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Signs of Diabetic Peripheral Neuropathy

Diabetic peripheral neuropathy is a condition caused by prolonged high blood sugar levels that damage the nerves, especially those in the feet, toes, and ankles. Many people first notice numbness, tingling, or burning sensations, which can become more intense at night. Some patients may feel sudden, sharp pains or an electric shock-like sensation in their feet. As diabetic peripheral neuropathy progresses, loss of balance and coordination may also occur due to weakened ankle muscles and decreased sensation. This can lead to an unstable gait that increases the risk of falls. Changes in foot structure, such as hammertoes, may develop as nerve damage affects muscle function. One significant concern is the inability to feel cuts, blisters, or pressure points, which can result in unnoticed wounds that may become infected. A podiatrist can evaluate nerve function, provide foot care strategies, and recommend treatment to help prevent complications like foot ulcers and deformities. If your feet and toes feel numb, it is suggested that you schedule an appointment with a podiatrist to find out if peripheral neuropathy is causing the problem.
Neuropathy
Neuropathy can be a potentially serious condition, especially if it is left undiagnosed. If you have any concerns that you may be experiencing nerve loss in your feet, consult with Dr. Gary Cesar from Michigan Foot and Ankle Center. Our doctor will assess your condition and provide you with quality foot and ankle treatment for neuropathy.
What Is Neuropathy?
Neuropathy is a condition that leads to damage to the nerves in the body. Peripheral neuropathy, or neuropathy that affects your peripheral nervous system, usually occurs in the feet. Neuropathy can be triggered by a number of different causes. Such causes include diabetes, infections, cancers, disorders, and toxic substances.
Symptoms of Neuropathy Include:
- Numbness
- Sensation loss
- Prickling and tingling sensations
- Throbbing, freezing, burning pains
- Muscle weakness
Those with diabetes are at serious risk due to being unable to feel an ulcer on their feet. Diabetics usually also suffer from poor blood circulation. This can lead to the wound not healing, infections occurring, and the limb may have to be amputated.
Treatment
To treat neuropathy in the foot, podiatrists will first diagnose the cause of the neuropathy. Figuring out the underlying cause of the neuropathy will allow the podiatrist to prescribe the best treatment, whether it be caused by diabetes, toxic substance exposure, infection, etc. If the nerve has not died, then it’s possible that sensation may be able to return to the foot.
Pain medication may be issued for pain. Electrical nerve stimulation can be used to stimulate nerves. If the neuropathy is caused from pressure on the nerves, then surgery may be necessary.
If you have any questions, please feel free to contact our offices located in Lansing and Mt. Pleasant, MI . We offer the newest diagnostic and treatment technologies for all your foot care needs.
Neuropathy
Neuropathy is a condition in which the nerves in the body become damaged from a number of different illnesses. Nerves from any part of the body, including the foot, can be damaged. There are several forms of neuropathy including peripheral neuropathy, cranial neuropathy, focal neuropathy, and autonomic neuropathy. Furthermore there is also mononeuropathy and polyneuropathy. Mononeuropathies affect one nerve while polyneuropathies affect several nerves. Causes of neuropathy include physical injury, diseases, cancers, infections, diabetes, toxic substances, and disorders. It is peripheral neuropathy that affects the feet.
The symptoms of neuropathy vary greatly and can be minor such as numbness, sensation loss, prickling, and tingling sensations. More painful symptoms include throbbing, burning, freezing, and sharp pains. The most severe symptoms can be muscle weakness/paralysis, problems with coordination, and falling.
Podiatrists rely upon a full medical history and a neurological examination to diagnose peripheral neuropathy in the foot. More tests that may be used include nerve function tests to test nerve damage, blood tests to detect diabetes or vitamin deficiencies. Imaging tests, such as CT or MRI scans, might be used to look for abnormalities, and finally nerve or skin biopsies could also be taken.
Treatment depends upon the causes of neuropathy. If the neuropathy was caused by vitamin deficiency, diabetes, infection, or toxic substances, addressing those conditions can lead to the nerve healing and sensation returning to the area. However if the nerve has died, then sensation may never come back to the area. Pain medication may be prescribed for less serious symptoms. Topical creams may also be tried to bring back sensation. Electrical nerve stimulation may be used for a period of time to stimulate nerves. Physical therapy can strengthen muscle and improve movement. Finally surgery might be necessary if pressure on the nerve is causing the neuropathy.
If you are experiencing sensation loss, numbness, tingling, or burning sensations in your feet, you may be experiencing neuropathy. Be sure to talk to a podiatrist to be diagnosed right away.
What to Know About a Broken Toe
Trauma to the foot, especially the toes, can occur in many ways. Banging them, stubbing them, or dropping something on them are a few different ways this trauma can occur. Given the fact that toes are positioned in front of the feet, they typically sustain the brunt of such trauma. When trauma occurs to a toe, the result can be a painful break or fracture. Another type of trauma that can break a toe is repeated activity that places stress on the toe for prolonged periods of time.
Broken toes can be categorized as either minor or severe fractures. Symptoms of minor toe fractures include throbbing pain, swelling, bruising on the skin and toenail, and the inability to move the toe with ease. Severe toe fractures require medical attention and are indicated when the broken toe appears crooked or disfigured, when there is tingling or numbness in the toe, or when there is an open, bleeding wound present on the toe.
Generally, a minor toe break will heal without long-term complications. However, it is important to discontinue activities that put pressure on the toe. It is best to stay off of the injured toe and immediately get a splint or cast to prevent any more additional movement of the toe bones. You can also immobilize your toe by placing a small cotton ball between the injured toe and the toe beside it. Then, tape the two toes together with medical tape. Swelling can be alleviated by placing an ice pack on the broken toe directly as well as elevating your feet above your head.
Severe toe fractures may be treated with a splint, cast, and in some cases, minor surgery, especially when the big toe has been broken. Due to its position and the pressure the big toe endures with daily activity, future complications can occur if it is not properly treated. Pain associated with minor toe fractures can be managed with over-the-counter pain medications. Prescription pain killers may be necessary for severe toe fractures.
The healing time for a broken toe is approximately four to six weeks. In severe cases where the toe becomes infected or requires surgery, healing time can take up to eight weeks or more. While complications associated with a broken toe are immediately apparent, it is important to note that there are rare cases when additional complications, such as osteoarthritis, can develop over time. You should immediately speak with your podiatrist if you think you have broken your toe due to trauma. They will be able to diagnose the injury and recommend the appropriate treatment options.
How to Stretch Your Feet
Your feet endure a great amount of stress each day from constantly allowing us to move around. It is important to stretch your feet to help prevent them from becoming injured. Your toes may easily deform into unhealthful positions if they are not stretched.
One of the most common reasons for toe deformities are the shoes you may be wearing. Shoes that are too tight may fold and shift the toes out of place. Heeled shoes may also push your toes upward. Forcing your toes into an unnatural position which may cause the muscles to tighten and prevent them from reverting to normal length. Another common reason is improper use of foot muscles. Many people fail to use the muscles in their feet or toes when they walk. Lastly, the positioning of your feet while walking may also cause toe deformities. If you walk with your feet facing outward, your “push-off” phase is on the side of your big toe instead of the bottom of your foot. This may cause the big toe to eventually tighten into a new shifted position.
There are many reasons why stretching your toes may be helpful. One reason is that healthy spacing may aid in avoiding calluses and other injuries that are caused by rubbing. Stretching will also prevent you from developing toes that curl, hammertoes, or bunions.
A great way to stretch your toes is to place them in your hands and bend them all downward; this will help you stretch the top of your foot. Next, you should repeat this process but instead bend them upward enough to feel a nice stretch in the bottom of your foot. You should then try to pull each toe apart from the next and pull any toes that are bent upward until they are back downward.
If you are looking to practice stretching your entire foot, you can try a towel stretch. This is done by sitting on the floor with your legs in front of you. Take a towel and wrap it around your toes. Afterward, pull the towel toward you with your toes and hold this position for 15 to 30 seconds before releasing. Practice this stretch for three sets. Another stretch your feet are towel lifts. This is done by sitting in a chair and trying to pick a towel up from the ground with your toes. Try lifting the towel with your little toes for five sets before switching feet.
If you are an athlete, or exercise often, it is especially important for you to practice stretching your feet. Those who suffer from foot pain caused by poor footwear, plantar fasciitis, or long hours of standing at work may also benefit from foot exercises.
Arthritis Can Cause Pain in the Feet and Ankles
Types of Gait Abnormalities

Gait abnormalities can place excessive strain on the feet, toes, and ankles, leading to pain and an increased risk of injury. Common gait abnormalities include propulsive gait, where a person leans forward while walking and spastic gait, which involves stiff, dragging movements. Steppage gait occurs when the foot drops, requiring exaggerated lifting of the leg. Waddling gait causes instability resulting from hip weakness, while ataxic gait results in unsteady, wide-based steps. Magnetic gait creates a sensation of the feet sticking to the ground, and antalgic gait shortens steps due to pain. These walking patterns may result from arthritis, nerve conditions, foot deformities, or injuries. A podiatrist can perform a gait analysis, which evaluates foot alignment, pressure distribution, and movement mechanics. This assessment helps identify the underlying cause of abnormal walking patterns and determines the best approach for relief. Treatment may include orthotic devices, footwear modifications, or even surgery. If you are experiencing foot pain while or after walking, it is suggested that you schedule an appointment with a podiatrist for a diagnosis and treatment options.
If you have any concerns about your feet, contact Dr. Gary Cesar from Michigan Foot and Ankle Center. Our doctor can provide the care you need to keep you pain-free and on your feet.
Biomechanics in Podiatry
Podiatric biomechanics is a particular sector of specialty podiatry with licensed practitioners who are trained to diagnose and treat conditions affecting the foot, ankle and lower leg. Biomechanics deals with the forces that act against the body, causing an interference with the biological structures. It focuses on the movement of the ankle, the foot and the forces that interact with them.
A History of Biomechanics
- Biomechanics dates back to the BC era in Egypt where evidence of professional foot care has been recorded.
- In 1974, biomechanics gained a higher profile from the studies of Merton Root, who claimed that by changing or controlling the forces between the ankle and the foot, corrections or conditions could be implemented to gain strength and coordination in the area.
Modern technological improvements are based on past theories and therapeutic processes that provide a better understanding of podiatric concepts for biomechanics. Computers can provide accurate information about the forces and patterns of the feet and lower legs.
Understanding biomechanics of the feet can help improve and eliminate pain, stopping further stress to the foot.
If you have any questions please feel free to contact our offices located in Lansing and Mt. Pleasant, MI . We offer the newest diagnostic and treatment technologies for all your foot and ankle needs.
Biomechanics in Podiatry
Podiatry is a branch of medicine that deals with the study, diagnosis, and treatment of foot and ankle conditions. There are various subdivisions in podiatry; biomechanics is one of them. Biomechanics is the way in which the bones, muscles, and joints of the feet and lower limb interact with each other.
Our feet play crucial roles in the way we move, and it is rare to have feet that are completely symmetrical. Common biomechanical issues include high or low arches or uneven leg heights. Excessive pronation often leads to fallen arches, or flat feet, and is a common cause of running injuries. People whose feet are over-pronated tend to have flexible and unstable feet. Pain is usually experienced during walking and running.
At times, people may be able to adapt to these abnormalities without any difficulties, but in other cases, these issues can cause a great deal of pain. This pain occurs because the joints, muscles, ligaments, and tendons are put under an excess amount of stress during movement. Common symptoms of biomechanical problems stemming from the feet include hip pain, knee pain, leg cramps, ankle pain, lower back pain, weak ankles, tripping, heel pain, Achilles pain, and shin splints.
Many biomechanical issues can be treated with orthotics. Orthotics are shoe insoles that are used to help control the way the foot operates. They can provide relief from foot pain, heel pain, and knee pain. Depending on your specific case, you may need to purchase over-the-counter orthotics or custom orthotics to fit your feet. Your podiatrist will be able to prescribe the perfect orthotic for your feet to help you walk around with ease.
Gait is defined as the way we move our bodies from one point to another. This is usually done by either walking or running. Gait analysis is a method used to assess the way we walk or run to highlight biomechanical abnormalities. Gait analyses are a great way to take a detailed look at how you walk and how your foot moves while you walk. An examination of the feet will help your podiatrist understand why you are suffering pain in other parts of your body.
Frequency of Achilles Tendon Injuries in Athletes

Achilles tendon injuries are among the most common seen in athletes, particularly those involved in running, jumping, or sports requiring explosive movements. The Achilles tendon, which connects the calf muscles to the heel bone, is essential for mobility, providing the necessary strength and flexibility for activities like sprinting, jumping, and walking. Athletes who participate in high-intensity sports such as basketball, soccer, and track are at a higher risk of experiencing Achilles tendon injuries, often due to repetitive strain or sudden, forceful movements. These injuries can range from tendinitis, which causes inflammation and pain, to complete tendon tears, which may require surgery for recovery. Overuse, inadequate warm-up routines, poor footwear, and muscle imbalances are common contributing factors. If you are athletic and have sustained an Achille tendon injury, it is suggested that you consult a podiatrist who can offer effective treatment solutions, enabling you to return to your desired sport as quickly as possible.
Achilles tendon injuries need immediate attention to avoid future complications. If you have any concerns, contact Dr. Gary Cesar of Michigan Foot and Ankle Center. Our doctor can provide the care you need to keep you pain-free and on your feet.
What Is the Achilles Tendon?
The Achilles tendon is a tendon that connects the lower leg muscles and calf to the heel of the foot. It is the strongest tendon in the human body and is essential for making movement possible. Because this tendon is such an integral part of the body, any injuries to it can create immense difficulties and should immediately be presented to a doctor.
What Are the Symptoms of an Achilles Tendon Injury?
There are various types of injuries that can affect the Achilles tendon. The two most common injuries are Achilles tendinitis and ruptures of the tendon.
Achilles Tendinitis Symptoms
- Inflammation
- Dull to severe pain
- Increased blood flow to the tendon
- Thickening of the tendon
Rupture Symptoms
- Extreme pain and swelling in the foot
- Total immobility
Treatment and Prevention
Achilles tendon injuries are diagnosed by a thorough physical evaluation, which can include an MRI. Treatment involves rest, physical therapy, and in some cases, surgery. However, various preventative measures can be taken to avoid these injuries, such as:
- Thorough stretching of the tendon before and after exercise
- Strengthening exercises like calf raises, squats, leg curls, leg extensions, leg raises, lunges, and leg presses
If you have any questions please feel free to contact our offices located in Lansing and Mt. Pleasant, MI . We offer the newest diagnostic tools and technology to treat your foot and ankle needs.
Achilles Tendon Injuries
The Achilles tendon is the largest tendon in the body; it is a tough band of fibrous tissue that stretches from the bones of the heel to the calf muscles. This tendon is what allows us to stand on our toes while running, walking, or jumping, it is common for this tendon to become injured. In severe cases, the Achilles tendon may become partially torn or completely ruptured. However, this tendon is susceptible to injury because of its limited blood supply and the high level of tension it endures.
The people who are more likely to suffer from Achilles tendon injuries are athletes who partake in activities that require them to speed up, slow down, or pivot. Consequently, athletes who engage in running, gymnastics, dance, football, baseball, basketball, or tennis are more likely to suffer from Achilles tendon injuries. Additionally, there are other factors that may make you more prone to this injury. People who wear high heels, have flat feet, tight leg muscles or tendons, or take medicines called glucocorticoids are more likely to have Achilles tendon injuries.
A common symptom of an Achilles tendon injury is pain above the heel that is felt when you stand on your toes. However, if the tendon is ruptured, the pain will be severe, and the area may become swollen and stiff. Other symptoms may be reduced strength in the lower ankle or leg area, and reduced range of motion in the ankle. When the Achilles tendon tears, there is usually a popping sound that occurs along with it. People who have acute tears or ruptures may find walking and standing to be difficult.
If you suspect you have injured your Achilles tendon, you should see your podiatrist to have a physical examination. Your podiatrist will likely conduct a series of tests to diagnose your injury including a “calf-squeeze” test. Calf squeeze tests are performed by first squeezing the calf muscle on the healthy leg. This will pull on the tendon and consequently cause the foot to move. Afterward, the same test will be performed on the injured leg. If the tendon is torn, the foot won’t move because the calf muscle won’t be connected to the foot.
Gout Symptoms and the Importance of Early Treatment

Gout is a form of arthritis that causes sudden and severe pain in the joints, frequently the big toe. The symptoms typically include redness, swelling, and intense pain that may last for hours or days. If left untreated, gout can lead to recurring flare-ups and long-term joint damage. Early treatment is vital in managing gout and preventing complications, such as joint deformities or kidney stones. Addressing the condition early with medication and lifestyle changes can reduce inflammation and pain, and help maintain joint function. Several risk factors contribute to the development of gout, including obesity, a diet high in purine-rich foods like red meat and seafood, excessive alcohol consumption, and family history. Additionally, conditions such as high blood pressure and diabetes can increase the likelihood of developing gout. If you have symptoms of gout, it is suggested that you are under the care of a podiatrist who can properly diagnose and help you to manage this painful condition.
Gout is a painful condition that can be treated. If you are seeking treatment, contact Dr. Gary Cesar from Michigan Foot and Ankle Center. Our doctor will treat your foot and ankle needs.
What Is Gout?
Gout is a form of arthritis that is characterized by sudden, severe attacks of pain, redness, and tenderness in the joints. The condition usually affects the joint at the base of the big toe. A gout attack can occur at any random time, such as the middle of the night while you are asleep.
Symptoms
- Intense Joint Pain - Usually around the large joint of your big toe, and it most severe within the first four to twelve hours
- Lingering Discomfort - Joint discomfort may last from a few days to a few weeks
- Inflammation and Redness -Affected joints may become swollen, tender, warm and red
- Limited Range of Motion - May experience a decrease in joint mobility
Risk Factors
- Genetics - If family members have gout, you’re more likely to have it
- Medications - Diuretic medications can raise uric acid levels
- Gender/Age - Gout is more common in men until the age of 60. It is believed that estrogen protects women until that point
- Diet - Eating red meat and shellfish increases your risk
- Alcohol - Having more than two alcoholic drinks per day increases your risk
- Obesity - Obese people are at a higher risk for gout
Prior to visiting your podiatrist to receive treatment for gout, there are a few things you should do beforehand. If you have gout you should write down your symptoms--including when they started and how often you experience them, important medical information you may have, and any questions you may have. Writing down these three things will help your podiatrist in assessing your specific situation so that he or she may provide the best route of treatment for you.
If you have any questions, please feel free to contact our offices located in Lansing and Mt. Pleasant, MI . We offer the newest diagnostic and treatment technologies for all your foot care needs.