The "symptomless" foot.

I have patients who come into my office and complain of a lack of sensation or worse, burning to their feet. Peripheral neuropathy effects primarily the feet and legs, sometimes affecting the hands. Peripheral neuropathy is dangerous because the onset is so subtle, people don't really know when they lose their sensation.
The main culprit is diabetes with arthritis, especially of the lower back, as the number two cause. Sometimes we don't know what the cause is and we refer to this as idiopathic neuropathy.
The 'symptomless' foot is actually more likely to have a problem because people will see their podiatrist when their foot hurts. But without pain, people with neuropathy delay seeking medical help which can lead to ulcerations, lacerations, puncture wounds with retained foreign bodies, pathologic fractures and worse amputations.
So what do you do if you have peripheral neuropathy? Here are a few tips:
1: Check you feet daily. You will need to use your eyes and hands to compensate for the lack of sensation. Have a family member or friend check the bottom of your feet daily for any of the above mentioned problems. If you live alone, get a small mirror and place it on an out-of-the-way place in the bathroom. This way you can visually inspect the bottom of your feet daily.
2: Check your shoes before putting them on. Turn them upside down and shake them. In addition, use your hands to feel for any objects that may be inside of the shoe.
3: Wear something on your feet as often as you can. I see to much trauma from people who don't wear shoes at home inside or out.
4: If you see a problem, seek medical attention immediately. The cut, ulcer, swelling may not feel bad or even look bad (especially on the bottom of the foot). But don't take a chance. 85% of the amputations I perform on neuropathic feet could have been prevented if medical treatment was sought immediately.
In addition to a lack of feeling, people with peripheral neuropathy can have a change in their circulation. So if the skin of your feet especially around the toes appear blue, purple or white, also seek the opinion of a medical professional.

"The journey of life is taken one step at a time... none of them should be painful." G.M. Barclay, DPM, AACFAS