Key Takeaways
- Burning, numbness, tingling and the "walking on sand" feeling in the feet are common signs of neuropathy, which means a nerve is not carrying its signal the way it should.
- Those symptoms can come from several different places: a nerve irritated in the low back, a nerve squeezed along its path through the hip, knee or ankle, or a cause elsewhere in the body, of which diabetes is the most common.
- Each of those has a different answer, so the most useful first step is an examination that sorts out where the problem starts.
- Numb feet change balance, and falls are the leading cause of injury for adults 65 and older, which makes neuropathy worth taking seriously early.
- At SYMETRx Chiropractic and Injury Care, the neuropathy examination takes two visits and ends with a plain-language explanation, including whether chiropractic care is the right fit.
What people describe
People with neuropathy in the feet tend to describe it in similar words. Burning, especially at night. Tingling or pins and needles. Numbness, or a feeling of walking on a cloud, on marshmallows, or on sand. Socks that feel bunched up when they are not. Some people notice their balance changing before they notice the numbness itself, because the feet stop reporting the ground accurately.
Those words describe a nerve that is not doing its job well. They do not, by themselves, say why.
A frayed cord is a good picture
Dr. Matt Frahm often explains nerves with a household cord. Imagine the cord running to a toaster, with the plastic coating worn through in places. Some days the toaster works. Some days it does not, depending on how the cord is lying. Sometimes it sparks.
Nerves have a protective coating too, called myelin, and it does the same job as the coating on that cord. When the coating or the nerve underneath it is irritated or damaged, the signal becomes unreliable. That unreliable signal is what people feel as burning, tingling or numbness, and it can come and go in a way that is confusing if nobody explains it.
The first question is where, not what
Searching for "neuropathy in feet treatment" turns up a long list of products and programs. The difficulty is that symptoms in the feet can start in very different places, and the right answer depends on which one it is.
- In the low back. A nerve can be irritated where it leaves the spine (see sciatica care). The foot is where it is felt, but the problem is higher up.
- Along the nerve's path. A nerve can be squeezed or irritated on its way down, at the hip, behind the knee, or at the ankle.
- Elsewhere in the body. Diabetes is the most common cause of this kind. Johns Hopkins notes that about one quarter of people with diabetes have symptoms of nerve damage. Other causes include medication effects, low vitamin B12, thyroid conditions, heavy alcohol use and chemotherapy.
Often it is more than one. A person with diabetes can also have a nerve irritated in the low back, and the two add together.
Why the cause matters for treatment
In his talks, Dr. Matt compares it to a car. If the bumper falls off after a fender bender, duct tape will hold it on for a while, but nobody would call that a repair. A mechanic would want to look under the hood before quoting a fix, and a good mechanic has a toolbox with different tools for different jobs.
Neuropathy works the same way. Relieving the symptoms is a legitimate goal, and a person's medical doctor is central to that. But a plan aimed at the low back will not help a problem that starts with blood sugar, and a plan aimed at blood sugar alone may miss a nerve being pinched in the spine. Sorting out where the problem starts is what makes the rest of the plan make sense.
Why it matters more after 60
Neuropathy becomes more common with age and with diabetes, and Manatee County has a large population of adults over 60. According to the Centers for Disease Control and Prevention, about one in four adults 65 and older report a fall each year, and falls are the leading cause of injury for that age group.
Feet that do not report the ground accurately make balance harder. Uneven sidewalks, boat decks and wet tile after an afternoon storm are all less forgiving. That is a practical reason to have numb or burning feet looked at early rather than waiting to see whether it gets worse.
What a careful evaluation looks like
At SYMETRx Chiropractic and Injury Care, the neuropathy examination takes place over two visits, so that the second one is a sit-down conversation rather than a rushed verdict.
- A detailed history: when it started, where it is felt, what makes it better or worse, medications and other health conditions.
- Sensation testing at 16 points on the feet, to map where feeling is reduced and to compare it over time.
- Balance and walking, because the feet often stop reporting the ground before a person notices the numbness.
- Infrared screening of the feet, a no-contact look at surface temperature patterns.
- The spine and the nerve path: reflexes, strength, and the places along the way where a nerve can be irritated.
At the second visit, Dr. Matt explains what he found in plain words, including whether he believes chiropractic care can help. Where the likely cause is elsewhere in the body, the honest answer is that the person's medical doctor needs to be central to the plan, and he says so.
If care is a fit
When the findings point to something conservative care can address, a plan may combine care in the office, steps continued at home, and nutrition and inflammation support, coordinated with the person's medical doctor rather than in place of them. The plan, how progress will be measured, and when it will be re-checked are all explained before anything is decided.
SYMETRx Chiropractic and Injury Care does not claim to reverse nerve damage and does not quote success rates. Neuropathy is one of the most over-promised conditions in health care, and a careful answer is worth more than a confident one.
Simple things that help at home
- Look at both feet every day, including the soles and between the toes, especially with diabetes. Reduced feeling means a small blister or cut can go unnoticed.
- Wear shoes that fit well and support the foot, indoors as well as out.
- Light the path from the bed to the bathroom at night.
- Tell the medical doctor about new or changing numbness, and keep up with the blood sugar plan if diabetes is part of the picture.
When to get medical care first
Some signs call for a medical evaluation right away rather than a chiropractic visit: weakness or numbness that spreads quickly over hours or days, numbness that comes with new trouble controlling the bladder or bowels, a foot wound that is not healing or shows signs of infection, and numbness that follows a fall or other injury.
Coming to one of Dr. Matt's talks
Dr. Matt hosts lunch-hour talks on neuropathy at the office on 6th Avenue East. They run about an hour, with time for questions, and cover what he looks for and how the examination works. This article is a good primer before attending.
Frequently asked questions
What is the best treatment for neuropathy in the feet?
It depends on where the symptoms are coming from. A nerve irritated in the low back, a nerve squeezed along its path, and a cause such as diabetes each call for a different approach. That is why the examination comes first.
Can chiropractic care help neuropathy?
For some people, yes. When a nerve is being irritated in the spine or along its path, conservative care aimed at that is reasonable. When the cause is elsewhere in the body, the medical side has to be central, and a good chiropractor will say so.
Can neuropathy be reversed?
No one can answer that honestly without knowing the cause. SYMETRx Chiropractic and Injury Care does not make that claim, and it is worth being cautious about anyone who does.
Why are my feet worse at night?
Many people with neuropathy notice burning or tingling more at night, when there is less to distract from it. It is worth mentioning at the examination, along with anything that makes it better or worse.
Should I see my medical doctor too?
In many cases, yes, especially when diabetes or another condition is likely involved. Neuropathy is often best handled with the medical side and conservative care working together.
Can I be examined in Spanish?
Yes. Se habla español, and the findings can be explained in Spanish.
For information about the neuropathy examination, contact SYMETRx Chiropractic and Injury Care at (941) 746-2612. SYMETRx Chiropractic and Injury Care has served Bradenton since 2003. This article is for general information and is not medical advice. Every person is different. If you are dealing with pain that is not improving, please have your condition evaluated by a qualified healthcare professional.