Don't Ignore Burning Feet or Numb Toes

Warning signs of diabetic peripheral neuropathy

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Overview

Burning feet, numb toes, or tingling in your toes or feet are more than annoying symptoms from walking. They may be warning signs of diabetes and the condition known as diabetic peripheral neuropathy. If left untreated, it can lead to foot ulcers and, potentially, amputation.

"Diabetic peripheral neuropathy is not only painful but dangerous," says Dr. John M. Giurini, president of the American College of Foot and Ankle Surgeons (ACFAS) in a press release.

"It's a leading contributor to foot ulcers in people with diabetes."

Causes

Diabetes is the leading cause of these symptoms in the United States. One out of four people with diabetes are undiagnosed and burning or tingling toes may be the first symptom they notice.

According to the American Diabetes Association, there are a number of sensations people describe feeling that may indicate neuropathy. They even have a checklist that you can take to your doctor to make it easier to describe your symptoms.

There are other health concerns that can cause burning feet and numb toes as well. For instance, thyroid problems, especially hypothyroidism, and nutritional deficiencies, especially vitamin B12 and B6, may also cause this feeling. 

The side effects of chemotherapy agents and some medications include neuropathy. People who have Lyme disease or HIV/AIDS are also at higher risk.

If you have back problems and pinched nerves in the ankles, your chances of neuropathy increase.

In addition, alcohol abuse is a leading cause of leg neuropathy.

There's no need to panic, however. Not every case of burning toes is tied to neuropathy, which is why it's important to see your doctor. For example, your toes may be burning from something like athlete's foot, a common fungal infection of the foot.

Shoe allergies may also produce funny feelings in your feet. If the symptoms appear only when wearing specific shoes, it could be that you are sensitive to the materials used in them. Leather tanning agents, adhesives, and glues and dyes are all common culprits for shoe allergies.

It is also possible that your blood is not flowing properly to your legs and feet. This is a common symptom of peripheral artery disease due to atherosclerosis.

Symptoms

Burning or numb toes may be one of the first signs that you have diabetes. The best course of action is to see your doctor and get a complete checkup as well as a foot exam.

Even people with diabetes who maintain good blood sugar levels can develop peripheral neuropathy. If the condition leads to foot ulcers, it leads to amputation 20 percent of the time, according to the ACFAS. For this reason (among many others, of course), it's important that you do not ignore these symptoms. It may just save your toes.

Diagnosis

When you go to the doctor, expect to have blood and urine tests run for diabetes and overall health indicators. They will also inquire about your general medical history and, most likely, give you a physical. The doctor will check your feet for the condition of the skin, muscles, bones, and blood flow.

Nerve function is tested with a monofilament or a tuning fork, looking for numb areas. If the doctor suspects peripheral neuropathy, further tests may be done such as nerve conduction studies and electromyography (EMG).

Treatment

If you are diagnosed with diabetic peripheral neuropathy, you need to carefully monitor your blood sugar levels and keep them within your target range. Medication is available for the pain and your doctor will consider your individual needs when prescribing it. It is very important to protect your feet so you don't develop any foot ulcers that may lead to amputation.

Prevention

It is best to see a podiatrist regularly to have your condition assessed.

A podiatrist can also address any needs for custom footwear and orthotics. Your shoes need to fit well, allowing enough room for your toes to move and not constrict the flow of blood. You don't want too loose of a fit, either.

Check your feet daily to see if you have any signs of injury or the beginnings of an infection. You may not notice this without looking because your feet may have lost sensation.

Look between the toes and at the soles of your feet as well. If you aren't limber enough to do this, enlist someone to help out. You might also use a mirror on a pole, which you can find online or ask about at a pharmacy.

Look for swelling, redness, and rashes. Consult your doctor or podiatrist whenever you spot these symptoms.

A Word From Verywell

If you feel a burning in your toes or feet, or if there is any sort of numbness, try not to brush it off. It may seem like a small annoyance, but your body is telling you something and it can be significant. The sooner you can get the condition diagnosed, the better it is for your treatment plan, even if it is not diabetic neuropathy. 

Sources:

American College of Foot and Ankle Surgeons. Foot Pain? You May Have Diabetes. Press Release. 2008.

American Diabetes Association. Peripheral Neuropathy. http://www.diabetes.org/living-with-diabetes/complications/neuropathy/peripheral-neuropathy.html.

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