This article discusses how diabetes can affect your feet and cause symptoms. It also covers how to care for your feet to lower the risk of serious complications.
What Is Foot Pain?
There are various types of foot pain, depending on the cause. When it’s associated with diabetes, it can feel like sharp pains or tingling from nerve damage, aching, or pain from sores or wounds due to diabetes.
Is Foot Pain a Symptom of Diabetes?
Foot pain is a common complication of both type 1 and type 2 diabetes, especially when blood sugar levels are not controlled by medication and a healthy lifestyle.
People may not be aware they have diabetes until they begin to experience complications. These symptoms may lead them to seek medical care and be diagnosed with diabetes.
High blood sugar in diabetes damages the small blood vessels so nutrients and oxygen can’t get to the individual cells. This can cause nerve damage to your feet, which leads to different types of foot pain as a symptom of diabetes.
The causes of foot pain in people with diabetes include:
Nerve damage Charcot foot Poor circulation leading to wounds, ulcers, and infection
Nerve damage can lead to a loss of sensation, so people with diabetes may not be aware of certain symptoms that would typically cause foot pain.
Nerve Damage
High levels of blood sugar forces excess sugar molecules into the nerves. This causes water to enter the nerve sheath. Over time, this damages the nerve sheath (called demyelination), slowing nerve conduction, changing sensation, or resulting in a lack of sensation.
When this happens to the longest nerve running to the toes and feet, it is a sign of peripheral neuropathy. This condition can cause sharp pains, numbness, and tingling. Once peripheral neuropathy continues to the mid leg, the person will start to have peripheral neuropathy in the fingers and hands.
Nearly half of all people with diabetes, either type 1 or type 2, develop neuropathy at some point.
Charcot Foot
Charcot foot is a rare complication of diabetes usually due to neuropathy, when the bones of the foot are damaged. Early signs are inflammation. You may not be aware of the symptoms due to loss of sensation.
If you continue walking, bones may break or move, and the arch can collapse and lead to “rocker bottom,” a rounding of the bottom of the foot. Offloading orthotics (shoe inserts that take some of the weight off of certain parts of the foot) or a Charcot restraint orthotic walker (CROW) boot can relieve pressure on the foot. Major reconstructive surgery to fix bony alignment may be performed.
The rounded rocker shape is a highly pressured area when walking and makes you prone to pressure sores. If the sores are not treated, they could become infected and, in the most severe cases, foot amputation could be necessary.
Poor Circulation
High blood sugar can damage the lining of the blood vessels, which can reduce circulation. If you don’t get enough blood to your feet, wounds like cuts, sores, and ulcers may not heal well. About a third of people with diabetes will develop at least one foot ulcer.
If you have diabetes, you may not feel injuries because nerve damage can cause a loss of sensation If sores or wounds become infected, it could lead to gangrene, in which tissue starts to die. The tissue may have to be surgically removed. A surgeon may have to amputate a toe, a foot, or part of your leg in order to save your life.
Treatment and Management of Foot Pain
If you have diabetes, learning how to care for your feet can prevent many serious complications and help you avoid pain. A healthcare provider can also check your feet and treat complications that require medical attention. Tips for treatment and management include:
Have a loved one look at the bottom of your feet daily (or check them yourself with a mirror) to ensure the bottom of the foot is normal and stable. Also look for any cuts, sores, or changes to skin or nails. If you find any abnormality, seek medical attention from a podiatrist or healthcare provider as soon as possible. Keep your feet clean to help avoid infection. Keep your feet moisturized but avoid putting lotion between your toes, which can be a breeding ground for fungal infections. Moisturize corns and calluses. Remove them carefully by soaking and exfoliating or see a podiatrist (a specialist in foot, ankle, and lower leg conditions). Don’t use pads or liquid removers, and be careful not to cut your skin. Keep your toenails trimmed straight across, not curved. Wear soft, well-fitting socks, shoes, and house slippers that don’t rub. Avoid walking barefoot, especially if you lack feeling in your feet. Put your feet up and move them around when you sit to stimulate circulation.
Most people have painless neuropathy (just loss of sensation). If you have pain, a healthcare provider may be able to prescribe medication to alleviate nerve pain, such as Neurontin (gabapentin) or certain antidepressants like Elavil (amitriptyline). Controlling blood sugar levels and caring for your feet are important ways to prevent foot problems from diabetes.
When to See a Healthcare Provider
If you have diabetes, see a podiatrist regularly. Most health insurance policies cover podiatry visits for people with diabetes, including cutting nails and removing calluses every two months or more. People with diabetes who have no nail or callus problems should still be seen once or twice a year to prevent problems and be educated about diabetes and their feet.
Even if you are not aware of foot pain, check your feet every day. If you see any of the following, contact a healthcare provider promptly:
Wounds like cuts or blisters that don’t heal within a few daysSkin on your feet that feels warm or looks redCalluses or corns with a red center, which may be bloodDark areas of skin with a foul odor (this could be gangrene and needs quick attention)
Go to urgent care or a hospital emergency room for any moderate to severe concern.
Summary
Foot pain is a common symptom of both type 1 and type 2 diabetes. High blood sugar can damage small blood vessels, slow the healing of foot problems like ulcers or cuts, and lead to nerve damage. Diabetes can also cause a rare condition called Charcot foot, which can change the shape of your foot.
Diabetic nerve damage can lead to a loss of sensation, and you may not realize your feet need medical attention. If you have diabetes, it’s important to check your feet on a daily basis.
People with diabetes should see a podiatrist regularly and get prompt medical care for any issues that develop.
A Word From Verywell
Diabetes treatment has come a long way, and many of the complications that used to be common are less so now. If you work with your healthcare provider and diabetes team to keep your blood sugar under control, you lower the risk of developing foot pain that can lead to serious complications. Your general health will benefit too.
