Quick answer: Treatment for peripheral neuropathy foot treatment michigan follows a stepwise approach: 1) conservative care first (rest, ice, supportive footwear, OTC anti-inflammatories), 2) physical therapy and targeted exercises, 3) in-office treatments (injections, custom orthotics) if conservative fails at 4-6 weeks, 4) surgery for refractory cases. Most patients resolve at step 1 or 2. Call (810) 206-1402.
Medically reviewed by Dr. Tom Biernacki, DPM · Board-Certified Podiatric Surgeon · Last reviewed: April 2026 · Editorial Policy
The most important clinical decision with Peripheral Neuropathy Foot Treatment Michigan isn’t which treatment to start with — it’s identifying the correct subtype. That changes everything. Call (810) 206-1402.
Quick Answer
Peripheral Neuropathy in the Feet: Causes, Symptoms & T relates to foot neuropathy — typically caused by nerve compression or systemic. Most patients improve in varies by cause with conservative care. Same-week appointments in Howell + Bloomfield Hills: (810) 206-1402.
Medically reviewed by Dr. Tom Biernacki, DPM — Board-Certified Podiatric Surgeon — Balance Foot & Ankle, Howell & Bloomfield Hills, MI. Last updated April 2026.
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Peripheral neuropathy — nerve damage that causes burning, tingling, numbness, or pain in the feet — affects an estimated 20 million Americans and is one of the most challenging conditions in podiatric medicine because it is often progressive, frequently undertreated, and carries serious consequences when unmanaged. Patients with neuropathy who cannot feel foot injuries, pressure sores, or skin breakdown are at dramatically elevated risk of foot ulcers, infection, and in severe cases, amputation. Dr. Tom Biernacki, DPM at Balance Foot & Ankle in Howell and Bloomfield Hills, Michigan provides comprehensive neuropathy evaluation, risk stratification, and management as a core component of our diabetic and general foot care services.
What Is Peripheral Neuropathy?
Peripheral neuropathy is damage to the peripheral nerves — the nerves outside the brain and spinal cord that transmit sensation, motor signals, and autonomic function to and from the extremities. In the feet, neuropathy primarily affects sensory nerves (causing abnormal sensations or numbness), motor nerves (causing weakness of intrinsic foot muscles and toe deformities), and autonomic nerves (causing reduced sweating, dry skin, and impaired circulation regulation). The classical pattern is “stocking-glove” distribution — symptoms begin in the toes and feet and progress proximally up the legs symmetrically.
Causes of Peripheral Neuropathy
Diabetes mellitus is the most common cause of peripheral neuropathy in developed countries — diabetic peripheral neuropathy (DPN) affects approximately 50% of diabetic patients over a lifetime and is strongly associated with poor glycemic control. The mechanism: sustained hyperglycemia damages small blood vessels (microangiopathy) and directly injures nerve fibers through advanced glycation end-products and oxidative stress.
Other significant causes include: alcohol-related neuropathy (toxic), B12 deficiency (common in patients on metformin, which depletes B12), chemotherapy-induced peripheral neuropathy (CIPN from taxane and platinum agents), hypothyroidism, kidney disease, autoimmune neuropathies (CIDP, vasculitic neuropathy), hereditary neuropathies (Charcot-Marie-Tooth), and idiopathic neuropathy (no identifiable cause, accounts for approximately 30% of cases). It is essential to identify the underlying cause — some are reversible with treatment (B12 deficiency, thyroid disease, alcohol cessation, glycemic control) while others require management of the primary condition.
How Neuropathy Is Diagnosed in Our Office
Neuropathy evaluation in our Howell and Bloomfield Hills offices includes: monofilament sensory testing (Semmes-Weinstein 5.07 monofilament — the standard clinical test for protective sensation; inability to feel the monofilament indicates loss of protective sensation and high ulcer risk), vibration perception testing with a 128 Hz tuning fork (the earliest sensory modality lost in most neuropathies), ankle reflex assessment (reduced or absent Achilles reflex is an early neuropathy sign), and ankle-brachial index (ABI) vascular screening (peripheral artery disease frequently coexists with neuropathy). We also assess foot deformities caused by motor neuropathy — intrinsic minus deformities, hammer/claw toe development, Charcot changes.
Classification: Severity and Risk Stratification
Risk stratification guides the intensity of preventive care. Low risk (intact monofilament sensation): annual diabetic foot exam, education on daily self-inspection. Moderate risk (monofilament positive — loss of protective sensation): custom diabetic footwear, insoles, quarterly podiatric visits, education on wound recognition. High risk (prior ulcer or amputation, monofilament positive, PAD): monthly podiatric evaluation, offloading orthosis for any pressure lesion, immediate evaluation for any skin change. Our office provides risk stratification at each diabetic foot evaluation and adjusts the care plan accordingly.
Medical Treatment for Neuropathy Symptoms
While peripheral neuropathy often cannot be fully reversed, treating the underlying cause can slow or halt progression and in some cases improve symptoms. For diabetic neuropathy, intensive glycemic control (target HbA1c <7%) is the most effective disease-modifying intervention. B12 supplementation for deficiency-related neuropathy (1000mcg methylcobalamin daily) can improve symptoms over 6–18 months. Alcohol cessation allows partial nerve recovery over 6–12 months.
For symptomatic relief of painful neuropathy: pregabalin (Lyrica) and duloxetine (Cymbalta) are FDA-approved for diabetic painful neuropathy and have the strongest evidence. Gabapentin (Neurontin) is widely used off-label with good clinical evidence. Topical lidocaine or capsaicin provides localized relief. MLS laser therapy has demonstrated benefit for painful diabetic neuropathy in several clinical trials — it reduces pain intensity and in some cases improves sensory threshold scores. We offer MLS laser as an adjunct therapy for neuropathy pain management at both our Howell and Bloomfield Hills locations.
The Most Common Neuropathy Mistake
The most common mistake: stopping B12 supplementation when neuropathy symptoms improve. Deficiency-related neuropathy responds slowly — improvement occurs over 6–18 months and requires sustained supplementation. Patients who stop B12 at 3 months because “they feel better” frequently relapse. Maintain B12 supplementation continuously for neuropathy attributed to B12 deficiency and recheck serum B12 and methylmalonic acid levels annually. This is one of the most reversible neuropathies when treated adequately.
Warning Signs — Same-Day or Urgent Evaluation
Seek same-day evaluation in a neuropathic patient for: any wound or opening in the skin (cannot rely on pain to detect severity); new redness, warmth, or swelling over any foot area (may indicate early infection or Charcot fracture); sudden worsening of numbness or asymmetric onset (suggests new or rapidly progressive neuropathy requiring urgent neurological evaluation); or any skin discoloration that is new (rule out arterial insufficiency and infection).
Book a Neuropathy Evaluation — Howell & Bloomfield Hills
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Dr. Tom Biernacki, DPM provides comprehensive neuropathy screening, risk stratification, Medicare therapeutic shoe prescriptions, wound care, and MLS laser therapy for neuropathic pain at both Balance Foot & Ankle locations. Same-day appointments available. Call (810) 206-1402 or book online.
Related: Diabetic Foot Wound Care · Charcot Foot · Best Shoes for Neuropathy
Dr. Tom’s Recommended Products for Diabetic Foot Care
📍 Located in Michigan?
Our board-certified podiatrists treat this condition at two convenient locations. Same-day appointments often available.
These are products I personally use and recommend to my patients at Balance Foot & Ankle.
- Dr. Comfort Men’s Paradise Diabetic Shoe — Medicare-covered diabetic shoe with seamless interior — eliminates pressure points that cause diabetic ulcers
- Foundation Wellness DASS Diabetic Socks (Levanta) — non-binding, seamless toe, moisture-wicking diabetic socks protecting neuropathic feet
- Derma Sciences Bordered Gauze Dressings — Non-adherent wound dressing ideal for diabetic foot wound management between podiatry visits
Affiliate disclosure: As an Amazon Associate, Balance Foot & Ankle earns from qualifying purchases. We only recommend products we trust for our own patients.
🧦 Dr. Tom’s Pick: DASS Medical Compression Socks
Medical-grade 15-20 mmHg graduated compression. DASS socks are the brand I recommend most to patients with swollen feet, poor circulation, and post-surgery recovery. Graduated compression means tightest at the ankle, gradually releasing up the leg — promoting upward venous blood flow.
View DASS Compression Socks on Amazon →Affiliate disclosure: As an Amazon Associate, Balance Foot & Ankle earns from qualifying purchases.
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Howell Office
4330 E Grand River Ave
Howell, MI 48843
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Bloomfield Hills Office
43494 Woodward Ave, #208
Bloomfield Hills, MI 48302
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Podiatrist-recommended products
As an Amazon Associate, Dr. Tom earns from qualifying purchases.
B-complex with alpha-lipoic acid targets nerve metabolism.
View on Amazon →Cushioned support reduces pressure on insensate feet.
View on Amazon →Menthol cream soothes burning and tingling symptoms.
View on Amazon →Cold therapy calms nerve flare-ups after standing.
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Same-week appointments · Howell & Bloomfield Hills · 4.9★ (1,123+ reviews)
☎ (810) 206-1402Book Online →In Our Clinic
Diabetic neuropathy patients in our clinic often don’t realize they have it until we put a 10-gram Semmes-Weinstein monofilament to the plantar foot and they can’t feel it. Many arrive for an unrelated concern — an ingrown toenail, a callus — and we catch the neuropathy on screening. The conversation then shifts: we need to discuss daily foot inspections, appropriate footwear, the urgency of any blister or open area, and the timing of vascular referral if pulses are diminished. Comprehensive diabetic foot exams are covered by Medicare annually. If you have diabetes, we want to see you once a year even if nothing hurts.
More Podiatrist-Recommended Diabetic Essentials
Diabetic-Approved Walking Shoe
Orthofeet Sprint — seamless, extra-depth, designed for neuropathic feet.
Seamless Diabetic Sock
Watch: Peripheral Neuropathy Home Remedies [Leg & Foot Nerve Pain Treatment] — MichiganFootDoctors YouTube
OS1st FS4 — non-binding, moisture-wicking, protects fragile diabetic skin.
Recovery Slide for Indoor Wear
HOKA Ora 3 — protects diabetic feet from barefoot injury at home.
As an Amazon Associate, Balance Foot & Ankle earns from qualifying purchases. Product recommendations are based on clinical experience; prices and availability shown above update live from Amazon.
When to See a Podiatrist
One unnoticed blister on a neuropathic foot can become a limb-threatening ulcer in under 14 days. Medicare covers diabetic shoes (A5500) and comprehensive foot exams annually for most diabetic patients with neuropathy or circulation concerns. Balance Foot & Ankle runs a dedicated diabetic limb-preservation program — vascular screening, offloading, ulcer care, and shoe fitting — all in one visit. Schedule your annual diabetic foot exam today.
Call Balance Foot & Ankle: (810) 206-1402 · Book online · Offices in Howell & Bloomfield Hills
In-Office Treatment at Balance Foot & Ankle
When conservative care isn’t enough, Dr. Tom Biernacki and the team at Balance Foot & Ankle offer advanced, same-day options — including Peripheral Neuropathy Treatment Michigan at our Howell and Bloomfield Hills clinics.
Same-day appointments available. Call (810) 206-1402 or book online.
Pros & Cons of Conservative Care for diabetic foot care
Advantages
- ✓ Daily inspection prevents amputation
- ✓ Most insurance covers DME
- ✓ Custom orthotics help
Considerations
- ✗ Daily commitment required
- ✗ Slow wound healing
- ✗ Charcot risk if neuropathy
Dr. Tom’s Recommended Products for diabetic foot care
Affiliate disclosure: As an Amazon Associate, Balance Foot & Ankle earns from qualifying purchases. We only recommend products we use with patients.
Drew Moonwalker Diabetic Shoe Dr. Tom’s Pick
Best for: Medicare-covered diabetic footwear
Diabetic Compression Socks Dr. Tom’s Pick
Best for: Daily protection + circulation
Ready to Get Back on Your Feet?
Same-day appointments in Howell + Bloomfield Hills. Most insurance accepted. Dr. Tom Biernacki, DPM & team.
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Call Now: (810) 206-1402
About Your Care Team at Balance Foot & Ankle
Dr. Tom Biernacki, DPM · Board-Certified Foot & Ankle Surgeon. Specializes in conservative-first care, minimally invasive bunion surgery, and complex reconstruction.
Dr. Carl Jay, DPM · Accepting new patients. Specializes in sports medicine, athletic injuries, and routine podiatric care.
Dr. Daria Gutkin, DPM, AACFAS · Accepting new patients. Specializes in surgical reconstruction and pediatric podiatry.
Locations: 4330 E Grand River Ave, Howell, MI 48843 · 43494 Woodward Ave Suite 208, Bloomfield Hills, MI 48302
Hours: Mon–Fri 8:00 AM – 5:00 PM · (810) 206-1402
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Dr. Tom Biernacki, DPM is a board-certified podiatrist + Amazon Associate. Picks shown are products he prescribes to patients at Balance Foot & Ankle Specialists. We earn a commission on qualifying purchases at no extra cost to you. All products independently tested + reviewed for 30+ days minimum. Last verified: April 28, 2026.
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In-Office Treatment at Balance Foot & Ankle
If home treatment isn’t providing relief for your nerve pain, our podiatry team at Balance Foot & Ankle can help with same-day evaluations and advanced in-office care.
Same-day appointments available. (810) 206-1402
Frequently Asked Questions
How long does treatment take to work?
Most patients see improvement in 4-8 weeks with consistent conservative care. Persistent symptoms after 8 weeks need imaging and escalation.
When is surgery needed?
Surgery is reserved for cases that fail 3-6 months of conservative care, structural deformities, or fractures requiring stabilization.
Is this covered by insurance?
Most diagnostic visits and conservative treatments are covered by Medicare and major insurers. Custom orthotics often require diabetic or post-surgical justification.
Our podiatrists treat the underlying cause, not just the symptom. Same-week appointments at our Howell and Bloomfield Hills, Michigan offices.
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Same-day appointments in Howell & Bloomfield Hills, MI.
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Dr. Tom Biernacki, DPM is a board-certified foot & ankle surgeon (ABFAS & ABPM) 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 made him one of the most-followed foot & ankle educators on YouTube.