neuropathy, diabetic, foot

neuropathy, diabetic, foot

Stage 1


In this stage, the patient is experiencing symptoms of neuropathy, but they are still very mild.

Stage 2-4


Many patients will experience the most pain here, along with the burning and tingling and it can become very hard to sleep. This is also where people typically begin taking medication for neuropathy.

Stage 5


At this point, the neuropathy has usually progressed to where the patient’s feet are numb and very weak. They aren’t in pain, but often have trouble standing or walking and don’t have the strength that they used to have. If the patient is diabetic, the risk of amputation goes up here, because the nerves are often dead.

The good news is that patients have an opportunity to decrease the risk of getting to stage 5 and also of amputation. During the middle stages, the nerves are still very much alive and that’s where nerve decompression surgery plays a very important role in the patient’s treatment. We can go in and open up these nerve tunnels that are being compressed and many times, we can reverse the symptoms of neuropathy and restless legs, drastically improving the patient’s quality of life.

To learn more, click here.

In this video, Dr. Anderson discusses the five neuropathy stages, the symptoms that can occur at each stage, and treatment options that are available throughout the journey.

  1. December 9, 2017

    I too am diabetic & currently on dialysis. I have much numbness on the bottom of my feet but can still feel (in a mild sort of way) “touch”.

    My question is this…am I a candidate for treatment and every morning, everynight I stimulate my feet and legs with high intensity vibration is this good?….or doing nothing.

    please advise / Steven Lochhead

    • December 18, 2017

      Hi Steven! We have both surgical and non-surgical treatment options for patients with diabetic neuropathy. When we see you in person, we discuss treatment options with you depending on your specific situation and needs. For example, how much is your daily living affected? How much pain are you in? How is your sleep being affected? How is your balance and stability? The good news is that after treatment, we often see that patients experience improved nerve function and therefore, the risk of amputation is reduced in diabetic patients.
      To answer your question about the treatment you are currently using, without knowing what technology this is, we don’t have the evidence to support if this works or if it could be harmful or not. The non-surgical treatment we provide is called ESTIM, and it has a scientific basis behind it to support the results that we see. You can learn more about this in our most recent blogs about neuropathy. We would also love to see you in person, and help answer your questions and discuss treatment options would be best for your specific needs. Please give us a call to schedule!

  2. January 13, 2018

    My name is Roger and I have had this nasty disease since 2000.
    I am too far away from you to make the trip but was wondering if there
    are other states or doctors living in a state closer to Pennsylvania.

    I can handle the cramps but eating “dill pickles” when the cramp comes on.
    I’ve had ankle/foot problems since I was 6 years old but it had nothing to do with
    Diabetes.

    The “dill pickle” starts delivering instant relief for my feet or where ever the cramp starts; and within minutes the pain is gone.

    • January 17, 2018

      Hi Roger! Thank you for your question. We are glad to hear you’ve found a solution for the cramps you experience.
      The best way for us to provide you with a treatment plan, or recommendations for treatments to pursue, is to see you in person and perform a physical exam. We have advanced treatments for both neuropathy and restless leg syndrome, including surgical and non-surgical options. Regarding surgery, we go in to open up tight nerve tunnels, and we operate on the soleal sling which many others do not have experience doing. We do have many patients who travel in for treatment as they are not able to find these options locally. If you would like to schedule a free phone consult with one of our doctors to discuss your symptoms and possible treatments in more detail, we would be happy to set that up for you. Please feel free to give us a call to schedule! We would love to help.

  3. February 12, 2020

    My wife is having neuropathy (shooting pain numbness and tingling) due to medication received after a heart transplant. She was treated with chemo drugs to fight the rejection. It has been over 2 months since the medication was stopped and she still hasn’t gotten any better. Have you had experience with any positive outcomes treating patients at this type?

  4. February 23, 2020

    I have peripheral neuropathy.. I’ve got to the stage where I’m in extreme pain at night in left leg.. and I’ve noticed I’m finding it hard to eat.. (if that’s linked to the neurophy) I’ve only had over the counter pain relief.. no retesting to see if deterioration has occurred.. any advice would be appreciated

  5. September 30, 2020

    I went through a 5 year period of excessive alcohol drinking. I have been sober 6 1/2 years now. I have been having foot problems for the past 16 months and no one can diagnose the problem. Can a person develop delayed neuropathy from alcholol abuse? My symptoms are the same as neuropathy, but are not being considered since I am not diabetic, nor do I drink. Any thoughts on this?

    Thank you.

    • October 6, 2020

      Cheryl, Yes this could be from alcohol use. Alcohol can be damaging to our nerve tissues. However we still can help people in your situation. We evaluate you to see if you have other issues such as tight nerve tunnels in the lower extremity similiar to carpel tunnel in the upper extremity . Conventionally if you’ve been diagnosed with neuropathy there are medications that you can take. The most common is Lyrica. We however address the problem differently because we believe that in the majority of cases neuropathy is caused by compression in nerve tunnels much like carpel tunnel syndrome. Your use of alcohol may have made your nerves more sensative to any tightness that you have in multiply tunnels in your feet and legs. Our surgical and non surgical options all address this specific cause of the symptoms. In the case of our conservative options such as laser and Estim we can restore more normal nerve function in many cases. If surgery is performed we open the nerve tunnels that have become too tight (compressed}. It would also suggest that you be evaluated for diabetes or pre- diabetes if you have not.

  6. October 3, 2020

    I had a nerve conduction test recrntly and the findings are as follow…mixed axonal loss; demyelinating sensorimotor polyneuropathy. Can you explain this to me i. Simple terms? Also what is best things to do and what medication is best. Thank you so much.

    • October 6, 2020

      Ola. I will try to simplify what the test is telling us. Mixed axonal simply means that various nerve fibers that have different functions are damaged(lost) and that could mean a nerve that lets you know when your skin is touched or one that tells you something is hot or cold. Demyelinating means that the nerves are losing some of the myelin that normally covers the nerve. Myelin is fat and is important for normal transmission of messages through the nerve. Less myelin can mean decreased nerve functions. Sensorimotor polyneuropathy describes that its effecting the nerves that send messages to muscles that allow you to contract muscles and sensori means nerves are damaged that send messages to the brain that let you know when something is painful, hot, cold etc. Polyneuropahty simply means its in multiple locations.
      Conventionally if you’ve been diagnosed with neuropathy there are medications that you can take. The most common is Lyrica. We however address the problem differently because we believe that in the majority of cases neuropathy is caused by compression in nerve tunnels much like carpel tunnel syndrome. Our surgical and non surgical options all address this specific cause of the symptoms. In the case of our conservative options such as laser and Estim we can restore more normal nerve function in many cases. If surgery is performed we open the nerve tunnels tha have become too tight (compressed}. It would also suggest that you be evaluated for diabetes or pre- diabetes if you have not.

  7. October 3, 2020

    Hello my name is James I was just diagnosed with this terrible disease 5 days ago in the emergency room I went very terrible pain in my feet and I can’t quit shaking I need some help this is quite terrible I can’t eat or sleep

    • October 6, 2020

      James sorry to hear that. Conventionally if you’ve been diagnosed with neuropathy there are medications that you can take. The most common is Lyrica. We however address the problem differently because we believe that in the majority of cases neuropathy is caused by compression in nerve tunnels much like carpel tunnel syndrome. Our surgical and non surgical options all address this specific cause of the symptoms. In the case of our conservative options such as laser and Estim we can restore more normal nerve function in many cases. If surgery is performed we open the nerve tunnels that have become too tight (compressed}. It would also suggest that you be evaluated for diabetes or pre- diabetes if you have not.

  8. October 7, 2020

    I have trouble walking or standing for long periods of time. My toes would go numb and then i would have shooting pains in my toes. When i go to bed i am awakened with shooting pains through my feet and toes. I have started having trouble in my wrist and fingers pain and numbness. When i get up in the mornings I can barely walk. Now my feet feel cold all the time and i hurt so very bad. What kind of doctor do i need to see?

    • October 13, 2020

      In general many patients will seek care from a neurologist. For many the treatment options become the use of medications to help deal with the pain. I am a podiatrist trained in peripheral nerve surgery. That we be the best option in my opinion. Very few podiatrist are trained to evaluate and treat the peripheral nervous system. You can contact us or look up the Association of Extremity nerve surgeons to see who in your region might be able to help.

  9. October 8, 2020

    15 years ago diagnosed with type 1 diabetes. Neuropathy on the top of my feet after being diagnosed with with compartment syndrome. The pain and tingling is getting worse. Not sure what to do. My primary care is more in tune with coughs and colds. I need some help it is evicting my sleep.

  10. October 13, 2020

    Diane, this is a great question. I am a podiatrist that has been trained in peripheral nerve surgery. For many suffering from neuropathy we are able to do nerve decompression surgery opening nerve tunnels that become too tight. Much like carpel tunnel surgery. The fact that you’ve been told you have a compartment syndrome issue leads me to think surgery could be a viable option for you. We offer non-surgical options also. Many primary care doctors may not be trained well in evaluation of peripheral nerve issues. The fact that yours is saying you may have compartment syndrome is great as its a step in the right direction. More specifically he could be entrapment of the superficial peroneal nerve tunnel. Both create similar symptoms. Please let us know if we can help.

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