Peripheral Neuropathy
Numbness, tingling, or burning in your feet signals nerve damage — peripheral neuropathy. It's most commonly linked to diabetes, but chemotherapy, vitamin deficiencies, and other conditions can cause it too. The danger isn't the sensation itself. It's what you can't feel. A cut, blister, or pressure sore that goes unnoticed can become a serious wound, especially in diabetic patients.
Symptoms
- Numbness or reduced sensation in the feet
- Tingling or 'pins and needles' feeling
- Burning pain, especially at night
- Sharp or stabbing pain episodes
- Loss of balance or coordination
- Muscle weakness in the feet
Who Gets It
Peripheral neuropathy is most common in diabetic patients — approximately 50% of people with diabetes develop some degree of neuropathy over time. Other causes include chemotherapy side effects, vitamin B12 deficiency, alcohol use disorder, hypothyroidism, and certain autoimmune conditions. Anyone with numbness or burning in their feet, regardless of cause, needs regular foot monitoring.
Austin's older and diabetic populations face elevated risk. Managing neuropathy well means staying mobile — a priority for patients who want to remain active in their community. Dr. Wokasien coordinates with primary care physicians and specialists to ensure foot care fits into the broader management picture.
Treatment
Dr. Wokasien manages neuropathy through:
- Regular monitoring exams — frequency based on severity and risk level
- Custom orthotics to redistribute pressure away from vulnerable areas
- Footwear assessment and recommendations to prevent hidden damage
- Wound care for any developing issues before they escalate
- Coordination with your primary care doctor for systemic management
Patients with neuropathy can't rely on pain to warn them of problems. Regular professional exams catch skin breakdown, pressure points that will become ulcers, circulation changes, and footwear problems creating hidden damage.
When to Call
If you have diabetes or any condition causing numbness in your feet, regular monitoring prevents problems that are hard to fix once they start. Call (512) 250-0444.
Frequently Asked Questions
Can peripheral neuropathy be reversed?
In some cases, yes — particularly when caused by a correctable underlying condition like B12 deficiency or hypothyroidism. Diabetic neuropathy can be slowed with better blood sugar control, but existing nerve damage rarely fully reverses. The focus shifts to managing symptoms, protecting the feet, and preventing complications.
How often should I see a podiatrist if I have neuropathy?
Frequency depends on severity. Mild neuropathy with no other complications warrants exams every 3-6 months. Active wounds, prior ulcers, or significant circulation changes may require monthly visits. Dr. Wokasien establishes a monitoring schedule based on your specific risk level.
What kind of shoes should I wear with neuropathy?
Extra-depth shoes with a wide toe box and no internal seams that create pressure points. Seamless, moisture-wicking socks. Dr. Wokasien evaluates shoe fit at every neuropathy visit — footwear that looks fine can be creating damage you can't feel. For high-risk patients, therapeutic footwear may be covered by Medicare or insurance.
I have neuropathy but no pain. Do I still need foot exams?
Especially if you don't have pain. Neuropathy removes the warning system. A wound that would be immediately obvious to someone with normal sensation can progress significantly in a neuropathic foot before it's noticed. Regular professional exams are how you catch things early when you can't rely on pain to alert you.
What daily foot care should I be doing at home?
Inspect your feet daily — use a mirror for the sole if needed. Look for cuts, blisters, redness, swelling, or skin color changes. Wash and dry feet thoroughly, including between toes. Moisturize to prevent cracking (but not between toes, where excess moisture promotes fungal infection). Call us for anything you don't recognize.
Can neuropathy cause balance problems?
Yes. Proprioception — your body's sense of foot position — depends on intact nerves. Neuropathy impairs this feedback, leading to balance difficulties and increased fall risk. Dr. Wokasien addresses this with appropriate footwear and orthotic support, and may recommend balance exercises.
How is neuropathy diagnosed?
Dr. Wokasien performs a clinical neurological exam during a foot evaluation — testing sensation with a monofilament and vibration fork to identify neuropathic areas. More detailed nerve conduction studies are done by neurologists when needed. For most patients with known diabetes, clinical testing is sufficient to establish monitoring needs.