More than 30 million Americans are living with diabetes, and peripheral neuropathy, or nerve damage in the feet, is one of the most common—and most serious—complications of the disease. Nerve damage causes burning, tingling, heaviness, or numbness in the feet and affects up to 70 percent of all diabetic patients.
“Neuropathy can be a rather scary aspect of diabetes because patients may not be able to feel pain,” said Jeff Merrill, DPM, a podiatrist at Klamath Falls Foot and Ankle, LLC and a member of the American Podiatric Medical Association (APMA). “If you can’t feel an injury or sore, it could lead to a serious infection.”
People with diabetes have a harder time healing from infections, and even a minor sore or blister could ultimately lead to amputation. Dr. Merrill says it’s important to try to prevent nerve damage before it happens, and to take extra precautions if you do experience symptoms.
Podiatrists recommend the following tips to help prevent peripheral neuropathy:
If you do experience diabetic nerve damage, foot care becomes even more critical. “It starts at home with daily checks on your feet,” said Dr. Merrill. “Check your feet for any injuries and for changes to the skin, hair, or even temperature of the skin. If you can’t see your feet well, try propping up a mirror, or ask friends or family for help.”
Dr. Merrill recommends patients with peripheral neuropathy never go barefoot because of the risk of injuries. People with peripheral neuropathy should see a podiatrist regularly to help catch any changes in their foot health early.
“Regular foot care—both at home and in your podiatrist’s office—is essential to avoid serious complications from diabetes,” Dr. Merrill said. “If you have diabetes, and especially if you have experienced symptoms of nerve damage, it’s critical to make foot health a priority.”
Click on the graphic below to download your free peripheral neuropathy PDF fact sheet.
Jeff Merrill, DPM is a podiatrist at Klamath Falls Foot and Ankle, LLC in Klamath Falls, Oregon. Call 541-850-6463 or visit www.klamathfallsfootandankle.com to make an appointment. Visit www.apma.org/diabetes to learn more about foot health and diabetic nerve damage.
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With kids back in school after a summer of bare feet and sandals, parents are shopping for shoes for feet that seem to have grown longer in just a few months. To help busy parents with shoe choices, a Klamath Basin foot surgeon recommends some simple guidelines to prevent or minimize possible foot problems from inappropriate shoes, such as painful ingrown toenails, blisters, heel pain and flat feet.
“When choosing kids’ shoes, size and shock absorption are the key considerations, especially if your child has flat feet that can worsen from improper fitting or worn-out shoes,” says Jeff Merrill, DPM, FACFAS, a member of the American College of Foot and Ankle Surgeons (ACFAS). “Also, a child’s foot can grow a size or two within six months, so it’s critical to allow room for growth in the toe box—about a finger’s width from the longest toe.”
Dr. Merrill says snug shoes put pressure on the toes, causing ingrown nails.
“The nail compresses and grows down into the skin,” says Dr. Merrill.
According to FootHealthFacts.org, the ACFAS consumer website, infection can occur when an ingrown nail breaks through the skin.
“If there’s pain, redness and fluid draining from the area, it’s probably infected,” he says. “The ingrown nail can be removed in a simple, in-office procedure. Don’t try to remove a child’s ingrown nail at home; this can cause the condition to worsen.”
Tight-fitting shoes also cause blisters, corns and calluses on the toes and blisters on the back of the heels.
“Never buy shoes that feel tight and uncomfortable in the store,” says Dr. Merrill. “Don’t assume they will stretch or break in over time.”
Conversely, he notes that shoes that are too loose can cause problems, too.
“If a shoe is too loose, the foot slides forward and puts excessive pressure on the toes.”
Dr. Merrill also recommends parents carefully inspect both new and old shoes to check for proper cushioning and arch support.
“Shoes lose their shock absorption over time, and wear and tear around the edges of the sole usually indicates it’s worn out and should be replaced," says Dr. Merrill. "If a child keeps wearing worn-out or non-supportive dress or athletic shoes, it elevates the risk for developing heel pain, Achilles tendonitis and even ankle sprains and stress fractures.”
A good tip for parents when buying new shoes: The toe box should flex easily and the shoe shouldn’t bend in the middle of the sole.
For children with flat feet, Dr. Merrill says parents should buy oxford, lace-up shoes that have enough depth for an orthotic insert, if necessary.
“Unfortunately, there isn’t much choice for kids with flat, wide feet. They need shoes with a wide toe box and maximum arch support and shock absorption,” he said. “Slip-on loafers aren’t right for them.”
For more information about childhood foot care, contact Dr. Merrill at 541-850-6463 or visit FootHealthFacts.org.