Anytime somebody comes into my office with a concern that they have a burning sensation in their feet (without an infection) I immediately become a little concerned. This usually means that the nerves in the feet are starting to die off. A condition is known as peripheral neuropathy. Of course, there could be other symptoms with this such as feelings of pins and needles in your feet, lack of circulation, numbness, or just a generalized pain. At first, the symptoms may come and go, however, they usually almost always return. It all depends on whether the body can heal the nerves and regenerate some of that tissue that’s been damaged or lost. This would be the first stage of peripheral neuropathy and most people ignore these warning signs. For some reason, as humans, we are programmed to believe that if something disappears it is no longer a concern. However with most chronic conditions though initial warning signs should guide us to doing something about them before they start to continually get worse. After the initial stage of numbness and pain, you’ll probably progress towards regular and persistent symptoms, then debilitating pain can occur, progression to constant numbness may happen, and then finally complete loss of feeling can also progress. And worst-case scenarios the tissue degenerates so much within the feet that amputation of some toes has to take place. Somebody rarely progresses this far but it does happen. How long does it take to progress? The answer is we don’t know, because in some people it can progress quicker than others. Usually, though it is a degeneration that takes years to develop. Not only will it affect pain and sensation in our feet, but quite often this is also going to affect things like balance. Balance is extremely important especially as we age because falls become one of the largest causes of injury and can affect life expectancy.
The worst case of peripheral neuropathy I worked with was when I was practicing in the states and I’ll never forget this one day. It seemed like a normal day, I just finished up with a few patients and was doing my rounds to check up on the patients who were doing different exercises or who were attached to different therapeutic pieces of equipment. When I looked over to the side I saw a gentleman who I had done a peripheral neuropathy exam on a few weeks prior. This gentleman was in a rough place when he first came in, he had very severe diabetic neuropathy in his feet and legs. This is when the nerves and tissue in the feet are starting to die off. His legs were pretty much purple from just below the knee down. The skin was cracking and it did not look like the tissue was going to last too much longer. When doing the examination we tested different sensations in his feet such as pain in which we poke the pads of the toes and feet with a little pin. We tested for cold sensation, where we would hold this little icy piece of metal up to the toes and feet. Hot sensation was also tested in which we would use this device similar to a blow dryer set on a higher level, then we’d test vibration with a tuning fork, and lastly test light touch with a tissue. Now basically none of these sensations were anything that the patient could feel! Imagine being poked in the bottom of your big toe with a thumbtack and not feeling it or dipping your foot in a burning-hot bath without feeling it scald your feet. This man was really in a rough place and we were unsure if we were going to be able to help him at all, so that’s what we told him. Other doctors he saw told him the same thing that we thought, he was on the way to eventually needing amputation starting with a few toes and possibly more depending on how much more things declined. Well, I see him with this huge smile on his face and tears forming in his eyes. He then says “doc I can feel my feet hurting; I never thought I’d ever be happy to feel pain again in my feet.” It was an absolutely amazing moment to share with this person. Within the next weeks and months, we started to notice the color change in his feet and the line of purple at the top of his lower leg started to migrate down away from his knee. Other sensations also started to return a bit and the pain started to decrease as this happened. Once again it was just an amazing experience of healing!
Of course, this is an example of a very advanced case that doesn’t apply to most people with peripheral neuropathy but, it is a great case to demonstrate how healing can take place. So how did we help him? The first thing that needs to be started with any degenerative condition where tissues are starting to be destroyed is to take a functional medicine approach. This is when a skilled practitioner looks at the metabolic side of things with a fine-tooth comb such as looking at labs, nutrition, and supplementation. Attempting to eliminate the bad things causing tissue destruction and adding the proper substances that build healthy living tissue. The next step is to look at modalities that aid in tissue healing like laser, PEMF (pulsed electric magnetic field), and infrared light therapy. From there you want to stimulate different sensory nerves. If you stimulate the cells in a nerve at the right frequency, intensity, and duration what you are doing is kick-starting the genetic expression and protein synthesis needed to make the cells healthier. This can be accomplished with different exercises, electric stimulation, vibration, adjustments, touch therapies, and many more.
What if I just have a little burning in my feet then? Start by decreasing the “bad foods” in your diet and increasing the “good foods”, then work on small little foot exercises like picking up objects with your toes, drawing letters on the carpet with your feet, and feeling different textures. If this isn’t making things better then it is time to advance to a clinical setting where they can take a multimodality approach to get you results. At Collegiate Sports Medicine we have multiple practitioners and techniques that can be used to get you or your loved ones better.
Dr. Dave Hardy, DC
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