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Peripheral neuropathy is a common condition that I see every day in my office. It's also one of the most frustrating conditions to have and to treat. My name is Dr. Andrew Schneider, and I'm a podiatrist in Houston, TX.
Peripheral neuropathy is nerve damage that affects the extremities, both the hands and the feet.

There are many causes of peripheral neuropathy. Too many to count. That's part of the problem with treating it. The most common causes include diabetes, aging, vitamin deficiencies, chemotherapy, alcoholism,
smoking, and some medications.

Let me also be clear, that in some cases, peripheral neuropathy is caused by the aging process. While we can help calm the symptoms, we don't have the fountain of youth. In fact, if a nerve is completely damaged, there's no way for it to regenerate.

The reason that peripheral neuropathy usually starts in the toes is due to the simple fact that your toes are the farthest point from your brain. Your brain receives impulses from the nerves and translates that into sensations. From your feet, all the way to your brain...that's a long way to go and plenty of opportunities for things to go awry.

Nerve pain comes in different forms. Some people feel a numb sensation. Others feel a burning and tingling sensation to varying degrees. Some feel pain so intense that it feels like their feet are on fire.

It's important to differentiate nerve pain from other causes of pain. If your feet are hurting, when you're standing and walking, that's usually a musculoskeletal pain such as tendinitis. If the pain primarily occurs when you're off your feet, such as when you're laying in bed at night, it's more likely to be nerve pain. To further muddy the waters. If you are pain-free when you go to bed, but you're awakened by your feet being in intense pain, this can be due to a circulation issue.

Some topical treatments do help nerve pain using a topical analgesic that contains menthol or capsaicin. There are many such products available over the counter. These analgesics work to provide another stimulus and essentially confuses the nerves as they send impulses to your brain. This can help reduce the pain you are experiencing from peripheral neuropathy. Many people have found relief using topical CBD preparations.

As I said, the pain you're feeling is often due to a combination of factors. Nerves travel along with other structures, such as tendons. If the tendons swell, it puts pressure on the nerves and can increase the nerve pain. That's why stretching, which is helpful to mobilize the muscles in tendons, helps to reduce the pain from the nerves.

If your foot flattens when you stand, that causes the nerves to stretch and become painful. Wearing insoles or custom orthotics to support the foot can also take pressure off the nerves and reduce the associated pain. Don't minimize how something so simple and approachable can make a difference in the pain you are feeling.

Nerve pain is also linked to circulation problems. When there's not enough blood flow to the nerves, they're deprived of oxygen and increase in pain. Massaging your calf and thigh helps increase the blood flow. Compression hosiery also provides support to the circulation. If you can increase your circulation, you'll often find some relief from nerve pain. Also, it is essential that you don't smoke. Smoking is one of the most preventable risk factors and can lead to poor circulation.

If you're in a situation where you feel like your feet are on fire, we can deaden the nerves with a topical lidocaine cream or patch. Some medications treat nerve pains such as Lyrica and Gabapentin. The problem is that these medications have significant side effects.

If you're diabetic, the best way to lessen the nerve pain is by getting your blood sugar in good control. It's not an easy thing to do, but it is worthwhile to minimize the side effects of diabetes, including peripheral neuropathy. Taking medication or insulin is not enough. You need to control your diet to lower your blood sugar.

Finally, sometimes peripheral neuropathy is caused by a physical impingement of the nerve. If I suspect that that's the cause I'll refer you to a neurologist who can measure the nerve impulses as they travel to your feet. Sometimes physical therapy can help a nerve impingement. Other times you may need surgery to free up the nerves.

#peripheralneuropathy #diabeticneuropathy #footpain

00:00 Introduction
00:50 Causes of peripheral neuropathy
01:52 Why peripheral neuropathy affects your feet
02:15 What peripheral neuropathy may feel like
03:03 Using topical treatments to treat peripheral neuropathy
03:35 How stretching and supporting the foot helps peripheral neuropathy
04:22 How nerve pain is related to circulation issues
05:15 How to treat neuropathy is you're diabetic
06:26 How to connect with Houston podiatrist Dr. Andrew Schneider