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Neuropathy

Understanding Neuropathy

Neuropathy is a dysfunction of nerves. It can lead to loss of feeling, heightened sensitivity or abnormal/incorrect sensations. It can also affect your ability to sweat, making your skin drier.

Peripheral neuropathy occurs at the periphery – feet, and hands. It can be commonly caused by certain diseases, such as diabetes or rheumatoid arthritis, side effects of medications or following chemotherapy treatments, or vitamin B12 deficiency. If your GP has checked all possible causes and cannot find a reason for it, this will be called idiopathic neuropathy.

How is it diagnosed?

Simple tests in the clinic using tools called a monofilament, vibratip or tuning fork, and neurotip will discover if there is a problem. You may need to be referred for blood tests, for nerve conduction studies, or to a neurologist if required. Some neuropathy is reversible, for example, a drug side effect will cease once you stop taking the drug, or when vitamin B12 deficiency is addressed. Unfortunately, the majority of neuropathy will be permanent and progressive.

Treatment

Hypersensitivity or abnormal/incorrect sensations. Your GP can prescribe either a cream (Capsaicin) or an adhesive tape (OpSite Flexifit) which you can apply as needed to the affected area. If these are not effective, your GP will then prescribe tablets which can help.

Loss of feeling/numbness. This is potentially dangerous as you can no longer rely on your sense of pain to tell you if anything is wrong. Some simple safety checks built in to your day will help you notice any problems promptly and prevent any damage which has occurred from worsening. 

  1. When you dress, just before putting your shoes or slippers on, look, and feel inside them to make sure there are no foreign bodies.
  2. When you have a bath or footbath, check the water temperature with your elbow, NOT your hand or foot.
  3. At the end of the day when getting undressed, look at the bottom of your feet.
  4. If you cannot bend easily, use a mirror on the floor and hold your foot over it. You are checking for any bleeding, colour changes, cuts or wounds, anything stuck in your foot, or anything out of the ordinary.

Dry skin. Swap your soap/shower gels for non-foaming emollient washes such as Aqueous cream, Aveeno shower gel, Eucerin shower oil, E45 shower cream. Apply a urea-based emollient to the affected areas daily after bathing, eg Eucerin 10% urea lotion, CCS foot cream, Flexitol foot cream, Gehwol herbal lotion.

If you are a driver and are diagnosed with peripheral neuropathy, you must notify the DVLA and complete form CN1, found on www.gov.uk. You can be fined up to £1000 if you don’t tell the DVLA about a medical condition that affects your driving and may be prosecuted if you are involved in an accident as a result.

Clare Rushmer  Podiatrist, Randell’s Footcare

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