Balance Foot & Ankle — Bloomfield Township Office
43494 Woodward Ave #208, Bloomfield Township, MI 48302Quick answer
Burning, tingling or numbness that starts in the toes and slowly spreads up the feet is usually peripheral neuropathy — damage to the long nerves that run to your feet. Diabetes is the most common cause, but low vitamin B12, thyroid disease, alcohol, chemotherapy and some other medicines can do it too, and some of those causes can be corrected. At our Bloomfield Township office we test your nerve sensation, look for the cause with your other doctors, treat the pain, and protect your feet from the wounds that numbness allows.
I’m Dr. Tom Biernacki. Many of the people I see with neuropathy come in for something else — a blister they didn’t feel, a callus, a nail problem — and find out their feet have lost sensation. Others have burning pain that keeps them up at night. Either way, the goals are the same: find the cause, ease the symptoms, and keep your feet safe.
What neuropathy feels like
- Burning, stinging or electric-shock pain in the feet, often worse at night
- Tingling or a pins-and-needles feeling
- Numbness, or feeling like you’re walking on cotton or wearing socks when you’re not
- Pain from light touch, such as bed sheets or sock seams
- Trouble with balance, especially in the dark
- Weak foot muscles, curling toes, and dry, cracked skin
- Cuts or blisters you didn’t feel happen
It usually affects both feet evenly and creeps upward over months or years. Symptoms in only one foot, or that come on over days, point to something else and need a prompt look.
What causes it — and which causes can be fixed
- Diabetes is the most common cause in adults. High blood sugar over time damages small blood vessels and nerve fibers.
- Low vitamin B12 is easy to miss and often treatable. Long-term metformin, stomach or weight-loss surgery, and years of acid-reducing medicine raise the risk. See B12 deficiency and neuropathy and metformin and neuropathy.
- Thyroid disease, heavy alcohol use, kidney disease, chemotherapy and some other medicines.
- Small fiber neuropathy, which causes burning with normal strength and normal standard nerve tests. See small fiber neuropathy in the feet.
- No cause found. In some people, even a full workup doesn’t find one. It usually progresses slowly, and the symptoms can still be treated.
A few other problems can feel like neuropathy. Tarsal tunnel syndrome — a pinched nerve at the inside of the ankle — usually affects one foot. A pinched nerve in the lower back tends to run down one leg with back pain. Poor circulation causes cramping in the calves when you walk and cold feet. Sorting these out is part of the exam.
How I test for neuropathy at your visit
Testing starts with a hands-on exam that takes a few minutes and doesn’t hurt:
- a thin nylon filament pressed on several spots on each foot to check protective sensation;
- a tuning fork on the big toe and ankle to check vibration sense;
- pinprick and temperature testing for the small nerve fibers that carry burning pain;
- ankle reflexes, balance, foot strength and shape;
- pulses, skin, nails and pressure spots that could turn into wounds.
If you have diabetes, the American Diabetes Association recommends a foot exam like this at least once a year (ADA, 2026). When the cause isn’t clear, we coordinate blood tests — blood sugar, B12 and thyroid — with your primary care doctor, and refer you for nerve conduction testing when the pattern is unusual. Standard nerve tests can be normal in small fiber neuropathy, which sometimes needs a small skin biopsy instead. More on what happens at a diabetic foot exam.
How neuropathy is treated
Treat the cause
This matters more than any single pill. For diabetic neuropathy, keeping blood sugar in your target range slows further nerve damage, so I work alongside your primary care doctor or endocrinologist. Low B12 is replaced by pill or injection, thyroid problems are treated, and cutting back on alcohol stops alcohol-related damage from getting worse.
Medicines for nerve pain
For burning or stabbing pain, the American Academy of Neurology recommends four groups of medicine — certain antidepressants (such as duloxetine, amitriptyline or nortriptyline), gabapentin or pregabalin, and sodium-channel blockers — which work about equally well, and it advises against opioids (Price et al., 2022). If the first one doesn’t help or causes side effects, we try a different group. Lidocaine or capsaicin creams can help small, localized areas.
Laser therapy
Laser therapy is available at our Bloomfield Township office for nerve pain in the feet. Some of my patients find it eases burning, but the research behind it is limited, so I offer it as an add-on to the steps above, not a replacement for them. We’ll tell you the cost before you start.
Supplements
Alpha-lipoic acid has some evidence for easing symptoms. Check with us or your doctor before starting any supplement, and avoid high-dose vitamin B6, which can cause neuropathy on its own.
Protective shoes and inserts
When your feet can’t feel pressure, the right shoes and custom inserts spread the load away from spots that tend to break down. Medicare covers diabetic shoes and inserts each year for people who qualify. See diabetic shoes and custom orthotics.
Balance and strength
Numb feet make falls more likely. Simple balance and strengthening exercises, good lighting at night and supportive shoes all help. Here are my neuropathy exercises and tips on balance problems and falls.
Protect your feet every day
With neuropathy, the biggest danger isn’t the pain — it’s the injury you don’t feel. These habits prevent most problems:
- Check your feet every day, using a mirror or a family member for the soles.
- Never walk barefoot, even at home, and shake out your shoes before putting them on.
- Test bath water with your elbow, not your feet, and skip heating pads on your feet.
- Moisturize dry skin, but not between the toes.
- Don’t cut corns or calluses yourself; have us trim thick nails and calluses. See diabetic nail care.
- Have your feet checked regularly — how often depends on how much sensation you’ve lost.
When to get seen quickly
- A wound, blister or crack you didn’t feel — book a visit within a few days. If it’s red, swollen, draining or you have a fever, go to an emergency room. See when a diabetic foot problem needs the ER.
- A red, hot, swollen foot without much pain — this can be Charcot foot, a bone problem that needs urgent care. Call us the same day.
- New weakness, foot drop, or symptoms that come on over days, or that are much worse on one side.
- Numbness in the groin or loss of bladder or bowel control — go to an emergency room now.
Your first neuropathy visit in Bloomfield Township
Bring a list of your medicines and any recent blood test results, such as your A1c. We’ll go over your symptoms, examine and test both feet, and leave you with a plan — and if you have diabetes, a schedule for foot checks that matches your risk.
We’re in network with most major Michigan plans, including Medicare and Medicare Advantage, Blue Cross Blue Shield of Michigan, Blue Care Network, Aetna, Cigna, UnitedHealthcare, HAP, Priority Health and Humana, and we check your benefits before you come in. No insurance, or we’re not in your network? Self-pay care is $200 for your first visit and $100 for each follow-up. The exam, X-rays, orthotics, and therapy are all included when they are medically necessary, and only surgery and diabetic shoes are priced separately.
Who treats neuropathy at our Bloomfield Township office
All three of our doctors see neuropathy patients: Dr. Tom Biernacki, Dr. Carl Jay and Dr. Daria Gutkin.
Patients come to our office at 43494 Woodward Ave from Bloomfield Hills, Birmingham, Troy, West Bloomfield, Rochester Hills, Royal Oak and Pontiac. If Livingston County is closer, see neuropathy treatment at our Howell office at 4330 E Grand River Ave.
Related care at this office: diabetic foot care in Bloomfield Township. For the full background, read my diabetic neuropathy treatment guide, or visit our Bloomfield Township office page.
Book a neuropathy visit in Bloomfield Township
Pick a time online, day or night. Choose New patient, then the first open day.
New-patient times are released a few weeks ahead, so today may show none — use the calendar to jump to the first green day, or call (810) 206-1402. Closer to Livingston County? Book at our Howell office.
Frequently asked questions
Can peripheral neuropathy be reversed?
It depends on the cause. Neuropathy from a correctable problem, such as low vitamin B12, thyroid disease, a medicine side effect or poorly controlled blood sugar, can improve once that problem is treated. Damage that has been there for years is less likely to fully reverse, but the pain can usually be eased and further loss slowed.
How long before neuropathy treatment starts to help?
Many people notice less burning or night pain within a few weeks of starting a nerve pain medicine at the right dose. Nerves heal slowly, so changes from treating the cause are measured over months, and we adjust the plan at follow-up visits.
Is neuropathy treatment covered by insurance?
The exam, sensation testing and most medical treatment are covered by Medicare and the major plans we accept. Coverage for diabetic shoes depends on meeting specific criteria, and laser therapy is typically self-pay. We check your benefits before treatment starts.
Do I need a referral to see a podiatrist for neuropathy?
Most PPO plans don’t require one. Some HMO plans, including Blue Care Network, may. Call (810) 206-1402 and we’ll check before your visit.
What kind of doctor treats burning or numb feet?
Podiatrists, neurologists and primary care doctors all treat neuropathy, often together. A podiatrist is a good place to start when the symptoms are in your feet, because we also manage the skin, nail and pressure problems that numbness causes.
References
- Price R, Smith D, Franklin G, et al. Oral and topical treatment of painful diabetic polyneuropathy: practice guideline update summary. Report of the AAN Guideline Subcommittee. Neurology. 2022;98(1):31–43. Read the guideline.
- American Diabetes Association Professional Practice Committee. 12. Retinopathy, neuropathy, and foot care: Standards of Care in Diabetes—2026. Diabetes Care. 2026;49(Suppl 1):S261–S276. Read the standards.
Request an appointment
If you have burning, numbness or tingling in your feet, send the form below or call (810) 206-1402, and our office will get back to you. We see patients at our Howell and Bloomfield Township offices.
Last updated September 2026. This page is general information, not a diagnosis.