If you have diabetes, you are at risk of getting neuropathy. In fact, half the people with diabetes will contract neuropathy. Once diabetic neuropathy occurs, it almost always gets worse. There are debates as to why neuropathy occurs and at present, there is no cure. However, there are treatments that can improve the symptoms.
With diabetic peripheral neuropathy of the feet, one of the first symptoms you notice will be a tingling or numbing of the toes. At first, these symptoms will come and go, but eventually they will remain constant. They may interfere with your going to sleep or cause you to awaken during the night. Over time, your absence of feeling in your feet will prevent you from realizing that your shoes are too tight or that there is a pebble in your shoe. Weakness of foot muscles may cause hammertoes or collapsed arches. Neuropathy is the leading cause of holes in the feet, infections in the feet, and loss of toes, or other advanced amputations.
There is now a new possible cause of neuropathy that may give new-found hope for diabetics. This procedure involves taking early measurements of sensibility of the feet to identify the earliest stages of foot neuropathy. In certain circumstances, areas of the feet and ankles that have compressed the nerves may be found. These areas of pressure can be treated with surgery to relieve the pain, tingling, and burning and in other cases, restore sensation to your feet.
COMPRESSED NERVES OF THE DIABETIC PERSON
The nerves of the diabetic are compressed compared to the person with normal blood sugar levels. Understanding why begins with an understanding of the nerve path from the spinal cord to the feet. Nerves begin in the spinal cord and extend to the toes. Along the path, there are anatomical tight places or narrowing. Common places are the “funny bone” at the elbow or the carpel tunnel of the wrist. There are other similar tight places in the ankle called the tarsal tunnel and one of the top of the foot. Everyone has these tight spots. However, with the diabetic person, the nerves become swollen because of the excess sugar in the blood and as a result, the nerve becomes pinched or compressed causing symptoms.
When your nerve gets pinched, it isn’t getting enough oxygen so it sends you a warning in the form of numbness, tingling, or prickling sensations. In the foot, there is a nerve that supplies the bottom of the foot, including the heel. Compression of this nerve results in numbness or tingling of the arch, the heel, the ball of the foot, and the bottom and tips of the toes. Continued compression without treatments can cause muscle weakness, and atrophy leading to hammertoes.
CONNECTION BETWEEN NEUROPATHY AND COMPRESSION
For years, doctors believed that compression involved only one foot or hand, independent of the other foot or hand. Therefore, they did not put together the connection between diabetic neuropathy and compression. They believed these were two different conditions. You see, in diabetic neuropathy, the entire foot or hand would be affected and usually both feet or hands are experiencing the same symptoms. The symptoms of diabetic neuropathy are essentially the same as nerve compression.
Knowing that there are areas in the feet that can be the center for compression and knowing that the swollen nerves cause this compression can help determine what procedure to take to relieve the compression. Even though the diabetes is causing the swollen nerves, relieving the compression of these nerves will relieve the symptoms of neuropathy. Of course, watching blood sugar is a priority to control this compression.
In foot neuropathy, the objective of surgery is to relieve the compression. This is accomplished by opening the tight area through which the nerve passes by dividing a ligament or fibrous band that crosses the nerve. This procedure allows more blood to flow to the nerve and gives the nerve more room to move and glide with movements of nearby joints and tendons. By decompressing the tight areas of the feet, the symptom-producing regions of friction are disbanded.
However, it is necessary to have this surgery early on in the neuropathy condition. If you wait too long (when you have ulcerations of the feet, or lost toes) the damage to the nerve has already occurred and restoration will be irreversible.
The prime candidate for surgery is the diabetic patient who is starting the see the symptoms of neuropathy in the feet. Numbness and tingling are usually the first signs. You may also notice changes in your feet and toes. If the neuropathy awakens you at night or keeps you from sleeping, you may be ready for this type surgery. Of course, your doctor will be the one who will prescribe this surgery, weighing the risks and benefits. It usually lasts about two hours and can be done as an outpatient in most cases.
Overall, decompression surgery has provided an alternate course for diabetics. If caught early, foot neuropathy can be treated in this way, thus relieving the symptoms and providing a better quality of life for the diabetic.
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