Neuropathy question

Diabetes Complications and other Conditions Feet
#1

Can people who have neuropathy tell me what it's like and how it developed?

For the past few years I've been having a lot of issues which seem to be caused by nerves. I have what seems to be carpel tunnel syndrome - I frequently wake up with half my hand tingly and numb, and sometimes my entire hand is completely numb. If I wear wrist splints it helps, but I don't always use them. My hands also go numb if I'm carrying grocery bags, using the mouse with my wrist resting on the table, or have my arm draped over the back of a chair or in another odd position.

I talked to my endo about it and he didn't feel it was caused by diabetes because I answered no to all his questions about neuropathy in my feet.

BUT! I think I do have something going on with nerves in my feet and other areas. If I wear a backpack, even if it's not all that heavy, my arms and hands will start tingling. And I have a lot of peoblems with pain in my big toes (but I also have bunions with my big toes - and the pain feels aching not like what I'd think of as nerve pain). In addition to this and flat feet, which causes pain as well, when I walk I frequently have pain along the sides of my ankles (like right along the ankle bone) and the entire top of my foot will go numb and (if I persist in walking) the entire top of my foot gets really painful. I googled it and it seems this is caused by a nerve issue and can be caused by shoes being too tight, but my shoes definitely aren't too tight from what I can tell. Over the past year and a half I've gotten custom orthotics, doctor-recommended shoes, been given stretches to do, and also had x-rays of my feet, and although that has helped other pain issues, I still can't walk any distance without having to stop because my ankles/feet hurt, which I hate (I'm 33 and it makes me feel 80!).

Like my hands that only go numb or tingly at specific, predictable times, my feet only ever hurt or go numb when I walk, with the exception of my toes which sometimes hurt at other random times even if I'm just sitting around. I should also note that I have no loss of senstation in my hands or feet at all - I read braille on a daily basis and I can feel if I step on a milimetre thick shard of glass (happened last week!).

Does this sound like diabetic neuropathy? How did neuropathy develop for others who have it? If it is neuropathy, is there anything that I can take to help it? I know controlling blood sugars better can help and I am working on that, but I am finding my feet issues intolerable (I can't even walk three or four blocks without feeling like I need to stop). I'm going to bring this all up with my GP, but how is something like neuropathy diagnosed? Is it done by my GP or endo or another specialist?

#2

I have a few questions for you, specifically for your arms.

1. Which fingers go numb from the presumed carpal tunnel syndrome? (I mean when it isn't your whole hand.)

2. What part of your arm are you pressing on when you drape it over a chair?

3. When you wear a backpack and your arms and hands go numb, is that everywhere or in specific places?

Also, if your hand problem is carpal tunnel syndrome, that isn't caused by neuropathy. Diabetics are more likely to get carpal tunnel, but I think that has to do with sugar buildup in the carpal tunnel--a thick sheath that one of the nerves in your hand has to pass through in order to get from your arm to your hand. That is not neuropathy, it's basically compression of the nerve.

The good news is that none of this sounds quite like neuropathy, at least not to me. What you're describing with your arms sounds like nerve compression--yes, even the backpack thing--and while that is not pleasant, it isn't neuropathy. Then again, because I don't have neuropathy you might get answers from others that say differently. I don't deny that your issues sound nerve-related, though.

Also, my feet often hurt or go numb when I walk long distances, no matter what shoes I'm wearing, although it's worse when I lace my sneakers too tight. I definitely don't have neuropathy, but I do have several other odd problems which are not nerve-related. And if your feet are flat and you don't have good inserts to support your arch, you will have pain in your ankle bone, most likely from an inflammation of the joint capsule called synovitis. I have flat feet and I've been dealing with this problem for years.

#3

With regards to my hands, when my hands go numb at night it's my thumb and index and middle finger. Same with when I'm carrying heavy grocery bags. When they go numb from resting my arm on a chair, it's the inside of my upper arm that I'm usually resting. When they go tingly from using my mouse, it's the outer two fingers (ring and pinky) that get tingly. It's usually this same area that goes tingly or numb if I'm wearing a backpack.

I have custom orthotics made by a podiatrist for my flat feet. I definitely noticed a HUGE difference when I don't wear them (I feel very unsteady and my feet hurt way, way more). This is partly why I'm so frustrated that I still can hardly walk. I've been back to the podiatrist about four times and he altered the orthoics once (because my feet were *so flat* they actually wore down part of the arch support, so he got it made higher with a tougher material), and he's also taken x-rays to rule out something like arthritis. It wouldn't bother me so much if they only went numb or hurt for long distances, but it's anything more than 3-4 blocks that makes my feet seriously unpleasant. So I can't even do basic things like grocery shopping or walking from the bus stop to work without pain.

#4

The thumb, middle, and index fingers sound like carpal tunnel syndrome. Hands going numb at night or when carry groceries is characteristic. Typing is, too, but not in the pinky and ring finger.

The nerves in your arms and hands start from your spine and criss-cross with each other a bunch of times in an area called the brachial plexus before becoming the nerves in your arms and hands. The brachial plexus is, essentially, in your shoulder, and it can be compressed by a backpack. That being said, a backpack that doesn't have much in it shouldn't do that. Also, that inner part of your arm is exactly where your ulnar nerve runs, and that's the nerve that's responsible for the sensation in your pinky and ring fingers. If you have a problem with your ulnar nerve at the level of the brachial plexus (meaning where it exits the brachial plexus) then it would make sense that light compression from a backpack or a chair would make your pinky and ring fingers tingle. I can't tell you why you'd have a problem with your ulnar nerve, but what you're describing is exactly that. (I'm also unsure as to why using a mouse would bother it, unless you lean the outside edge of your wrist on the table when you do so.)

#5

I do often rest my wrist on the table when I'm using a mouse, and this is when my hand goes numb. I try not to do it, though. It also happens sometimes when I'm using my video magnifier at work, becasue it has a "wrist rest" surface that makes it almost impossible not to rest my wrists on it while I'm reading.

#6

I have been diagnosed with peripheral neropathy. The symptoms started in my calves in 2007. Walking caused such terrific pain my calves that it caused me to leave my very active job. I didn't have any other symptoms until several years later when I began to have a burning sensation on the pads of my feet...and then numbness on and off in my toes when I walked a lot and at night when sleeping.

Around the same time I began to have the exact same symptoms you describe in my hands. Tingling and numbness when using my mouse, or when I lay the wrong way on the couch, and many nights when I wake up in the middle of sound sleep because almost all ten fingers and sometimes half my hands are numb and painfully tingling. It happens to my feet as well.

#7

How did you get diagnosed?

And, if I did have neuropathy, is there anything that can help, especially with walking?

#8

Neuropathy is damage to nerves and can be caused by lots of things. Diabetic neuropathy is damage to nerves caused by high blood sugars (although lots of people argue it occurs because high blood sugars cause microvascular damage). Diabetic neuropathy is a type of neuropathy. Diabetic neuropathy isn't the only kind of neuropathy that can be caused by diabetes. I consider CTS a complication of diabetes. High blood sugars cause a thickening of our tendons and this causes things like frozen shoulder and CTS.

As others have noted you sound like you have Carpal Tunnel Syndrome (CTS). You can confirm the diagnosis of CTS with Phalen's test which I discussed previously. I suffer from CTS and for some years was able to do exercises to keep my wrists flexible and avoid the worst of it. However my CTS got worse and I suffered through it for far too long. I eventually went to get it tested (by a neurologist) and then had surgery. Despite the surgery I still suffered some permanent damage and have lost much feeling in one finger and have some numbness in others.

There are basically two routes. If you confirm with Phalen's test that you have CTS you could seek the advice of your GP who will probably advise physical therapy as a first option. Or you could see a neurologist who would also offer you a path towards surgery. I'd try the physical therapy but if it continues don't delay seeking more aggressive treatment like I did.

#9

I have had similar issues a few years back. Ended up having Carpal tunnel surgery first. It seemed to help at first. A few years later had a spinal fusion done my neck and that gave me instant relief. Before the spinal fusion numbness tingling and pain went from neck all the way to the tips of my fingers. The symtoms came on gradually and kept getting worse over time.

#10

When I've tried that test (both on my own, and my endo had me try it) it once caused very mild tingling which could have been my imagination (it was that mild) and the other time caused nothing. I don't know if that means it can't be carpel tunnel syndrome or if it doesn't need to be positive. Maybe I need to see a physical therapist for my hands and feet, or see a chiropractor for my spine...

#11

I've wondered about spinal issues since I am having problems with both my hands and feet. If I had to pick which bothered me most, it would by far be my feet, though I'm also worried about doing some sort of permanent nerve damage.

#12

I have Neuropathy, I have lost no sensation in my feet. My nerves are damaged and react to nothing at times, kinda like my ears ringing all the time, my feet do the same thing. I can get up in the morning and my feet feel like I'm walking on pins and needles. My hands and arms cannot hold heavy objects for long periods of time without cramping...I think that is common for someone that's not conditioned for that type of job...carrying a sack of food out of the store once a week is not going to condition my arms.

Just do the best you can and keep going...most of us where put on this earth to be rescued...not be the rescuer...;-)

#13

I wouldn't mind too much if it were neuropathy (honestly, after 23+ years of diabetes, it would not surprise me at all). But my concerns are that my life is seriously affected by not being able to walk 3-4 blocks without pain and not being able to easily carry bags or backpacks (or sometimes dragging a wheeled case behind me) without my hands going tingly. I can't drive, which means I rely on walking every day and have no real choice but to carry things like groceries home or carry things like laptops when I need to, so I actually do think my arms should be more conditioned for these things than most as I've been carrying things long distances since high school (used to be textbooks, now it's groceries or laptops).

My other reason for being concerned is that if it ever caused permanent numbness, that would really seriously affect my daily life - no reading braille, no touch typing (I can't see to write easily with a pen), not being able to feel tactile information from my cane, not being able to feel what's under my feet for balance (I already have issues with falling randomly due to weak ankles that collapse if I step wrong), not being able to accurately feel things while cooking or pressing a button or finding where to a package... I know this is worst-case scenario and I would find ways to cope, but I rely so much on touch, probably similar to what a sighted person relies on vision for, that the idea of permanent nerve damage freaks me out about as much as the idea of permanent vision loss freaks sighted people out.

#14

Good question! I have wondered this before. I get occasional tingling in my hands, but I always chalk it up to bad circulation, due to aging. I'm also 33 and interested in reading the replys. I see your concern. Do your ankles swell after walking when you can pain in your feet?