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16/08/2024 | Press release | Distributed by Public on 17/08/2024 00:17

Diabetes and Foot Pain: How to Prevent and Treat Diabetic Neuropathy

Key takeaways:

  • Foot pain is common in people who have diabetes. It's commonly caused by damage to the nerves and called diabetic neuropathy.

  • Well-managed blood sugar levels can lower the risk of developing diabetic foot pain. Smoking cessation can help lower the risk too.

  • Regular foot checks and exams are important for everyone with diabetes. Foot checks can help you avoid complications like foot ulcers and foot injuries.

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Featuring Sandra Arévalo, RDN, Minisha Sood, MD, William Spielfogel, MD
Reviewed by Mera Goodman, MD, FAAP | April 30, 2023

Diabetes can impact almost every part of the body. Your legs, feet, and even toes are no exception.

Many people with diabetes experience diabetes-related foot pain (also called diabetic foot neuropathy). The longer you have diabetes and the higher your blood sugar levels run, the more likely it is you'll develop foot pain or discomfort in the future.

Here's what you need to know about diabetic foot pain.

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Why does diabetes cause pain in your feet?

When you have diabetes, high blood sugar levels can damage nerves and blood vessels.

The nerves and blood vessels supplying the feet are long and delicate. Because of that, the feet - and especially the toes - often get affected first.

Damage to the nerves and blood vessels in the feet causes two separate but related problems: peripheral neuropathy and peripheral artery disease. Together, they can lead to foot pain and complications.

EXPERT PICKS: WHAT TO READ NEXT
  • Why do people with diabetes get foot ulcers? Our experts explain how diabetes can lead to foot ulcers and skin breakdown.

  • What are the early signs of diabetic foot ulcers? Learn how to spot an early foot ulcer, so you can get help fast.

  • Diabetes can affect other parts of your body too. Here's how diabetes can affect your body long term.

GoodRx Health

1. Peripheral neuropathy

This is the name for damage to any nerves outside the brain and spinal cord. When it happens in the feet and legs, peripheral neuropathy causes pain, numbness, and other problems related to balance and foot stability.

2. Peripheral artery disease

This is when damage to blood vessel walls causes blood vessels to become stiff and narrow. This can lower blood flow to the feet, which, in turn, leads to:

  • Breakdown of the skin, making it more prone to damage and infection

  • Slower healing of injuries

  • Greater risk of infection, ulcers, and gangrene

What does foot pain from diabetes feel like?

Many people describe diabetes foot pain as:

  • Tingling: This is a "pins-and-needles" kind of sensation. It feels similar to when your foot falls asleep.

  • Pain or higher sensitivity: This is pain from or sensitivity to things that are normally not painful. It could be painful for bed sheets to brush against your feet, or uncomfortable to wear certain socks.

  • Numbness or weakness: Nerves help you feel, and they tell your muscles to work. If you're noticing that you don't feel when you step on an object or cut your feet, this can be a sign of nerve damage.

People may also notice that even mild foot injuries take longer to heal. That's because blood vessels carry immune cells to wounds to help fight infections and repair damaged tissue. But people with diabetes can develop poor circulation from peripheral artery disease. This leads to slow wound healing.

What are some risks of diabetic foot pain if you don't get treatment?

Diabetes-related foot pain is more than just pain; it's a warning sign from your body. This type of nerve pain can lead to other foot complications like:

  • Dry, cracked skin: This may not sound too bad, but when your skin is too dry, your risk of getting skin infections goes up.

  • Calluses: This is an area of thickened skin that has less feeling. People with diabetes get calluses faster and more often than those without diabetes.

  • Ulcers: These are foot sores that develop due to poor blood circulation. All ulcers (no matter how small) need to be treated. Without treatment, they can become infected.

  • Amputations: Foot infections can cause the skin and muscle tissues to die. Once this happens, it can't be fixed. The only way to stop the infection from spreading to the rest of the body is to amputate part (or sometimes all) of the foot.

What can you do to manage and prevent diabetes-related foot pain?

Diabetes-related foot pain can't be cured. But treatment can keep it from getting worse. The best way to prevent or manage diabetic foot pain is by keeping your blood sugar in a healthy range. You can do this with the right diet, exercise, and diabetes medications.

Here are five things you can do at home to help manage your diabetes-related foot pain and prevent complications.

1. Check your feet

Check the bottoms of your feet every morning when you wake up and every night before you go to bed. Look for cuts, wounds, and anything else unusual.

2. Wear shoes around the house

When you have diabetic foot pain, you can't always feel when you step on things. Wearing shoes helps to prevent cuts and injuries.

3. Follow up with your healthcare provider

It's important to attend your regular healthcare appointments. Not only will your provider be able to perform foot exams, but they can catch problems early and keep them from becoming more serious.

4. Follow your diet plan

Just because diabetes-related foot pain isn't reversible doesn't mean it can't be improved. The right diet helps keep blood sugar levels within a healthy range. You can work with a diabetes dietician to develop the right meal plans for you.

5. Stop smoking

Smoking damages your blood vessels and can worsen peripheral artery disease. Smoking cessation helps to improve blood flow to your feet.

If you're having trouble quitting smoking, talk with your primary care provider or diabetes treatment team. They can recommend treatments and support groups that are right for you.

6. Have corns and calluses removed by a professional

Corns and calluses are areas of thickened skin that are less able to perceive pain and sensation. Treatment can help smooth these surfaces so that you can maintain better sensation in those areas. But don't try to remove them on your own. This can lead to serious infections. Instead, work with a foot doctor (podiatrist) who is trained to care for people with diabetes.

What are treatment options for diabetic foot pain?

You can also take medication to help lessen symptoms from your diabetes-related foot pain. Here are some of the most commonly recommended ones:

  • Pregabalin (Lyrica)

  • Duloxetine (Cymbalta)

  • Gabapentin (Neurontin)

  • Amitriptyline (Elavil)

Over-the-counter pain relievers like acetaminophen (Tylenol), ibuprofen (Motrin, Advil), and naproxen (Aleve) don't improve nerve pain.

When to seek care for diabetes-related foot pain

You should see your healthcare team if you notice any unusual sensations or pain in your feet. Your team can test the sensation in your feet to see if you're developing signs of neuropathy. They may suggest additional tests to look for nerve damage. They may also suggest that you meet with a podiatrist.

The bottom line

Diabetic foot pain is bothersome and can also be a sign of worsening diabetes. Daily self-foot exams and regular foot exams with your doctor are an important part of managing diabetes.

To keep your foot pain from worsening, work with your healthcare team to get your blood sugars in your target range. Medications can help lessen pain too.

References

American Diabetes Association. (n.d.). Peripheral neuropathy.

Bodman, M. A., et al. (2024). Diabetic peripheral neuropathy. StatPearls.

View All References (3)
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Fakorede, F. (2021). Reducing disparities in diabetic amputations. National Institute of Diabetes and Digestive and Kidney Diseases.

National Institute of Diabetes and Digestive and Kidney Diseases. (2017). Diabetes & foot problems.

National Institute of Diabetes and Digestive and Kidney Diseases. (2018). Peripheral neuropathy.

GoodRx Health has strict sourcing policies and relies on primary sources such as medical organizations, governmental agencies, academic institutions, and peer-reviewed scientific journals. Learn more about how we ensure our content is accurate, thorough, and unbiased by reading our editorial guidelines.

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