Medically reviewed by Dr. Tom Biernacki, DPM — Board-Certified Podiatric Surgeon — Balance Foot & Ankle, Howell & Bloomfield Hills, MI. Last updated April 2026.

Peripheral neuropathy — damage to the nerves that carry signals between the feet, legs, and brain — is one of the most challenging foot conditions to manage. It causes burning, tingling, shooting pain, numbness, and weakness in the feet and lower legs. At Balance Foot & Ankle, Dr. Tom Biernacki provides comprehensive neuropathy foot care for Michigan patients, focusing on preventing serious complications like wounds, infections, and amputation.

What Causes Peripheral Neuropathy?

Diabetes is by far the most common cause — approximately 60–70% of people with diabetes develop some degree of peripheral neuropathy. Other causes include chemotherapy (chemo-induced neuropathy), alcohol abuse, vitamin B12 deficiency, thyroid disorders, kidney disease, autoimmune conditions (such as lupus or rheumatoid arthritis), infections (HIV, Lyme disease, shingles), and hereditary conditions (Charcot-Marie-Tooth disease).

Symptoms of Foot Neuropathy

Neuropathy symptoms vary by nerve type affected. Sensory neuropathy causes burning pain, tingling (“pins and needles”), numbness, hypersensitivity to light touch, inability to feel temperature changes, and loss of protective sensation. Motor neuropathy causes weakness, foot drop, and muscle atrophy. Autonomic neuropathy causes dry, cracked skin (from reduced sweating), poor circulation, and impaired wound healing. Most patients have a combination of all three.

The Danger of Numbness

Numbness is the most dangerous neuropathy symptom. When you can’t feel pain in your feet, you can’t detect cuts, blisters, burns, or pressure sores before they become serious. A small blister from a new shoe that would heal in a week in a healthy person can become a deep infected wound in a neuropathic foot — potentially leading to amputation. This is why diabetic and neuropathic patients need professional foot care and preventive education.

Neuropathy Foot Care at Balance Foot & Ankle

Comprehensive neuropathy examination — Dr. Biernacki performs a detailed sensory exam using monofilament testing, vibration testing, and vascular assessment. This identifies which patients are at high, moderate, or low risk for foot complications and guides care frequency recommendations.

Diabetic shoe fitting — Qualified neuropathic patients are eligible for Medicare-covered therapeutic diabetic shoes with custom-molded inserts. These shoes are designed with extra depth, seamless interiors, and protective features that reduce ulcer and blister risk by up to 70%. Dr. Biernacki is a certified prescriber.

Wound care and ulcer prevention — If you have developed a foot wound, specialized wound care services are available at Balance Foot & Ankle including offloading, debridement, advanced wound dressings, and infectious disease coordination.

Nail and callus management — Neuropathic patients should never trim their own toenails or treat calluses themselves. Dr. Biernacki provides professional nail care and callus debridement, removing pressure points before they become wounds.

Symptom management coordination — While a podiatrist cannot cure peripheral neuropathy, Dr. Biernacki coordinates with your primary care physician and neurologist. Medications such as gabapentin, pregabalin, duloxetine, and topical compounded creams can significantly reduce neuropathic pain symptoms.

Michigan Neuropathy Foot Care Locations

Balance Foot & Ankle provides neuropathy foot care at southeast Michigan offices in Dearborn, Flat Rock, Monroe, and Taylor. If you have diabetes or neuropathy, annual or more frequent foot exams are essential. Call (734) 479-6200 to schedule yours today.

Frequently Asked Questions

Living with Peripheral Neuropathy? We Can Help

Neuropathy robs you of sensation and balance while adding burning pain. Our podiatrists manage neuropathic foot care with medications, nerve decompression, protective footwear, and fall prevention strategies.

Clinical References

1. Callaghan BC, et al. “Diabetic neuropathy: clinical manifestations and current treatments.” Lancet Neurol. 2012;11(6):521-534.
2. Tesfaye S, et al. “Diabetic neuropathies: update on definitions, diagnostic criteria, estimation of severity, and treatments.” Diabetes Care. 2010;33(10):2285-2293.
3. Boulton AJM, et al. “Diabetic somatic neuropathies.” Diabetes Care. 2004;27(6):1458-1486.

Your Board-Certified Podiatrists

Dr. Tom Biernacki, DPM

Board-Certified · FACFAS

Dr. Carl Jay, DPM

Board-Certified Podiatrist

Dr. Daria Gutkin, DPM

Podiatrist

Dr. Tom Biernacki, DPM

Dr. Tom Biernacki, DPM is a double board-certified podiatrist and foot & ankle surgeon at Balance Foot & Ankle Specialists in Southeast Michigan. With over a decade of clinical experience, he specializes in heel pain, bunions, diabetic foot care, sports injuries, and minimally invasive surgery. Dr. Biernacki is a member of the APMA and ACFAS, and his patient education content on MichiganFootDoctors.com and YouTube has reached over one million views.