Managing Your Diabetic Foot Pain

Foot pain for any reason can disrupt your day, but when coupled with a condition like diabetes, it can cause additional challenges. Read on to learn more about managing diabetic foot pain.

Diabetes is a chronic condition that affects how your body converts the food you eat into energy.⁷ After you eat, the food is broken down into sugar, which then enters your bloodstream, causing your blood sugar to rise.⁷ When this happens, it signals your pancreas to release insulin, which helps to move the blood sugar into your body’s cells to use as energy.⁷ If you have diabetes, your body either doesn’t make enough insulin or doesn’t use the insulin it makes as effectively as it should.⁷ Instead of fully converting blood sugar to energy, too much blood sugar remains in your bloodstream, which can lead to serious health complications if not properly managed.⁷ One of these complications is a type of diabetic neuropathy in the feet.

What Is Diabetic Neuropathy?

Diabetic neuropathy is nerve damage that’s caused by diabetes.¹ If not properly managed, an excess of high blood sugar can lead to long term damage to blood vessels and nerves within the body, most commonly in the legs and feet.^1,2 This type of neuropathy that affects the feet is referred to as peripheral neuropathy, though there are other varieties that may affect the heart, hips, and eyes.²

For some, neuropathy can be the first sign of diabetes, and about 50% of people with diabetes suffer from some kind of nerve damage.³ This damage is primarily caused by high blood sugar, which causes chemical changes in the nerves, making it difficult for them to send or receive signals.¹ High blood sugar can also cause harm to the blood vessels that carry oxygen and nutrients to those nerves.¹ In some individuals, genetics can be a determining factor in whether or not they have neuropathy as part of their diabetes.^1,3 Others may find that their individual metabolic factors play a role in their diabetic neuropathy.³ For example, people who are overweight or obese have an increased risk of developing diabetic nerve damage that leads to pain.³

Diabetic Foot Pain Symptoms

It can be difficult to tell if the pain in your foot is due to diabetic neuropathy or something else. Common symptoms of diabetic foot pain include:

• A tingling feeling in the feet that may resemble a “pins and needles” sensation¹
• Foot problems like dry or cracked skin, claw toes, calluses and weakness in the ankles¹
• Numbness or a decreased ability to feel pain or changes in temperature in the feet²
• Swollen feet⁵
• Burning, stabbing or shooting pains in the feet⁴
• Feet that are extremely sensitive to the touch⁴
• Inability to feel your feet while walking⁴
• Feeling unsteady and uncoordinated while standing or walking, as though the muscles have weakened^3,4
• Open sores on the feet and legs that heal very slowly⁴

Diabetic foot pain and nerve damage can put an individual at risk for injuries because it lessens their ability to sense problems.³ While some cases of neuropathy are mild and may go unnoticed for years, others can lead to severe pain due to worsening nerve damage.³ Not only do daily activities like sleeping and walking become painful and difficult, but chronic foot infections, wounds, and ulcers may develop and become slow to heal due to the damaged nerves and blood vessels.^1,3 If improperly managed, these sores and infections due to neuropathy can lead to the loss of a toe, foot, or part of your leg.⁵

In some rare instances, diabetic foot pain can even cause changes to the shape of your feet and toes.⁵ Some diabetics with nerve damage in their feet may suffer from an uncommon condition called Charcot’s foot, which can damage the bones, joints and soft tissues in the feet, causing them to become misshapen.⁵

Diagnosing Diabetic Nerve Damage

Because diabetic foot pain is so common, diabetics should have a complete foot exam once a year on top of regular podiatry appointments.⁴ This exam checks the feet’s skin, muscle tone, and bones, and whether circulatory issues are present.⁴ Your doctor will also check for nerve damage and numbness by using tools like a tuning fork or a monofilament.⁴ Your doctor may conduct additional tests like an electromyography to see how your nerves and muscles respond to electronic impulses.^3,4 Because nerve damage in the feet can be so destructive, it’s important to properly identify injuries.

Treating and Managing Diabetic Foot Pain

Diabetic foot pain and nerve damage is best managed by keeping blood sugar levels in check to keep the damage from worsening.⁴ Once neuropathy is detected, the main focus is on managing the pain and keeping the legs and feet healthy and protected since this type of nerve damage cannot be reversed.⁴

To protect your feet, check them every day for blisters, cuts, and cracked skin.² Wash your feet daily but avoid soaking them. Make sure to dry them carefully after washing and then moisturize the skin on your feet to prevent skin cracks.² Keep the skin between your toes dry to inhibit fungal growth and carefully trim your toenails to avoid sharp edges. Wear clean, moisture-wicking socks and cushioned shoes that fit well to avoid falling.² All this may seem like a lot of work for your feet, but diabetic foot pain and nerve damage can make it hard to tell if something is wrong with your foot—you may be unable to tell if your foot is irritated in the moment, so taking the time to care for them can help ease your mind.

When it comes to diabetic foot pain relief, your healthcare practitioner may recommend physical therapy to improve strength and balance or a device called a bed cradle, which keeps sheets and blankets off your legs and feet while you sleep.⁵

Talk to your doctor before taking any medications for diabetic foot pain. Many over-the-counter medications may affect blood sugar levels.⁶ While some people with acute presentation of diabetic foot pain may be able to safely take OTC pain medications, like Advil Tablets, your doctor should have the final say. Be sure you review a drug’s safety information and are aware of any potential side effects that you may experience as a result of your diabetes.