Ask the Doctors: What can be done about foot pain caused by peripheral neuropathy?
It’s a condition in which the nervous system malfunctions because of disease or some kind of damage.
Dear Doctor: My dad is 65 and has Type 2 diabetes. He recently developed pain in his feet, which his doctor says is peripheral neuropathy. What is that, and what treatments are available?
Answer: With neuropathy, the nervous system malfunctions due to disease or some kind of damage. Peripheral means the problem lies in the body’s complex network of nerves.
The peripheral nervous system collects and sends sensory information to the central nervous system — the brain and spinal cord.
So, for instance, when you break into a sweat on a hot day or keep your balance with your eyes closed, that’s thanks to information your peripheral nervous system sent to your brain.
An estimated 20 million people in the United States experience peripheral neuropathy. Symptoms include numbness, twitching, throbbing or tingling, burning sensations, problems with balance and skin sensitivity so acute that ordinary stimuli, like the touch of a shirt on bare skin, are painful.
When motor nerves are affected, peripheral neuropathy causes weakness and can lead to the loss of muscle mass.
If nerves serving organs or glands are involved, it can result in impaired digestion, perspiration, urination or sexual function.
At its extreme, peripheral neuropathy causes breathing difficulties or leads to organ failure. But this is rare.
Diabetes is the most common cause of peripheral neuropathy. Other factors include infections such as shingles or the Epstein-Barr virus, certain kidney disorders, vitamin deficiencies, physical damage, cancers that press on or infiltrate nerve fibers and autoimmune diseases.
Exposure to toxic substances such as lead, arsenic or pesticides as well as medical agents like chemotherapy drugs also can cause the condition. So can heavy alcohol consumption.
Your father’s symptoms began in his feet — common with diabetes, which causes blood vessels in the foot and leg to become stiff and narrow.
Treatment will focus on controlling his diabetes to prevent further nerve damage and giving him relief from the pain. Mild pain often responds to over-the-counter NSAIDs. Antidepressants, anticonvulsants and narcotics are used for chronic pain. Physical therapy and specialized footwear can help.
Dr. Eve Glazier is an internist and associate professor of medicine at UCLA Health. Dr. Elizabeth Ko is an internist and assistant professor of medicine at UCLA Health.