Neuropathies are a group of disorders involving the nerves located outside of the brain and spinal cord--the peripheral nerves. Infections, trauma, nutritional deficiencies, diabetes, genetic disorders, alcoholism and toxins include some of the many causes of neuropathy. The feet are commonly affected by neuropathies. Symptoms range from mild to severe and often overlap.
A burning sensation in the feet proves a common symptom of neuropathy. The sensation may occur in specific locations such as the toes or sole of the foot or may be more generalized. One or both feet may become involved depending on the underlying cause of the neuropathy. Burning often proves an early symptom of neuropathy.
Tingling proves a common experience with neuropathy of the feet. It tends to be an early symptom and the location and distribution vary depending on the underlying cause of the neuropathy.
Pricking or the sensation of being poked with pins is a frequent symptom of neuropathy in the feet. One or both feet may become involved with a variable distribution.
Unexplained pain in the feet can indicate neuropathy. Sufferers often describe pain as sharp or similar to an electric shock. It tends to wax and wane, though it may become persistent. Both feet are involved when the underlying disorder is systemic rather than local.
Foot neuropathy may cause hypersensitivity to touch. Pain and discomfort may be stimulated by even light touch. This symptom can greatly interfere with activities of daily living as putting on shoes or walking causes pain.
Decreased sensitivity to touch or numbness commonly occurs with foot neuropathy. This symptom can prove dangerous as injuries to the feet may not be recognized.
Complete loss of sensation (anesthesia) in the feet typically proves a late symptom of foot neuropathy. There is a high risk of unrecognized injury, which may lead to serious infection. This is particularly common in diabetics with foot neuropathy. Foot anesthesia can also cause falls leading to fractures or other injuries.
Some foot neuropathies affect the muscle control functions of the involved nerves. The muscles of the feet can become weak causing difficulties walking. People with neuropathic foot weakness are typically unable to walk on their tiptoes or heels. The feet may drag while walking; people with this symptom may literally trip over their own feet. Muscle twitches or cramps may also occur.
Foot drop occurs with neuropathies involving the peroneal nerve. As the name implies, the involved foot hangs down from the ankle and cannot voluntarily be pulled up into its normal walking position. Numbness over the skin on top of the foot commonly accompanies this symptom. Commonly a foot brace to support the foot helps those dealing with this condition.
Balance and Coordination Disturbances
The nerves of the feet provide constant input to the brain about their position and movement--a function called proprioception. This function is important to balance and coordination of foot movement. Proprioception functions can decrease in neuropathies of the feet causing loss of balance and incoordination.
Some forms of neuropathy affecting the feet cause skin changes. The skin may become thinner than normal and have a blotchy or shiny appearance.
Is This an Emergency?
- “Harrison’s Principles of Internal Medicine, 16th Edition”; Dennis L. Kasper, M.D., et al, Editors; 2004
- University of Chicago, Jack Miller Center for Peripheral Neuropathy: Peripheral Neuropathy Symptoms
- University of Chicago, Jack Miller Center for Peripheral Neuropathy: Charcot-Marie-Tooth Disease
- Merck Manual: Peripheral Neuropathy, Mononeuropathies
- Merck Manual: Peripheral Neuropathy, Polyneuropathies
- Medline Plus: Peripheral Neuropathy
- Medline Plus: Neuropatía periférica