Feeling Any Changes in Your Feet?

Ladies and Gentlemen,  I started this New Year encouraging you to get your COVID-19 vaccination.  I hope that you were successful in getting vaccinated;  if not, hopefully you are scheduled for your vaccination appointment in the near future.  Getting that shot in your arm is protective of your health.  Today, I want to  talk with you about your feet, in particular, changes in sensation – tingling, numbness or pain – symptoms associated with peripheral neuropathy (PN).

PN is common in older persons, resulting from damage to the nerves outside of the brain and spinal cord.   The aging process alone can cause damage to our nerves.  But, diabetes as one of the most common causes of PN,  along with smoking and alcohol abuse.  Diabetic PN is the most common form of neuropathy worldwide, and the most common type of distal symmetric neuropathy,  accounting for 75% of all diabetic neuropathies.  (Hicks & Selvin, 2019).

About three-fourths of these neuropathies are distal neuropathies,  which means the nerves farthest from your core body – yes, that means those in your feet, where worse symptoms develop first, then generally next in your hands.  This neuropathy is also usually symmetrical, occurring in both feet, and will ascend from your feet up your legs, in your fingers, up into your hands.  This pathology pattern is referred to as stocking-glove pattern, as you can see in this picture.

However, there are multiple other causes of PN, including but not limited to:  traumatic injury,  autoimmune diseases, vitamin deficiencies, infections, medications,  chemotherapy, metabolic problems and exposure to toxins.

As you learn about the many causes of PN, I hope this helps you to realize how common PN is among older adults, but how important  it is for you to let your provider know that you are experiencing any sensory problems in your feet.  The first symptoms experienced reported  with PN are numbness, tingling or pain in your feet.  Loss of sensation, tingly,  even pain  often begins occurring  during the night.

These changes in sensation,  especially numbness, can change how you walk and also your balance.  So, again, it is very important for your to tell your provider, your Harmony Team, about any tingling that you have in your feet, any numbness that you are experiencing.

Only you can provide this important history about what you are experiencing.   After you let your provider know, your provider will follow-up with a physical exam, for example, checking to evaluate feeling in your feet, the amount of strength of your muscles.


Ladies and Gentlemen, PN can be treated and often resolved.  If untreated, though, it can progress from sensory problems to muscle involvement – weakness,   twitching and cramps,  further impairing your ability to walk and maintain your balance,  increasing your fall risks.

Muscle strength is known to decrease with aging, which results in problems with postural sway and  balance (Bok, Lee, & Lee, 2013),  made worse with the addition of PN.  You will recall that about 30% of older adults 65 and older fall at least once per year (Strait & Medcaff, 2012).

Your Harmony Team is committed to reducing your fall risks, to help you prevent falls, with our goals to promote your function and independence.

I hope this message is helpful to you and provides you with encouragement  to talk to your Harmony Team about any sensory changes you are experiencing in your feet.  Open communication with your healthcare team about any changes you are experiencing in  function, your health status, is an essential practice that also reduces your fall risks.

As always, stay safe, strong, active, and connected with your healthcare team.

Your Harmony Team is here to help you!

Thank you for reading this message.

Pat Quigley



Bok, S., Lee, T.H., & Lee, S.S. (2013).  The effects of changes in ankle strength and range of motion according to aging on balance.  Ann Rehabil Med, 37(1).  10-16

Hicks, C.W., & Selvin, E. (2019, Aug. 27).  Epidemiology of peripheral neuropathy and lower extremity disease in Diabetes.   Curr Diab Rep. 19(10).  86  Available:  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3604218/

Strait, S., & Medcaff, P.  (2012, Nov.).  Peripheral neuropathy in older people.  GM Journalhere


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