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Diabetes Feet: About the Diabetic Foot Pain

Living with diabetes can be difficult to say the least.

On top of worries about medication, blood sugar regulation, cardiovascular damage, kidney damage, and eye damage, there’s also a significant risk of foot injuries.

Knowing which common diabetic foot injuries to watch out for — and a few tips for diabetic foot care to prevent those injuries — can help you catch potential problems early and stay on top of any complications.

Foot Injuries and Diabetes

The most critical link between diabetes and painful feet is peripheral neuropathy, or damage and inflammation in the nerves in the extremities. This damage and inflammation makes it difficult or even impossible for the nerves to signal sensations properly, including pain.

Researchers believe that high or uncontrolled blood sugar, one of the hallmarks of diabetes, is the driving cause behind neuropathy, as well as damage to the blood vessels that are meant to deliver nutrients and oxygen to the feet.

Foot injuries can be a major problem for people with diabetes, since this loss of sensation from neuropathy makes it difficult to notice warning signs of injury until the skin has become broken and infected, or severe internal damage has taken place.

Common Foot Issues for Individuals with Diabetes

Because of neuropathy and other factors linked to diabetes (e.g., obesity) many people with diabetes suffer from foot ailments. The following are some of the most common foot ailments that coincide with diabetes:

Dry, Cracking Skin

Uncontrolled blood sugar and nerve damage can lead to changes in the skin on the feet, making them very dry. The skin may crack and peel due to damage in nerves that control the moisture and oil content. You can help avoid this problem by applying unscented moisturizer after bathing to seal in moisture and avoid the drying and cracking of the feet.

Foot Deformities

The nerve damage from neuropathy can cause the feet and toes to become shaped differently, even the toes. These changes in shape can cause standard shoes to rub and injure the toes and sides of the feet over time. Help address foot deformity by wearing special shoes created just for diabetic feet. Never force your feet into a regular pair of shoes if you notice changes in how your shoes fit.

Calluses

Calluses on pressure points beneath the foot build up faster and occur more often for people who suffer from diabetes. If calluses are not trimmed and taken care of properly, the skin can thicken and turn into an ulcer or open sore. A health care provider should remove a diabetics callus to avoid infection and ulcers. At home, to slow the growth of calluses, you can use a pumice stone every day. Be sure to apply lotion or petroleum jelly right after use of a pumice stone to lock in moisture and avoid dry and cracked skin.

Ulcers

Ulcers are one of the most serious foot problems people with diabetes face. These open sores usually occur on the bottom of the big toe or the ball of the foot where rubbing and pressure occur while walking. Some ill fitting shoes can cause ulcers on the sides of the feet as well. No matter the location of the ulcer, it’s important to take it seriously. While the ulcer may not hurt, it can become infected and ultimately lead to the loss of a limb. Check all areas of your feet for ulcers daily.

If you do notice an ulcer, stay off the affected foot and talk to your doctor. Pressure and use will force the infection deeper into the foot and it can infect the bone. Special footwear may be prescribed to you to protect the ulcer until it heals. Even after the infection has subsided and healed, the footwear should be worn to avoid the breakdown of the scar tissue and the return of the ulcer.

Circulation Problems

Diabetes contributes to poor circulation makes it more difficult to heal and fight infection. The blood vessels of the legs and feet narrow and harden over time, which makes it difficult for white blood cells to go to the site of an infection. All of these factors contribute to higher rates of foot and leg amputations for diabetics. Keep in mind that smoking worsens these circulatory problems even further, because of how it affects the small blood vessels and further impairs wound healing.

Can Diabetes Make My Feet Hurt?

While the danger of numbness and loss of sensation from peripheral neuropathy is the biggest threat to diabetes sufferers, feet with sensation (that can feel pain!) are no picnic either.

Diabetes can contribute to painful feet, especially heel pain from plantar fasciitis. While researchers haven’t identified all of the links between diabetes and plantar fasciitis, most believe that rapid or excessive weight gain (which places extra strain on the plantar fascia ligament) plays a significant role, as do aging joints and ligaments (diabetes is more common in older adults).

The pain from plantar fasciitis can appear gradually or suddenly, and may be dull or sharp. Heel pain from plantar fasciitis is often worse in the morning, when muscles and ligaments are tightest.

Special Considerations for Treating Diabetic Heel Pain and Other Foot Injuries

Diabetic foot injuries caused by neuropathy or plantar fasciitis need to be treated carefully. If you have diabetes, make sure to keep the following considerations in mind as you work with your doctor to keep your feet healthy:

  • Check your feet daily for cuts, sores, and ulcers. Wash feet and toes daily in warm, soapy water then dry completely and apply a high-quality lotion to keep skin from drying out and cracking
  • Trim your toenails regularly, with the help of a professional familiar with diabetic foot care if possible to avoid cuts or ingrown nails
  • Don’t go barefoot. Wear shoes (or supportive slippers) and socks at all times to avoid potential injuries or small cuts that can develop into ulcers.
  • Don’t wait to tell your doctor about any new symptoms, cuts, bruises, or loss of sensation in your feet and legs.
  • Check your shoes each morning to make sure there are no pebbles or stray debris inside that might rub against your feet while you walk and create a sore or cut. Regularly replace your shoes to ensure that they fit properly and are not too worn to support your feet effectively while you walk.
  • If you have heel pain from plantar fasciitis and wear orthotic inserts to support your arch, you may want to choose gel inserts, which are softer and can help you avoid pressure ulcers.
  • Gently stretch and exercise the muscles and ligaments in your feet and legs to keep them as limber and flexible as possible (remember, any exercise routine you follow should be done with a doctor’s knowledge and support).
  • As much as possible, avoid smoking (smoking further restricts blood flow to the extremities and can worsen nerve damage and neuropathy) and maintain a healthy diet and level of physical activity

Managing your diabetes can get overwhelming. But taking the time to learn about potential problems can go a long way toward avoiding the pain, expense, and trauma of serious complications.

Taking good care of your feet is still possible, even with diabetes. Know which foot problems to watch out for, do your best to stay active, check your feet regularly, and stay in good communication with your doctor!

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