Neuropathy in your feet and how to treatment in Dallas & Plano; Peripheral neuropathy is a condition that commonly affects the legs and arms. Neuropathy in your feet is when the nerves that carry pain signals from your feet to your brain gets damaged or affected.
When this happens, you may start feeling pain, numbness, or tingling in your feet. You may feel pain in your feet even when there is no injury or trauma causing the pain. The nerves in your feet begin to malfunction and your brain begins to receive wrong pain signals.
Neuropathy in your feet prevents you from making good use of your feet. You may be unable to stand, walk, or run with your feet. It affects your daily use of your legs and ultimately affects your general wellbeing.
Symptoms of neuropathy pain in the feet
The symptoms of neuropathy pain in the feet may slightly defer from person to person. This means that the symptoms one person experiences may be slightly different from the symptoms another person experiences.
Common symptoms include:
- Shooting, burning or stabbing pain
- Tingling and numbness
- Spontaneous pain
- Pain that occurs without a trigger
- Evoked pain, or pain caused by events that are normally not painful
- Chronic sensation of feeling unpleasant or abnormal
- Difficulty sleeping or resting
- Emotional problems and loss of sleep
- Constant pain may occur intermittently
- Sharp pain or cramps
- Reduced ability to feel pain or numbness
- Changes in body temperature
- The weakness of the muscles
- Loss of reflexes
- Increased skin sensitivity
- Severe foot problems
- Bone or joint pain
- Loss of balance
- Excessive sweating
- Heat intolerance
- Changes in blood pressure
- Nausea or vomiting
- Abdominal bloating
- Blurred vision
Causes of neuropathy pain in the feet
Common causes of neuropathy pain in the feet include:
Cancer treatment may cause neuropathy pain. Cancer treatments such as chemotherapy and radiation can impact the nervous system and cause unusual pain signals.
Injuries to tissue, muscles, or joints are an uncommon cause of neuropathy pain. Back, leg and hip problems or injuries can damage the nerves leading to pain.
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 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.
Some other types of diseases such as kidney disease, liver disease, connective tissue disorders and an underactive thyroid can cause nerve damages.
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.
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.
Most people with diabetes develop some type of neuropathy. Diabetes is one of the most common causes of nerve damages
People with a family history of neuropathy are likely to develop the disorder.
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.
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 some common causes of nerve damages.
Holding still in a position for too long or inactivity can cause neuropathy.
Increased pressure on the inside of the ankle or knees can lead to nerve compression or entrapment which can lead to peripheral neuropathy.
When the body lacks B vitamins such as B-1, B-6 and B-12, vitamin E and niacin, it could 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 initiated will be targeted towards the areas of most concern but work towards full resolution of symptoms.
At times, our providers may recommend a Sudoscan test to measure the amount of nerve fibers in the skin.
Weekly assessments of pain, stability and healing progress is important and most patients will be seen more than once a week for treatments
One of these treatments is MicroVas, which is a unit that stimulates microcirculation and blood flow to the nerve which allows the nerves to regenerate. The patient needs to be aware that improvement will be gradual and may take several months, although some patients do feel a difference quickly. The treatment’s duration is 45 minutes and is recommended 2 times a week initially. The patient essentially just sits and relaxes while the unit is attached to the patient’s leg and gradually increases in intensity to their level of tolerance.
Oral and topical medications can be beneficial as well. There are multiple oral medications that treat neuropathy symptoms which can be prescribed to help. This is usually a first line treatment and may be beneficial to most patients once a baseline of the neuropathy severity has been established.
The Microvas encourages blood flow to the nerve and the prescription vitamin medications such as Nufola or Metanx nourishes the nerve and encourages re-growth.
CBD topical therapy research studies have shown to be effective, even to those who have not responded to pharmaceutical therapies, and the psychoactive side effects are not as debilitating as those presented by opiates. The way CBD works is 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 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 angiogenesis (healing) and recruitment of the body’s cells to this area.
Some common types of injection therapies for nerves include corticosteroid, 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. Therefore, a precise delivery technique is required for treatment of peripheral nerves with high-dose vitamin B12. 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 and may be a treatment modality depending on our diagnostic assessment and prior treatments.