Diabetic Nerve Pain in Ankle, Feet and Legs

It is important to be aware of diabetic neuropathy and the ways it can affect your feet, ankles, and legs if you have diabetes, also called diabetes mellitus.

Diabetic neuropathy is a condition that results from damage to the nerves due to high blood sugar levels and nerve damage can cause a wide range of symptoms including pain, numbness, tingling, burning sensations, and weakness. In some cases, diabetic neuropathy can lead to serious complications such as diabetic foot ulcers.

There are several treatment options available for diabetic neuropathy that range from physical therapy to medications and we will discuss them all.

However, by following your doctor’s advice and taking steps to manage your diabetes, you can help prevent diabetic neuropathy or slow its progression.

What is neuropathy?

Neuropathy is a general term for nerve damage while peripheral neuropathy is damage to the nerves outside of the brain and spinal cord also called the peripheral nerves.

Your peripheral nervous system includes all of the nerves that send information from your brain and spinal cord to the rest of your body.

Diabetes is one of the leading causes of neuropathy although many other risk factors and medical conditions can cause it including:

• Injury
• Autoimmune disorders
• Infections such as HIV and hepatitis B and hepatitis C
• Hereditary disorders such as Charcot-Marie-Tooth disease
• Kidney disease
• Liver disease
• Bone marrow disorders including bone cancer
• Tumors that are both cancerous and benign
• Exposure to toxins
• Alcoholism
• Vitamin deficiencies
• Certain medications, especially those used in chemotherapy to treat cancer

If you have any of these conditions and think you may have neuropathy please talk to your doctor for a diagnosis.

There are also other forms of neuropathy such as autonomic neuropathy, proximal neuropathy (diabetic polyradiculopathy), and mononeuropathy (focal neuropathy) but we will focus on peripheral neuropathy as it is the most common type if you have diabetes.

What is diabetic neuropathy?

Diabetic neuropathy, or diabetic peripheral neuropathy, is a type of nerve damage that can occur if you have diabetes and it can inhibit your nerve functions.

High blood sugar (glucose) over long periods of time can injure nerves throughout your body although it most often damages nerves in your extremities, specifically your legs, ankles, and feet followed by your hands and arms.

Depending on the affected nerves, the most common symptoms of diabetic neuropathy can include:

• Numbness or a loss of feeling
• Tingling
• Burning sensation
• Shooting pain or sharp pain
• Sensitivity to touch such as your blankets when you try to sleep
• Loss of balance and coordination
• Foot deformities such as Charcot foot and hammertoe
• Sensitivity to heat or coldness

It is important to check your feet and legs, or wherever you have neuropathy daily to ensure that you do not have a cut or wound in that area as you may not be able to feel your injury due to a loss of sensation in the affected area.

If these sores go untreated, they can become diabetic ulcers which is a common complication that can then become infected and can lead to amputation.

Please seek medical attention if you have any of these symptoms or think you may have diabetic nerve damage.

What are the treatment options for diabetic neuropathy?

The best way to treat diabetic neuropathy is to keep your blood sugar levels in a healthy range.

If you are already diabetic, this means working with your doctor on a diabetic treatment plan that works for you.

The most common ways to manage your blood glucose levels include eating a healthy diet, getting regular exercise, taking any medications for diabetes as prescribed by your doctor, and maintaining a healthy weight.

Other treatments are available depending on the severity of your symptoms including:

Medications

Your doctor or health care provider may prescribe medications or suggest over-the-counter drugs too. Usually, the over-the-counter medications suggested are pain relievers such as ibuprofen (Advil) or acetaminophen (Tylenol).

Prescription medicines that your doctor may prescribe include antidepressants and anti-seizure medications as they are both known to help with nerve pain.

You may also be prescribed pain medications such as oxycodone for short periods if you have severe pain although these medications are addictive and are not long-term solutions.

Physical therapy

Physical therapy treatments usually consist of some low-resistance exercises such as swimming or walking in a pool to help relieve diabetic neuropathy pain as well as improve your blood circulation.

It is important to avoid high-impact exercises as they may exacerbate your symptoms.

There are also massage techniques that can help relax muscles, ease tension, and promote blood flow although you may want to avoid any massages that involve deep pressure on the affected area as it could be too painful.

Topical treatments

Capsaicin cream, which you can find over-the-counter, can be applied to the affected area which is made with chili peppers and works by numbing the pain signals sent to your brain.

There is not enough research confirming its benefits for peripheral neuropathy and it is best to consult with your doctor before starting any treatment option.

Treating complications caused by neuropathy

Lastly, any complications caused by diabetes or diabetic neuropathy need to also be treated such as urinary tract problems, sexual dysfunction (erectile dysfunction in men or vaginal dryness in women), low blood pressure, and digestive problems.

Many of these complications are caused by other forms of neuropathy and not peripheral neuropathy although it is important to know about them and treat them too.

Are there any ways to help prevent diabetic neuropathy?

The best prevention measure is to monitor and manage your blood glucose levels if you have diabetes which includes eating a healthy diet, maintaining a healthy weight, getting regular exercise, and taking any diabetic medications as prescribed by your doctor.

You need to also see your doctor regularly to monitor your diabetes and diabetic neuropathy. Other ways to prevent diabetic neuropathy include:

• Not smoking
• Limiting your alcohol intake
• Checking the areas affected by neuropathy every day for cuts, sores, blisters, or other issues
• Wear shoes that fit properly as better-fitting shoes are less likely to cause irritation and sores
• Wearing clean, dry socks every day for proper foot care and to avoid a foot infection
• Washing your feet and hands daily with warm water and completely drying them
• Cleaning any minor cuts or wounds with water and mild soap
• Use a daily moisturizer on your extremities after you dry off from a shower or bath
• Wear appropriate footwear that has plenty of cushioning and provides stability to avoid falls
• Cut your toenails straight across to avoid getting ingrown toenails

By practicing these diabetic neuropathy prevention methods, you can help keep your feet healthy and avoid complications.

Diabetic neuropathy is a serious diabetic complication but it is also preventable and treatable despite there being no cure so be sure to talk to your doctor about any concerns you have and to determine the best treatment plan.

Summary

Diabetic neuropathy is a complication of diabetes that usually affects your feet, ankles, and legs.

There is no cure for diabetic neuropathy; however, there are treatment options available to help manage your symptoms.

If left untreated, diabetic neuropathy can lead to serious complications including foot, leg, or ankle ulcers which can lead to the amputation of limbs.

There are ways to help prevent diabetic neuropathy including monitoring and managing your blood sugar levels and other tips we listed above.

Be sure to talk to your doctor, podiatrist (foot doctor), or health care provider regarding any questions or concerns you have and to determine the best treatment plan for you.

References and sources:

Mayo Clinic 

• Diabetic neuropathy – Overview
• Diabetic neuropathy – Diagnosis

Healthline

• Symptoms of Diabetic Peripheral Neuropathy
• Tips for Treating Diabetic Nerve Pain

Cleveland Clinic 

• Why You Need to Control Your Blood Sugar to Avoid Diabetic Neuropathy

NHS

• Overview – Peripheral neuropathy

Fact Checked and Editorial Process

Diabetic.org is devoted to producing expert and accurate articles and information for our readers by hiring experts, journalists, medical professionals, and our growing Diabetic.org community. We encourage you to read more about our content, editing, and fact checking methods here. This was fact checked by Jacqueline Hensler and medically reviewed by Dr. Angel Rivera.