How Does Diabetes Cause Leg, Foot, and Toe Pain?

If you are experiencing pain in your toes, it could be due to your diabetes.

Diabetes is a chronic condition that affects the way your body processes blood sugar.

One of the complications of diabetes is diabetic neuropathy, which is a condition that can cause chronic pain and numbness in your legs, feet, and toes.

In this article, we will discuss the symptoms of diabetic neuropathy and the effective treatment options available for those who suffer from the condition while also highlighting its causes and giving you tips on how to prevent it.

What is diabetes?

Diabetes is a condition that affects the way your body metabolizes blood sugar called glucose.

The two most common types of diabetes are known as type 1 and type 2, although there are other rarer forms of it.

Type 1 diabetes, also known as juvenile-onset diabetes or insulin-dependent diabetes, occurs when the pancreas does not produce enough insulin because your immune system attacks the cells that produce it.

If you have type 1 diabetes you can not prevent it and you will have to take insulin for the rest of your life. Type 2 diabetes, also known as adult-onset diabetes or non-insulin dependent diabetes, occurs when your body does not produce enough insulin or your cells do not respond properly to the insulin that is produced which is called insulin resistance.

It is the most common form of diabetes and can often be controlled through diet and exercise, although you may eventually require medication or insulin injections and it is usually preventable.

If any form of it goes untreated you may have diabetes complications such as cardiovascular disease (heart disease), chronic kidney disease, or diabetic foot pain.

What are the symptoms of diabetes?

No matter what type of diabetes you have, both types cause an increase in blood sugar levels which can lead to several different symptoms.

One of the most common symptoms is called polyuria, or excessive urination, which happens because your body is trying to get rid of the excess sugar in your blood by excreting it through urine.

Frequent urination can lead to dehydration, weakness, and increased thirst. Other common symptoms include fatigue, blurred vision, and slow healing wounds.

You may also experience weight loss because your body is unable to properly utilize the sugar in food for energy. Irritability and mood swings are also possible as is an increased risk of infection.

How does diabetes cause pain in your legs, feet, and toes?

One of the complications of diabetes is diabetic neuropathy, also called diabetic peripheral neuropathy, which is a type of nerve damage to the peripheral nerves (nerves not in your brain or spinal cord) in your extremities that can occur when your blood sugar levels are too high for prolonged periods.

Diabetic neuropathy can cause pain, numbness, tingling, and weakness in your legs, feet, and toes.

It is possible to have diabetic neuropathy in your arms or hands although it is more common in your legs and feet. Untreated diabetes-related neuropathy can also lead to problems with balance and coordination as well as an increased risk of falls.

Peripheral artery disease, also called peripheral vascular disease, is a medical condition that can also play a role in causing pain in your legs, feet, and toes by hardening your blood vessels and causing poor blood flow. A lack of circulation can lead to foot ulcers and infections due to the affected areas not getting enough nutrients from your blood.

Although peripheral artery disease can develop without peripheral neuropathy, it is more likely that peripheral neuropathy is causing you pain as peripheral artery disease often goes unnoticed.

If you notice any of the symptoms of diabetic neuropathy, please seek medical care from your doctor as soon as possible. 

What causes diabetic neuropathy?

What causes diabetic neuropathy is unknown although it is thought to be a result of uncontrolled blood glucose levels although more research is needed.

There are a few different risk factors besides poor glucose control that can contribute to diabetic neuropathy such as high blood pressure and smoking. It is also more common if you have had diabetes for a longer period of time.

According to one study, if you have type 2 diabetes you are more likely to develop diabetic neuropathy than if you have type 1 although nearly a quarter of the participants in the study with type 1 diabetes still developed diabetic neuropathy.

Finally, obesity and being overweight can also be risk factors as can kidney disease.

Are there any treatment options for diabetic neuropathy?

There is no cure for diabetic neuropathy but treatments are available to help ease pain and improve your quality of life.

The most important thing you can do for your pain due to neuropathy is to monitor your blood sugar levels to make sure they are in the target range and to manage your diabetes.

To manage your diabetes you will need to exercise regularly, eat a healthy diet, maintain a healthy weight, and take any medicines as prescribed by your doctor.

There are other treatment options available to you and these include:

Medications

Both prescription and over-the-counter medications may be used to help mitigate your symptoms of diabetic neuropathy. Ibuprofen (Advil) and acetaminophen (Tylenol) may be used for mild or moderate pain but prescription medications are usually used for any severe pain.

The type of prescription medication will depend on the pain you are experiencing. Antidepressants may be prescribed as they can help with pain even if you do not have depression.

Other medications that can be used to treat diabetic neuropathy include anticonvulsants (anti-seizure medications), topical pain relievers such as capsaicin cream which is derived from chili peppers, and opioids have all shown evidence for pain reduction.

Some anticonvulsants and antidepressants have been shown to help ease diabetic nerve pain while capsaicin cream has been shown to block or reduce pain signals to your brain.

Opioids may help with severe pain but they need to only be used sparingly as they carry a risk for addiction. Please consult with your doctor or podiatrist before starting any new medications or treatment plans as some may have adverse effects or interact with medicines you are already taking.

Therapy

Physical therapy, occupational therapy, and massage therapy may all help you ease pain caused by diabetic neuropathy.

Physical therapy can help you regain strength and mobility as well as improve your balance to reduce the risk of falls.

Occupational therapy can help you find ways to do everyday tasks that have become difficult due to pain or weakness. Massage therapy may help to ease pain by improving circulation and relaxing your muscles.

Transcutaneous electrical nerve stimulation (TENS)

TENS is a pain relief method that uses electrical current to stimulate your nerves and block pain signals to your brain. TENS is usually used for mild or moderate pain but it can be used for severe pain as well.

Alternative medicines

Acupuncture and certain dietary supplements can also help you ease pain caused by diabetic neuropathy although more research and long-term studies are needed to determine their effectiveness.

Acupuncture is a traditional Chinese medicine that involves inserting thin needles into your skin at specific points. Dietary supplements that have been shown to help ease pain and cause improvement in neuropathy include alpha-lipoic acid, acetyl-L-carnitine, and B vitamins.

Dietary supplements and acupuncture are not regulated by the United States Food and Drug Administration (FDA) so please talk to your doctor before starting any new treatment options.

Is diabetic neuropathy preventable?

Unfortunately, there is no surefire way to prevent diabetic neuropathy as it is still not clear what causes the condition in the first place.

However, you can lower your risk of developing diabetic neuropathy, delay its onset, or stop its progression by managing your diabetes which includes maintaining good blood sugar control, exercising regularly, eating a healthy diet, and taking any medications as prescribed by your doctor for optimal care.

You need to also see your doctor or podiatrist (foot doctor) regularly for diabetic foot exams.

Besides these options, other ways to prevent diabetic neuropathy include:

• Checking your feet daily for any cuts, sores, or irritations
• Washing your feet daily with mild soap and water and dry them thoroughly, even between the toes
• Moisturize your feet after drying them to avoid dry skin and cracks
• Wear shoes with clean socks everywhere, including inside the house, and avoid going barefoot
• Keep your feet away from extreme temperatures
• Wear comfortable shoes that fit properly and avoid open-toed shoes
• Trim your toenails carefully straight across to avoid ingrown nails
• Choose low-impact exercises that will not bother your feet as much such as biking, swimming, or walking

By following these health tips, you can prevent, delay the onset of, or stop the progression of diabetic neuropathy and the pain it causes you.

Summary

Diabetic neuropathy is a condition that causes pain in your legs, feet, and toes and the pain is caused by damage to the nerves from high blood sugar levels.

Diabetic neuropathy is a common complication of diabetes and the pain can range from mild to severe. There are several symptoms of diabetic neuropathy including pain, numbness, tingling, and weakness.

The pain from diabetic neuropathy can be treated with pain relievers, therapy, TENS, or alternative medicines and you and your doctor can determine what is best for you.

Diabetic neuropathy can be prevented by following some of the health tips listed above and by managing your diabetes.

If you have pain in your legs, feet, or toes, talk to your doctor, podiatrist, or health care provider about whether diabetic neuropathy could be the cause and what treatment options are available to you.

References and sources:

Mayo Clinic 

• Diabetes – overview
• Diabetic neuropathy

Healthline

• Diabetes Leg Pain and Cramps: Treatment Tips

CDC

• Diabetes and Your Feet

WebMD

• Diabetic Nerve Pain: 10 Foot Care Tips to Protect Yourself

Diabetes UK

• Serious Foot Problems and Diabetes

NIH

• Diabetic Neuropathy Prevalence and Its Associated Risk Factors in Two Representative Groups of Type 1 and Type 2 Diabetes Mellitus Patients from Bihor County

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.