By Kate Clayton-Jones
MSN PhD(c) RN CFCN CFCS
At FootCare by Nurses, we take care of a lot of people who tell us that they have peripheral neuropathy. When asked “what kind?” there is often a long pause. Peripheral neuropathy affects a lot of people. It manifests in a number of different ways. For whatever reason, be it diabetes, an injury, muscle weakness or lack of blood flow or something else, the nerves in our hands and feet (the periphery of our body) stop functioning normally. Symptoms are described as pain, numbness, cold, hot, excessive sweating, increased sensitivity and burning. These sensations may or may not occur as a result of a stimulus. For some people, it is just a nuisance, for others, it is a debilitating condition. Having sensation in your feet is protective. Not being able to feel your feet can lead to negative outcomes from insult such as; cuts, blisters, infections and even amputations. Insensate feet can also throw off balance, which can lead to falls.
At FootCare by Nurses we believe in prevention and person-centered care. With regard to peripheral neuropathies, while we cannot cure it, from our perspective there are some things that we can do and encourage you to do, that are helpful for enhancing circulation. Wearing socks that wick away moisture is important for those with autonomic neuropathy. Lamb’s wool between the toes can also be a useful tool for excessive sweating. Using the right moisturizers that are not petroleum based (petroleum is an occlusive, which means it is not well absorbed) and learning how to take care of your skin is important for overall skin health. Since some peripheral neuropathies are related to microvascular blood flow, actions that enhance blood flow to the extremities are very helpful. These include massage to the feet and encouraging people to participate in exercises found in disciplines such as tai chi, chi gong, and low impact yoga. Our nurses can even show you deliberate foot and toe exercises that can be helpful.
There is also another cause for blood flow restriction. It is called edema. There are many causes for edema. Examples include restricted lymph flow (lymphedema), cardiac-related edema and dependent edema. Even the mildest edema restricts lymph and microvascular flow by putting pressure on the peripheral vessels. Massage and lymph flow enhancing exercises can help. If there are no arterial concerns wearing a mild (8-15 or moderate 15-20) graduated compression sock can make a great positive impact on peripheral blood flow. On the market now are some great, fun and very comfortable compression socks. In fact, most of our nurses choose to wear them regularly because they are so comfortable and make such an incredible difference.
Medications can also influence microvascular flow. Medications can be life-saving, but learning about how they impact you and your peripheral circulation can bring peace of mind. There is nothing worse than being in pain constantly especially when you don’t understand why. At FootCare by Nurses, we have rubbed feeling back into people’s feet and pain away too many times to think of our work as mere coincidence. The science behind our work has to do with helping our patients understand how things work, the way that the fascia connects to the rest of the body and utilizing the benefits of circulation-enhancing massage and exercises.
Please feel free to share your experiences and ask your FootCare by Nurses nurse any questions you have about peripheral neuropathy.