If you are overweight and have recently experienced pain, tingling, or numbness in one or both feet, you fit the classic profile of a person with diabetic neuropathy(DN).
This condition occurs when diabetes leads to nerve damage, which often affects the feet…Sometimes DN hurts, while other times it creates an inability to feel pain,heat or cold. This loss of sensation is serious, because a sore or ulcer can go unnoticed, become infected and sometimes lead to foot or leg amputation.
Here is the kicker: You may not have DN or diabetes. Even though people who are overweight are at a greater risk for type 2 diabetes, you may not have the disease. Still when doctors see a heavy patient with foot pain, tingling and/or numbness, many are quick to assume that it is DN. Also, the widespread advertising for (Lyrica) , an antiseizure medication often is used to treat nerve pain of DN, you can see how many doctors would jump to this treatment.
What else could it be? If your doctor has diagnosed you with DN, make sure your blood tests(fasting blood glucose test) confirm that you actually have diabetes. If you are not a diabetic but your doctor has diagnosed DN, it is time to find a new doctor. If you don’t have DN, than what is causing your foot problems? It is important you have the proper cause so it can be treated properly.
If your entire foot is affected..it could be sciatica. This condition is characterized by shooting pain that travels down one or both legs, can occur when the piriformis muscle in the buttocks compresses the sciatic nerve, which runs down the leg before branching off in the foot. The result can be gluteal pain, as well as pain, numbness, or a “pins and needles” feeling in the foot. Sciatica often occurs when the gluteus medius muscle is weak, leading the piriformis muscle to compensate.
If your entire foot is affected..it could be sciatica. This condition is characterized by shooting pain that travels down one or both legs, can occur when the piriformis muscle in the buttocks compresses the sciatic nerve, which runs down the leg before branching off in the foot. The result can be gluteal pain, as well as pain, numbness, or a “pins and needles” feeling in the foot. Sciatica often occurs when the gluteus medius muscle is weak, leading the piriformis muscle to compensate.
If it just the top of the foot… You may have a pinched peroneal nerve. symptoms are similar to those of weak gluteal muscles. Unlike sciatica, the altered foot sensation is on the top of the foot only, not all over.
If the pain is in the sole of your foot...you may have a collapsed arch.
If the muscles that support the arch are weak, your arch may flatten. When this occurs, the sole of your mid-foot will be flat on the floor when you stand or walk, compressing nerves in the bottom of the foot. This trigger tingling and or numbness in the sole.
As a physical therapist, I treat all three types of conditions doing strengthening and lengthening of muscles to reduce and eliminate the pain.
With sciatica, exercises are given to lengthen the buttock and low back muscles and strengthening the core muscles.
Peroneal entrapment problems need exercises to strengthen and lengthen the lower leg and ankle muscles.
Problems with mid-foot and plantar fasciitis need lengthening and strengthening ankle and foot musculature.
Pills and injections may help,but correcting the problem requires proper treatment decreasing the muscular imbalances, with proper exercises being completed on a consistent basis.