fibers in the skin.
Weekly assessments of pain, stability and healing progress are important, and most patients will be seen more than once a week for neuropathy feet treatments
One of these foot nerve pain treatments is MicroVas, which stimulates microcirculation and blood flow that allows nerves to regenerate. Improvement will be gradual and may take several months, although some patients feel a difference quickly. The treatment’s duration is 45 minutes, and we recommend two times a week initially. You can just sit and relax while the unit is attached to your leg and gradually increases in intensity to your level of tolerance.
Oral and topical medications can be beneficial, as well. We can prescribe multiple oral medications that treat neuropathy symptoms. These are usually first line foot nerve pain treatments and may be beneficial to most patients once a baseline of neuropathy severity has been established.
MicroVas encourages blood flow to the nerve and prescription vitamin medications such as Nufola or Metanx nourishes the nerve and encourages re-growth. CBD topical therapy has shown to be effective, even for those who have not responded to pharmaceutical therapies, and the psychoactive side effects are less debilitating than those presented by opiates. CBD works by interacting with the body’s endocannabinoid system. and research reveals that this particular system plays an important role in the regulation of pain and inflammatory receptors.
Injection therapy stimulates regeneration and repair of injured tissue including wounds, muscle, tendons and nerves. Neural prolotherapy (NPT) was primarily born out of clinical observations and involves the treatment of neurogenic inflammation. This treatment was originally performed with local anesthetic and dextrose, but further research has shown increased benefits with other agents. Combining this therapy with the MicroVas vascular treatment system has been shown to stimulate neuromuscular contractions that drive venous muscle pump, improve blood flow and tissue oxygenation, which helps stimulate a healing and recruitment of the body’s cells to this area.
Some common injection therapies include corticosteroids, B-12, platelet rich plasma and bone marrow aspirate injection therapy. Only a small proportion of the vitamin B12 gets absorbed when it is taken orally. Instead, we use a precise delivery technique for treatment of peripheral nerves with high-dose vitamin B12 injection. Ultrasound-guided perineural vitamin B12 injection has the advantage of high-dose B12 delivery to defective nerves. IV medications have also shown to provide relief of neuropathy symptoms.
Are you suffering from foot nerve pain or neuropathy? Schedule an appointment with Graff Foot Ankle and Wound Care. Call (972) 403-7733 today or use our convenient Request an Appointment form to schedule your visit.
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June 17, 2022
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