The brain sends messages to every part of our body and vice versa via the nervous system. When the nerves are affected or damaged, and these signals are not being sent through, thus causing a condition called neuropathy, which is a long-term complication which can cause problems in various parts of the body.

Neuropathy can be more common in those with Diabetes. High blood glucose level over long periods of time can damage the small blood vessels which supply nutrients to the nerves. The nerve fibres can be damaged or disappear if those essential nutrients are lacking.

There are three types of neuropathy:

• Sensory
  Affecting the sensation of feet and hands and even legs and arms. It is the most common type of neuropathy in diabetics, also called peripheral neuropathy.
• Autonomic
  Affecting the nerves in the heart, stomach, intestines, bladder and sweat glands.
• Motor
  Affecting nerves in the muscles making it difficult to walk and move fingers. This neuropathy is quite rare in diabetics.

Symptoms of Sensory Neuropathy

When the sensory nerves have been affected, the symptoms one can experience are:

• Numbness
• Tingling sensation
• Unexplained burning feeling
• Stabbing pains
• Difficulty to sense pain or extreme temperatures.
• Dysesthesia, which is an abnormal sensation such as, a burning feeling under the skin or hyper sensibility of clothes and bedding.

Complications – Specifically in diabetics.

Having sensory neuropathy can make it difficult for someone with loss of feeling to sense pain and heat which could result in unnoticed injury being sustained in our feet and hands. Feet are harder to see and get to and are more vulnerable than our hands, thus making feet more predisposed to possible trauma. Some minor injuries due to sensory neuropathy could be caused by:

• Sharp objects inside shoes
• Barefoot walking
• Friction from badly fitting shoes
• Burns from radiators or hot water bottles

It is important to check inside one’s shoes and to inspect one’s feet on a regular basis to prevent and avoid or rule out any minor injuries.

If we leave these minor injuries untreated, they may develop into infections and ulcerations.

In diabetics with severe neuropathy, a rare complication can occur which is called Charcot Foot. Bones in the feet can break and go unnoticed due to the existing neuropathy, then these bones heal abnormally causing the foot to become deformed.

Treatment

Unfortunately, there is no treatment to heal or repair nerve damage, although there are a variety of treatments that could be helpful. It would be ideal for diabetics whether experiencing a loss of sensory sensation or not, to keep their blood glucose levels under control to help prevent neuropathy from developing or worsening, such as diet control, regular exercise and medication. It is important to have medical attention and to have regular check-ups and routine appointments.

At The Footcare Centre, our podiatrists will conduct neurological and vascular test to all new patients and specifically recommend diabetic checks, to rule out any neuropathic problems. To book an appointment call please call 01932 849373 or book online.

This blog has been written by Steven Castillo Pinel and is not necessarily the opinion of The Footcare Centre Ltd

This blog discusses what chronic venous insufficiency is and what you can do to help manage it.

Chronic Venous Insufficiency (CVI) is the poor functioning of vein valves either being hereditary or the simple damage or blockage causing there to be a venous reflux, for example after a deep vein thrombosis or blood clot. The valves in the veins allow the blood to travel against gravity, from the legs to the heart. When the valves are not able to close properly the blood flow reverses and accumulates at the bottom increasing the venous pressure and causing the lower leg to swell.

There are also some who are more predisposed to CVI.  These risk factors include:

• Family history
• Over 30 years of age
• Previous blood clots in veins
• Females
• Multiple pregnancies
• Prolonged standing
• Heavy lifting

As the blood pressure builds up in the lower leg, the symptoms and signs that one can experience are:

• pain
• itchiness
• the enlargement of varicose veins
• inflammation
• changes in skin (discolouration, eczema, scarring and hard skin)
• venous ulceration

If you believe you present CVI, it would be the best interest to visit a Vascular Surgeon who will assess your symptoms and ask about your medical history. The vascular surgeon will need to physically assess you via Doppler (which is a hand-held instrument used to listen to your blood flow), a venous duplex ultrasound (this provides an actual image of your veins to rule out any blockages or blood clots) and for severe cases, a CAT scan or MRI can be useful to exclude any other causes for leg inflammation.

Apart from treating CVI surgically, it can be helped with the following conservative managements:

• Diet and lifestyle- maintaining a healthy weight
• Avoiding prolonged sitting and standing
• We sitting/lying- elevation of feet and legs, ideally above the heart
• Structured exercise to strengthen leg muscles.
• Compression stockings
• Regular moisturising to reduce itching and prevent cracking minimising the risk of infection (cellulitis)

It is important to prevent any severe swelling and the development of ulcers. It is also very relevant to know that, even after a successful treatment, recurrence can occur, and further care may be needed.

If you do suffer with CVI and find it hard to reach your feet, and simply want some advice and help, our podiatrists here at The Footcare Centre can assist, treat and guide you. To book an appointment call 01932 849373 or book online

This blog has been written by Steven Castillo Pinel and is not necessarily the opinion of The Footcare Centre Ltd

At this time of year the cold weather can have many effects on us as well as colds and lingering coughs that many of us have the misfortune to pick up.  Over the winter months the cold can also play its part on our feet.

One such problem is perniosis or pernio, commonly known as chilblains.

Chilblains are diagnosed on clinical grounds and should be suspected when a person has one or more intensely itchy, painful, swollen skin lesions that appear within 12–24 hours of exposure to cold.

• • The lesions appear as single or multiple (usually symmetric) red patches, papules, on a cool/cold swollen base
  • They occur most commonly on the toes and fingers
  • The colour can change from red to purple (or marked darkening in people with dark skin), and swelling can progress to painful. In severe cases, it can lead to the chilblain becoming “broken” due to blistering or ulceration.

People presenting with an acute or recurrent episode of chilblains should be reassured that the condition is self-limiting, caused by exposure to cold, and will resolve if further exposure to cold is avoided.

To avoid chilblains we advise the following:

• Dressing warmly to protect the feet, for example thermal socks
• Avoiding scratching, rubbing, or applying direct heat.
• Smoking cessation, if relevant.
• Keeping dry to reduce heat loss.
• If you are prone to chilblains each year then start applying a chilblain cream such as balmossa from late autumn through to spring in the hope this prevents the development.

If you are currently suffering from chilblains and they are unbroken or intact carry out the above but if they are ulcerated then book an appointment with a Podiatrist so that they can be assessed and made more comfortable (via padding/dressing and possible low level laser therapy) as infection can often occur in this case, if left.

In extreme cases the Podiatrist may ask your GP for a medicine called Nefidipine to be prescribed which is causes vasodilation in the extremities and therefore improved blood flow to the extremities, which can aid healing or prevent development.

If you are suffering from chilblains and want further advice or treatment from one of our podiatrists please call 01932 849373 or book online.

This blog has been written by Paul Sen and is not necessarily the opinion of The Footcare Centre Ltd

In the interest of promoting good foot health, we thought we would put together this blog with a few pointers that everyone can follow to keep your feet healthy at home.

The soles of the feet (particularly the heels) tend to dry out and form calluses through the pressures of everyday wear and tear, and even more so when high stress activities such as running are taken into consideration.

A Podiatrist can help to identify the causative problem, and remove these calluses. But, there are also a few things you can do at home to help maintain a happy balance to your feet.

As part of your daily routine, most of us will use a moisturiser on our face, our arms, and even our legs. But we often forget our feet. As the skin on the soles of the feet are on average twice the thickness of anywhere else, you would want to use a Foot specific cream that has the necessary ingredients (mainly urea based) to actively reduce the rate of callus build up.

In addition to creaming, using a course foot file twice a week on callused areas will also help to reduce how fast calluses return.

Before you take the above advice and cream every inch of your foot, stop a second and read below.

The one area of your feet, you do not want to start putting any cream, is in-between your toes.
This is because, for most people, the areas around your toes tend to be quite moist due to sweat and moisture build up that is prevented from evaporating by your toes being close together.

This excess moisture build up can make you more prone to skin infections such as Athletes Foot.
To help prevent this excess moisture; you want to make sure that you dry well in-between your toes after showers or baths.

There are a couple of extra things you can do if you suffer from particularly moist toes.
Changing socks midway through the day or through work/long walks helps to maintain a dry environment around the toes. Also, a small amount of surgical spirit on a cotton wool bud rubbed between the toes will remove sweat and dry the skin also.

Be a little cautious with this last one though, if you have a splits or eczema in the area then the surgical spirits will result in unpleasant stinging. So please check between your toes, or have a Podiatrist assess and advise you first.

This blog has been written by Tristan White and is not necessarily the opinion of The Footcare Centre Ltd