What is neuropathy and what causes it?

Neuropathy is damage to the peripheral nerves that causes pain, numbness, tingling, or weakness, most commonly in the feet and legs. Diabetic peripheral neuropathy is the most common cause, resulting from chronically elevated blood sugar damaging nerve fibers. Balance Foot & Ankle specializes in neuropathy management at both our Howell and Bloomfield Hills offices.

What are the symptoms of diabetic peripheral neuropathy in the feet?

Symptoms include burning, tingling, numbness, sharp pain, sensitivity to touch, and loss of balance. Some patients feel nothing at all, which is particularly dangerous because injuries go unnoticed. Our podiatrists at Balance Foot & Ankle perform thorough neuropathy assessments — call (810) 206-1402.

Can diabetic neuropathy be reversed or cured?

Diabetic neuropathy cannot be fully reversed, but its progression can be slowed with tight blood sugar control, and symptoms can be managed with medications, MLS laser therapy, and custom orthotics. At Balance Foot & Ankle, Dr. Tom Biernacki DPM and team offer advanced neuropathy treatments to improve quality of life.

How is diabetic neuropathy diagnosed?

Diagnosis involves a physical exam assessing sensation, reflexes, and vibration perception, often combined with nerve conduction studies. Balance Foot & Ankle uses clinical testing to evaluate neuropathy severity and guide treatment at our locations in Howell and Bloomfield Hills, MI.

What treatments does a podiatrist offer for neuropathy?

Podiatric treatments for neuropathy include custom orthotics to prevent injury, MLS laser therapy to reduce pain and promote nerve healing, diabetic footwear, and regular monitoring to catch wounds early. Contact Balance Foot & Ankle at (810) 206-1402 or visit 4330 E Grand River, Howell or 43494 Woodward Ave #208, Bloomfield Hills.

How often should diabetics check their feet?

Daily self-exams plus professional exams annually (or every 3-6 months for neuropathy/PAD patients). Dr. Biernacki provides comprehensive diabetic foot care programs.

Why do diabetics have foot problems?

Diabetes causes nerve damage, reduced blood flow, and impaired immunity. Injuries go unnoticed and heal slowly. ~15% of diabetics develop ulcers. Prevention through regular podiatric care is essential.

What are signs of diabetic neuropathy?

Tingling, burning, numbness starting in toes, sensitivity to touch, muscle weakness, balance problems. Schedule evaluation at 810-206-1402 for nerve testing and management.

What foot complications are associated with diabetes?

Diabetes causes two pathways to foot problems: peripheral neuropathy reduces protective sensation so injuries go unnoticed, and peripheral arterial disease reduces blood flow so wounds heal poorly. Together these create the diabetic foot ulcer — the leading cause of non-traumatic lower limb amputation in the US. Charcot neuroarthropathy can destroy the foot's architecture within weeks from unnoticed repetitive trauma.

What are compression socks and who should wear them?

Compression socks apply graduated pressure — tightest at the ankle, progressively lighter up the leg — to improve venous return and reduce swelling. They benefit people with chronic venous insufficiency, varicose veins, lymphedema, prolonged standing or sitting, and mild to moderate peripheral edema. Medical-grade compression (15–20 mmHg mild; 20–30 mmHg moderate to severe) is the evidence-supported range.

What causes swollen feet and ankles?

Common causes include venous insufficiency, heart failure, kidney disease, liver disease, lymphedema, deep vein thrombosis, medication side effects (calcium channel blockers, steroids), and prolonged sitting or standing. Bilateral symmetric swelling usually indicates a systemic cause; unilateral asymmetric swelling raises concern for DVT, infection, or local venous obstruction. New onset significant swelling warrants medical evaluation.

When should I see a podiatrist for a foot wound or ulcer?

Diabetic patients should see a podiatrist within 24–48 hours for any foot wound. Non-diabetic patients should seek care if a wound has not begun healing within 7–10 days or shows signs of infection (increasing redness, warmth, pus, odor). Wound care at Balance Foot & Ankle includes debridement, offloading, advanced dressings, and vascular assessment. Call (810) 206-1402 immediately.

What Is Diabetic Peripheral Neuropathy? 2026

You are in the right place. Dr. Tom Biernacki, DPM, FACFAS — board-certified foot & ankle surgeon with 3,000+ surgeries — explains exactly what what is neuropathy diabetic peripheral neuropathy means and what works. Call (810) 206-1402 for same-day appointment at Howell or Bloomfield Hills.

Quick answer: What Is Neuropathy Diabetic Peripheral Neuropathy affects roughly 1 in 4 adults in our practice. Effective treatment starts with a targeted diagnosis, conservative-first treatment, and escalation only when needed. We treat this regularly at our Howell and Bloomfield Hills practices. Call (810) 206-1402.

Medically reviewed by Dr. Tom Biernacki, DPM · Board-Certified Podiatric Surgeon · Last reviewed: April 2026 · Editorial Policy

MICHIGAN PODIATRIST INSIGHT

The most important clinical decision with What Is Neuropathy Diabetic Peripheral Neuropathy isn’t which treatment to start with — it’s identifying the correct subtype. That changes everything. Call (810) 206-1402.

Quick Answer

Medically reviewed by Dr. Tom Biernacki, DPM

Board-certified podiatric surgeon | Balance Foot & Ankle
Last reviewed: May 2026

What is Neuropathy? [ DIABETIC Peripheral Neuropathy] relates to diabetic foot care — typically caused by reduced circulation + neuropathy. Most patients improve in ongoing daily inspection with conservative care. Same-week appointments in Howell + Bloomfield Hills: (810) 206-1402.

Video by Dr. Tom Biernacki, DPM — Michigan Foot Doctors — Watch: Dr. Tom Biernacki explains the topic in detail · Subscribe to Michigan Foot Doctors on YouTube

✅ Medically reviewed by Dr. Tom Biernacki, DPM — Board-Certified Podiatrist · Last updated April 6, 2026

Neuropathy – Understand It, Manage It, Treat It. For specialized treatment, see our neuropathy foot care at Balance Foot & Ankle.

Best Orthotics

What is neuropathy? It’s a question many patients ask when they begin noticing strange sensations in their feet—tingling, numbness, or even sharp pain. This nerve-related condition can interfere with daily life and mobility if left unaddressed. At Balance Foot & Ankle in Michigan, our team of podiatry experts helps you break down the signs, causes, and options to manage neuropathy, so you can protect your feet and your future.

https://youtu.be/TMyUjJPSMew

Discover the Causes, Symptoms, and Treatments from Leading Michigan Foot Expert

We will review Peripheral Neuropathy. Do you have diabetes? Have you lost sensation in your feet? Diabetic foot pain? Manage YOUR Diabetic Foot Symptoms & Prevent Diabetic Foot Ulcers and more ! Support your feet!

Peripheral Neuropathy is more than just a tingling sensation—it’s a serious nerve condition that can severely impact your quality of life, especially if you have diabetes. Many patients don’t realize the early signs of neuropathy until they start losing sensation in their feet or experiencing sharp, burning pain. If you’re diabetic, these symptoms are even more concerning because they could be the warning signs of diabetic neuropathy, which increases the risk of foot ulcers and infections. Recognizing the symptoms early is the first step to protecting your feet and overall health.

Have you noticed numbness, diabetic foot pain, or trouble feeling temperature changes in your feet? These signs often point to peripheral neuropathy, a condition that damages the nerves outside of your brain and spinal cord—typically starting in the toes and feet. For diabetic individuals, this loss of sensation can lead to unnoticed injuries, slow healing, and eventually serious complications like ulcers or even amputation. Managing blood sugar levels, wearing proper footwear, and scheduling regular podiatric exams are essential in reducing risk and maintaining foot health.

In-Office Treatment at Balance Foot & Ankle

If home treatment isn’t providing relief for your neuropathy, 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

Learn about our neuropathy treatment → | Book online →

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Frequently Asked Questions

Why is diabetic foot care so important?

Diabetes causes two problems that make foot wounds dangerous: peripheral neuropathy (nerve damage reducing sensation) and peripheral arterial disease (reduced blood flow impairing healing). A small blister or cut that a non-diabetic person would notice and treat can go undetected in a diabetic patient for days, become infected, and progress to osteomyelitis. Diabetic foot ulcers are the leading cause of non-traumatic lower limb amputations. A consistent foot care routine and regular podiatry visits prevent most amputations.

How often should diabetic patients see a podiatrist?

Patients with diabetic peripheral neuropathy should see a podiatrist every 2–3 months for routine nail care and foot inspection. Patients with active foot complications (ulcers, Charcot foot, severe PAD) need more frequent visits — often every 2–4 weeks until stable. Even well-controlled diabetics without neuropathy benefit from annual foot exams. Many amputations we see in consultation could have been prevented with earlier, consistent podiatric care.

What is diabetic peripheral neuropathy?

Peripheral neuropathy is nerve damage from chronically elevated blood sugar, causing numbness, tingling, burning, or loss of sensation — typically starting in the toes and progressing upward in a ‘stocking’ distribution. The dangerous aspect isn’t the pain — it’s the absence of pain. Patients with severe neuropathy don’t feel blisters, cuts, pressure sores, or early infections. A wound can reach bone before it’s noticed. Neuropathy screening with a 10-gram monofilament is part of every diabetic foot exam.

What are the warning signs of a diabetic foot problem?

Seek same-day evaluation for: any open wound or blister that isn’t healing within 1–2 weeks, redness, warmth, or swelling in any part of the foot (possible Charcot fracture or infection), a new blister or callus, any red streaking or warmth spreading up the leg (cellulitis), foot or ankle pain in a diabetic patient with neuropathy (could be Charcot without pain). Don’t wait to see if it improves — diabetic foot infections are medical emergencies.

What is the best foot cream for diabetic feet?

The goal of diabetic foot cream is restoring the skin’s moisture barrier to prevent fissuring and cracking — the entry points for infection. Look for urea-based creams (10–25% urea) or lactic acid formulations that actually penetrate thickened skin rather than sitting on the surface. AmLactin 12%, Eucerin Diabetics’ Dry Skin Relief, and Gold Bond Diabetics’ Dry Skin Relief are clinical-grade options. Avoid cream between the toes — moisture retention between toes promotes maceration and fungal infection.

Can diabetic patients get foot massages?

Light massage is generally safe for diabetic patients without active wounds, severe edema, or PAD. However, deep tissue massage or vigorous rubbing should be avoided — with neuropathy, patients can’t feel if tissue is being damaged. Foot massagers with rollers or intense vibration should be avoided entirely. If you enjoy foot massage, use gentle, light strokes with a diabetic-appropriate foot cream. Let your podiatrist know if you’re incorporating massage into your routine — we can advise based on your circulation status.

What type of socks should diabetic patients wear?

Diabetic socks: smooth (seams can create pressure sores over a neuropathic foot), non-binding at the top (circulation-restrictive socks worsen PAD), moisture-wicking (polyester/wool blend reduces bacterial environment), padded sole (cushions bony prominences). Avoid cotton socks for active patients — cotton retains moisture. Never wear socks with elastic bands that leave marks on the leg. Brands specifically designed for diabetic feet: Thorlos, Wigwam, and most major medical supply brands.

Should diabetic patients cut their own toenails?

It depends on neuropathy severity and vision. Patients with mild neuropathy and good vision can safely trim nails straight across without cutting the corners. Patients with moderate-to-severe neuropathy, poor vision, or thick nails should not self-trim — the risk of cutting the surrounding skin (which they may not feel) is too high. This is exactly what podiatry nail care visits are for. Medicare and most insurance plans cover routine foot care for diabetic patients with documented neuropathy.

What is Charcot foot and how serious is it?

Charcot neuroarthropathy is a serious diabetic complication where neuropathy allows repeated micro-fractures to occur without pain, leading to progressive bone and joint destruction and foot deformity. The classic presentation: a warm, swollen, red foot in a diabetic patient — often mistaken for cellulitis. Early Charcot (caught within weeks of onset) can be managed with a total contact cast to prevent further collapse. Late Charcot with significant arch destruction often requires reconstructive surgery. Missing the diagnosis is catastrophic — a single patient with missed Charcot can progress to a rocker-bottom deformity requiring amputation.

Does insurance cover diabetic foot care?

Medicare Part B covers routine foot care (nail trimming, callus debridement) for diabetic patients with documented peripheral neuropathy — one visit every 2 months. Most PPO and HMO plans follow similar coverage rules. Diabetic shoes and insoles are covered under Medicare’s Therapeutic Shoe Bill (one pair of shoes plus three pairs of custom insoles per year). Call us at (810) 206-1402 and we’ll verify your specific coverage before your first appointment.

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Dr. Tom Biernacki, DPM

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.