Wednesday, 21 November 2012

Foot Damage From Neuropathy

Today's post from (see link below) discusses ulceration, one of the foot problems that can arise from neuropathy. Most people manage to avoid severe ulceration but for many it can be a serious problem. Loss of feeling and numbness in areas on the feet can lead to small cuts and wounds becoming ulcerated without you even noticing it. Normally the feet are very sensitive to injury and we can respond immediately to any warning pain but sensory loss removes that early warning system. Ulceration can severely affect the quality of your life and it is vital that you see a doctor the moment you notice it. As a general rule for people living with neuropathy, checking your feet daily is a good idea - they need looking after; they've got to carry you a long way yet!

The Pins and Needles of Peripheral Neuropathy

November 12th, 2012 | Posted by SueKelly in Care Connections

Most people know what it is like to experience the numbing effect of ‘pins and needles’. But if you are diabetic or suffer from circulatory problems – this ailment can be a serious and ongoing concern.

Peripheral neuropathy is damage to the nerves in the limbs and particularly the feet where the body’s nerves are the longest. The risk of developing neuropathy increases the longer a person has been afflicted with diabetes or congestive heart failure or other circulatory problems. The nerve damage prevents people from knowing when their feet are too hot, too cold or sore or painful. Therefore a person loses the warning signs that their feet could be in jeopardy. This is called “loss of protective sensation”.

Loss of protective sensation (LOPS) contributes significantly to ulcer development. In healthy individuals, irritants like bunions, blisters or calluses may cause an unconscious change of gait. In people living with diabetes who experience LOPS as a result of peripheral neuropathy, no discomfort is felt, so pressure on specific sites is continued, directly affecting the development of ulcers. Early detection of LOPS and implementation of preventative strategies will reduce the rates of limb-threatening complications.

Many foot ulcers begin in innocent ways. As a visiting nurse I was always curious how a problem started and would ask my clients what was the first sign that brought them to the doctor? Often the response was one of embarrassment and foolishness as they described the simple way it began – a blister, a piece of torn skin or a small amount of bleeding. The harmless scratch burgeoned from a trivial occurrence to a condition that threatened the maintenance of limbs and in some cases, life.

The following signs may be an indication that you have peripheral neuropathy or decreased circulation. If you have any one of these symptoms, make an appointment to see your health care professional.

Signs of Peripheral Neuropathy
Signs of Poor Circulation
  • Pain, tingling, burning and numbness that starts in the feet and slowly progresses up the calves; tends to be worse at night
  • Inability to detect excessive heat such as in a bath or a heating pad
  • Any small sore, cut or ingrown toenails
  • Weakness in small muscles of the feet that cause the toes to claw, or in more serious cases foot drop will develop
  • A change in gait
  • Swelling or redness on any part of the foot
  • The existence of a bunion, callus, corn or wart
  • Absence of foot pulses
  • A pale colour of the feet when the feet are raised
  • Feet that feel cold
  • Pain at rest
  • Pain at night relieved by hanging the feet over the side of the bed
  • A blue colour to the toes
  • A reddish colour of the feet
  • Swelling of the feet

Given the alarming statistics of foot problems in patients living with diabetes, it is prudent to assess all diabetics for their level of risk related to foot problems. Special attention needs to be paid to the elderly and over-weight clients. In older clients limited mobility and poor eyesight may prevent them from properly examining their feet – a task that should be done daily. In obese patients, excessive weight will be an impediment to easy foot inspection.

People with diabetic foot ulcers face incredible challenges in their family, social and work lives, which sometimes affect their sense of self-worth. From the ease with which the ulcers seem to develop, to the future unpredictability imposed by the condition, people describe the dramatic impact that having a foot ulcer has on their activities of daily living. There is a great deal of stress and fear that comes with the uncertainty of not knowing when and if the ulcer will heal and in some cases whether or not amputation will become an eventuality.

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