Diabetes can affect your feet by damaging nerves in the legs and feet. This condition is called peripheral sensory neuropathy, or diabetic neuropathy.
Peripheral sensory neuropathy, characterised by a loss of nerve fibres, first affects the nerves furthest away from the trunk, for example, in the toes and the soles of the foot. This condition reduces the speed of conduction of impulses along the nerve, and as a result, the function of the nerve is impaired. Peripheral sensory neuropathy usually presents symmetrically, and affects the sensation of the feet.
Common symptoms are:
- Pain in the feet (may be sharp, tingling, or burning, particularly on the soles of the foot, toes, or front of the legs).
- Skin tenderness.
A neuroma is the swelling of a nerve passing between the metatarsals (long bones of the foot). At the base of the toes, the nerve splits into a “Y” and enters the toes. It is in this area that the nerve gets pinched and swells, forming the neuroma. They are often caused by tight, poor fitting footwear, and can also be caused by poor foot function and splaying of the feet.
The pain is usually described as sharp, burning, tingling or cramping located in the ball of the feet with occasional shooting and numbness in the toes. Neuroma’s can also cause pins and needles in the affected area.
Conditions that mimic the pain associated with a neuroma are stress fractures of the metatarsals, inflammation of the tendons in the bottom of the toes, arthritis of the joint between the metatarsal bone and the toe, or nerve compression or nerve damage further up on the foot, ankle, knee, hip, or back.
With reduced sensation in the feet, the ability to detect injuries in hindered. Without feeling in your feet, cuts, abrasions, wounds, infections, and fractures may go unnoticed. If such problems are left for a period of time, the risks of ulceration and amputation are increased.