What is Diabetic Peripheral Neuropathy?
Peripheral neuropathy results from damage to the peripheral system, the communications network that is responsible for connecting limbs and organs to the central nervous system. While the central nervous system consists of nerve endings located in the brain and spinal cord, the peripheral nervous system refers to the nerves located throughout the rest of the body.
The peripheral nervous system takes the information and commands that originate in the brain and relays them throughout the body. It’s responsible for communicating cold, heat, pain, and touch in the extremities, as well as controls movement and the muscles that allow movement. Peripheral neuropathy refers to the damage of a single nerve or group of nerves within the peripheral system. Diabetic peripheral neuropathy refers to damage of peripheral nerves specifically caused by diabetes.
Causes of Diabetic Peripheral Neuropathy
Peripheral neuropathy is the most common complication of diabetes. In fact, 60 to 70 percent of all diabetes patients will eventually develop it, although not all will suffer pain. Diabetic peripheral neuropathy is often caused by chronically high blood sugar.
Chronically high blood sugar levels damage nerves in the extremities and other parts of the body, as well as weaken the walls of blood vessels that supply nerves with oxygen and nutrients. Damaged nerves cannot effectively carry messages between the brain and other parts of the body, meaning that when the extremities experience a stimulus they cannot relay this back to the brain. This is why those with peripheral neuropathy may not feel heat or cold in the hands, feet, or legs. Damaged nerves can lead to numbness, loss of sensation, and pain in the extremities.
While peripheral neuropathy is commonly associated with diabetes, it can also be caused by autoimmune disorders, infections, tumors, nutritional imbalances, and can even be hereditary.
Symptoms of Diabetic Peripheral Neuropathy
Diabetic peripheral neuropathy symptoms typically begin with a numbness or tingling in the outer extremities, like the toes and fingers. This is more commonly known as a pins and needles sensation. Over time, this sensation moves up the limbs into the arms and legs. Numbness symptoms are often joined by a sense of imbalance or dizziness.
Common diabetic peripheral neuropathy symptoms include:
- Foot and ankle pain
- Burning or stabbing pain
- Limited range of movement
- Heightened sensitivity to touch
- Inflammation in the shoulders, calves, and knees
- Numbness and tingling in the extremities and limbs
- Cramps in the extremities and limbs
- Symptoms that worsen at night
- Headaches and migraines
- Chronic pain and fatigue
- Weakness or tremors
- Stiff neck muscles
Extremely severe cases of neuropathy can also cause paralysis, breathing problems, or loss of consciousness. If you are experiencing any of these symptoms, see a medical professional immediately.
How is Diabetic Neuropathy Diagnosed?
Diabetic neuropathy is diagnosed through various physical examinations with a careful review of medical history. During a physical exam, your doctor will check your:
- Sensitivity to touch and vibration
- Overall muscle tone and strength
- Tendon reflexes
However, alternate physical tests designed specifically for diabetic neuropathy diagnosis include:
- Quantitative Sensory Testing: Determines how nerves respond to changes in temperature and varying vibrations.
- Filament Testing: A soft nylon fiber known as a monofilament is brushed against the skin to test sensitivity to touch.
- Nerve Conduction Studies: Determines the speed with which nerves send messages by measuring how quickly the nerves in the arms and legs conduct electrical signals.
- Electromyography (EMG): Determines the electrical discharges produced in muscles and checks if the nerves and muscles work in harmony.
As a diabetes patient, your doctor should check your feet for sores, cracked skin, blisters, and joint and bone problems at every visit. Persistent foot problems are an indicator that nerve signalling in the extremities is weak, causing poor blood flow and delaying the healing process. For those with existing foot problems, feet should be checked more often. Routine physical examinations and monitoring of the feet can help accurately and quickly diagnose diabetic neuropathy.
Diabetic Peripheral Neuropathy Treatment
Diabetic peripheral neuropathy has no known cure. However, diabetic neuropathy treatment can help relieve pain, manage complications, and restore function to affected extremities. Diabetic peripheral neuropathy treatment can also help slow the progression of the disease, allowing you to live pain-free longer.
Keeping blood sugar levels within your target range is critical to preventing or delaying nerve damage. In fact, doing so can even improve your current symptoms. Once neuropathy has been detected, focus should be on keeping the feet and legs healthy and on managing pain. Multiple prescription medications are available for diabetes-related nerve pain, such as anti-seizure drugs and antidepressants. However, side effects can cause further discomfort for patients, and their effects may not work for everyone.
Lifestyle and Nutrition Habits
Once nerve damage has began, our diet and lifestyle can improve or worsen the condition. Nutrition is an important aspect of preventing complications of disease, and for diabetics, it is critical for stabilizing blood sugar.
Diet and lifestyle habits recommended for diabetic peripheral neuropathy treatment include:
- Stop Smoking: Diabetes patients who use tobacco in any form are more likely to develop circulation problems in the feet, and are more likely than non-smokers with diabetes to die of heart attack or stroke. Eliminating tobacco can greatly improve overall health.
- Stay Active: The American Diabetes Association recommends 150 minutes of moderate exercise a week for adults with diabetes. Light exercise is one of the best ways to keep blood sugar under control, improve blood flow, and keep your heart healthy.
- Make Healthy Food Choices: A balanced diet should include a variety of healthy foods, including fruits, vegetables, and whole grains.
- Take Supplements: While a balanced diet alone can provide a variety of nutrients, diabetic peripheral neuropathy treatment benefits from additional diet supplementation including vitamin B12, Acetyl L Carnitine, and Alpha-Lipoic acid. The former are found in fish, lean red meats, and broccoli, and Alpha-Lipoic acid is naturally found in the liver and kidneys.
- Maintain Healthy Blood Pressure: Those with diabetes are more likely to have high blood pressure; having both high blood pressure and diabetes damages blood vessels and reduces blood flow, putting you at greater risk of complication. Have your blood pressure checked at each visit, and try to keep it in your recommended range.
Chiropractic Care for Diabetic Neuropathy
While keeping your blood sugar levels within your target range can keep diabetic neuropathy from getting worse, there aren’t treatments that can reverse nerve disease. However, rather than mask the pain and symptoms of peripheral neuropathy with harmful medications, chiropractic aims for the source of the problem in order to improve overall health.
Chiropractic care addresses nerve damage holistically, looking at the entire peripheral system as a whole as opposed to attempting to target nerves clustered among the extremities. Likewise, unlike medication, chiropractic doesn’t simply blanket the entire system, but rather takes a deeper look into how each component of the peripheral system works in conjunction with the nervous system to function properly.
A chiropractor can administer a variety of pain-relieving and soothing therapies to restore function and slow the progression of diabetic peripheral neuropathy. At ChiroCare of Florida, our physicians also provide priceless lifestyle advice to help manage blood sugar levels. ChiroCare of Florida physicians provide nutritional support and diet advice as well as fitness routines that are safe for those with decreased feelings in the legs or feet.
Chiropractic therapies used in diabetic peripheral neuropathy treatment include:
- Acupuncture: A quick search for acupuncture near you will reveal just how many benefits the art of acupuncture truly has. At ChiroCare of Florida, our targeted acupuncture services can help alleviate pain and inflammation, as well as improve nerve response to stimulus.
- Electric Stimulation (E-Stim): E-Stim therapy utilizes small electrodes placed on the skin to deliver minor electrical impulses to specific nerve pathways. What this does, is prevent pain signals from reaching the brain, helping to alleviate pain and discomfort.
- Massage therapy: Therapeutic massage soothes painful extremities and can be helpful at decreasing inflammation present in surrounding tissue. Likewise, it can help promote better blood flow and aid nerve communication in the feet, hands, arms, and legs.
