The Center for Podiatric Care and Sports Medicine

The Burning, Shooting Pain of Peripheral Neuropathy: How to Prevent Its Progression?

Posted by on Monday, November 25th, 2013


Are you awakened by burning feet in the night? Do you feel numbness, tingling, and shooting pains? Since it’s Diabetes Awareness Month, we’d like to take this opportunity to discuss this common diabetic foot issue. Peripheral neuropathy is debilitating nerve damage caused by chronically elevated glucose levels, alcoholism, autoimmune disorders, exposure to chemicals, infectious diseases, or certain medications. People with this condition say it greatly disrupts their everyday activities.

The tingling, burning pain of peripheral neuropathy can make it difficult to complete routine, day-to-day tasks. (Image Credit: Flickr CC user Greg Pye)

The Pain of Peripheral Neuropathy

Early symptoms of peripheral neuropathy include: sharp, burning, shooting pains and a feeling as though the feet are either freezing cold or burning hot. These sensations sometimes travel up the leg or result in total numbness.

Here is a short video about peripheral neuropathy from the American Diabetes Association:

Diagnosing Peripheral Neuropathy

As with most foot issues, the earlier you treat peripheral neuropathy, the better the outcome. Visiting a podiatrist is a relatively stress-free experience. We’ll give you a full physical exam to evaluate your reflexes, muscle strength, ability to feel different sensations, and coordination. In some cases, a minimally-invasive lower leg or foot skin biopsy is done to evaluate the nerve fiber density. Nerve conduction studies can show us which nerves are affected and damaged. We may also run blood tests to measure vitamin and sugar levels.

Treating Early Peripheral Neuropathy

Dietary interventions and maintaining stable blood sugar levels are the best way to prevent the disease from progressing further. The American Association of Clinical Endocrinologists recommends that diabetics keep blood sugars below 140 mg/dl (7.8 mmol/L) within two hours of a meal. Neuropathy supplements like Alpha Lipoic Acid, Magnesium, B12, fish oil and high-dose antioxidants have all shown promise in diminishing symptoms of neuropathy, although more research is needed.

Here at Dr. Geldwert’s office, we offer patients some of the latest technologies used to treat peripheral neuropathy, such as Transcutaneous Electrical Nerve Stimulation. More studies are needed before TENS is promoted on a larger scale, but we have found many patients with severe neuropathy pain respond well to the painless, low-dose electrical currents. Dozens of recent studies are also looking into the usefulness of pulsed infrared light therapy in the treatment of neuropathy.

Medications Used In The Treatment Of Peripheral Neuropathy

Of course, there are always medications designed to ease the symptoms of peripheral neuropathy. Generally, we like to explore other treatment options first, since neuropathy medications can have troublesome side effects.

Drug options may include:

– Anti-seizure medications – which come with side effects of drowsiness and dizziness

– Immunosuppressive medications – which may cause high blood pressure, hives, and water retention

Capsaicin – which may cause burning, itching, redness, and irritation

Lidocaine patch – which may cause tremors, drowsiness, or uneven heartbeats

– Antidepressants – which may come with side effects of thirst, nausea, drowsiness and constipation

 It’s best to speak with a qualified podiatrist to explore your options based on your medical history.



If you have any foot problems or pain, contact The Center for Podiatric Care and Sports MedicineDr. Josef J. GeldwertDr. Katherine Lai, Dr. Ryan Minara and Dr. Mariola Rivera have helped thousands of people get back on their feet. Unfortunately, we cannot give diagnoses or treatment advice online. Please make an appointment to see us if you live in the NY metropolitan area or seek out a podiatrist in your area.