The Neuropathic Foot
The Neuropathic Foot
What is neuropathy? Neuropathy refers to damage or dysfunction of the peripheral nerves that carry signals between the brain, spinal cord, and the rest of the body. When it affects the feet, it’s commonly called peripheral neuropathy or “the neuropathic foot.” Causes include diabetes (the most common), autoimmune disorders, infections, toxins, certain medications, nutritional deficiencies, alcohol use, and inherited conditions.
How neuropathy affects the foot
Sensory loss: Reduced or absent sensation (numbness) and altered sensation (tingling, burning, electric shocks). This makes it difficult to feel pain, temperature, or pressure, increasing risk of injury, blisters, and ulcers.
Motor dysfunction: Weakness of small foot muscles can lead to deformities such as hammertoes, claw toes, high arches (pes cavus), or collapse of the transverse arch. Weakness alters gait and increases pressure points.
Autonomic changes: Reduced sweating and dry skin, thinning of skin, and poor circulation. These changes increase risk of cracks, fissures, and infection.
Pain: Some people experience neuropathic pain—sharp, burning, or shooting—even without obvious external injury.
Common signs and symptoms
Numbness or loss of feeling in part or all of the foot
Tingling, pins-and-needles, or burning sensations
Sharp, electric, or shooting pains
Increased sensitivity to touch (allodynia)
Muscle weakness, foot instability, frequent tripping
Changes in foot shape or gait
Dry, cracked skin; calluses; slow-healing wounds
Unnoticed cuts or pressure sores
Increased risk of infections and ulceration, particularly in people with diabetes
How footwear and foot care makes a difference for the neuropathic foot
Promotes the body’s natural ability to heal
Protects the foot from injury.
Creates routine that keeps the mind engaged in the health of the feet.
Strategic in helping to ease and cope with symptoms of pain or discomfort
Builds back muscle tone, flexibility, balance and stability
Corrects gait, foot shape and arches
Keeps nails, skin and soft tissues healthy for comfortable walking performance
Case Studies document how obtaining the right footwear and foot care through therapeutic interventions by professionals can alter the foot to the point of wellness with normal functioning.
Here is the case of Ruth. Ruth came into FootSaviv, shoe studio and spa, to get help with the numbness, tingling, swelling and pain in her feet. This was causing her difficulty in balance and walking. She tended to walk by shuffling her feet forward and not lifting them. She would sometimes use furniture in the room to steady herself as she walked. Sometimes she would hold on to her husband Bo. Ruth was in her 40’s and had just survived cancer. Ruth came to us as a referral from a pediatrist. The pediatrist sent with her a list of shoes and creams that could be useful to her. Ruth works with her husband at their bakery and has to be on her feet all day until closing time Tuesday through Saturday.