Neuropathy and Peripheral Artery Disease (PAD) are two common conditions often associated with diabetes. They both affect the feet and legs, causing pain and discomfort. While both conditions may share some similarities in symptoms, they are distinct disorders with different underlying causes and require separate diagnostic approaches and treatment strategies. A Southlake podiatrist can explain the differences between neuropathy and PAD to ensure proper diagnosis and can recommend the most appropriate treatment options for your individual needs. 

Patients with diabetes often suffer with two common complications: neuropathy and PAD. Neuropathy is nerve damage, usually in the feet and hands, and PAD restricts blood flow to the limbs. These two conditions are similar in some ways, but their underlying causes are different.

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Causes of Neuropathy and PAD

  • Southlake podiatrist discusses neuropathy and PAD differencesNeuropathy. Neuropathy, also known as diabetic peripheral neuropathy, occurs due to damage or dysfunction of the peripheral nerves that transmit signals between the central nervous system and the body. Common causes include prolonged elevated blood sugars due to diabetes, infections, autoimmune disorders, and hereditary factors.
  • Peripheral Artery Disease. PAD results from a narrowing or blockage of the arteries that supply blood to the lower extremities. The most common cause of PAD is atherosclerosis, the buildup of plaque in the arterial walls. PAD is often associated with risk factors such as diabetes, smoking, high blood pressure, or high cholesterol. Being overweight or of an advanced age can also increase your risk for the condition.

Symptoms of Neuropathy and Peripheral Artery Disease

  • Neuropathy. The symptoms of neuropathy are primarily sensory, affecting the nerves' ability to transmit signals. Symptoms often include numbness, tingling, burning pain, or a loss of sensation in the feet and legs. The discomfort typically begins in the toes and progresses upward. Neuropathic pain and discomfort are often present even at rest. Symptoms may persist regardless of physical activity or exercise.
  • Peripheral Artery Disease. PAD symptoms are related to inadequate blood flow and oxygen supply to the affected area and may include leg pain, cramping, fatigue, and slow-healing wounds or ulcers. Unlike neuropathy, the discomfort experienced with PAD is often triggered by physical activity or exercise and tends to improve with rest. This is known as intermittent claudication, a hallmark symptom of PAD.

Another primary difference between neuropathy and PAD is how each condition begins and progresses. The onset of neuropathy is often gradual, and symptoms may progress slowly over time. Nerve damage can occur over a long period, leading to worsening symptoms if left untreated. PAD symptoms can develop gradually or suddenly, depending on the extent of arterial blockage. The condition may progress more rapidly if the underlying atherosclerosis worsens.

Diagnosing Neuropathy and PAD

Given the complexities involved in diagnosing neuropathy and PAD, seeking medical attention from a qualified Southlake podiatrist is crucial. Early detection and intervention can significantly improve outcomes for both neuropathy and PAD. Regular visits to a podiatrist, especially for those with risk factors such as diabetes, high blood pressure, or a history of smoking, are crucial for identifying and managing these conditions promptly. A podiatrist will carefully monitor the progression of symptoms, provide appropriate treatments, and refer patients to other specialists if necessary.

It is possible to have both neuropathy and PAD at the same time. When this happens, it can result in more severe symptoms and complications. The reduced sensation caused by neuropathy can mask the pain associated with PAD, leading to delayed diagnosis and increased risk of complications. Additionally, impaired blood flow due to PAD can worsen nerve damage in individuals with neuropathy, further compromising the health of the affected limbs.

To diagnose neuropathy, a podiatrist will perform an examination, and your symptoms will be evaluated. In addition, the doctor will review your medical history and conduct a neurological assessment. They may order specialized tests such as nerve conduction studies to assess nerve function.

To diagnose PAD, a podiatrist will perform a physical examination, and your pulse will be checked. The doctor will assess your skin color and temperature and conduct non-invasive tests such as Doppler ultrasound or ankle-brachial index (ABI) measurements to evaluate blood flow.

Once the diagnosis is established, a Southlake podiatrist can recommend appropriate treatment options for either condition.

Treatment Options for Neuropathy

Regular monitoring and collaboration between health care providers, such as neurologists, vascular specialists, and your diabetic foot care podiatrist, are crucial to optimize treatment and minimize the risk of complications from both neuropathy and PAD.

There is no cure for neuropathy. Treatment for neuropathy focuses on managing the condition, providing pain relief, and slowing the progression of the condition to prevent further nerve damage. Depending on the specific cause and severity of neuropathy, treatment options may include:

  • Medications to reduce pain and manage associated conditions, such as diabetes
  • Physical therapy to improve muscle strength and coordination
  • Transcutaneous electrical nerve stimulation (TENS) to provide pain relief
  • Lifestyle modifications, such as a healthy diet and regular exercise

In some cases, treating the underlying cause, such as addressing nutritional deficiencies or managing autoimmune diseases, can help improve neuropathy symptoms.

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Treatment Options for Peripheral Artery Disease

  • Making simple lifestyle changes, such as quitting smoking, eating a healthy and nutritious diet, and exercising regularly, can help in managing the condition.
  • Medications can be taken to manage underlying risk factors.
  • For those suffering from claudication, a wearable neurostimulator can be used to interrupt the pain signals that cause cramping in your legs.
  • Surgical interventions, such as angioplasty, stenting, or bypass surgery, can be performed to restore proper blood flow.

Without Treatment: Possible Complications of Neuropathy and PAD

Untreated neuropathy and PAD may lead to various complications that can significantly affect an individual's health and well-being. Some potential complications of untreated neuropathy and PAD include:

Seeking treatment at the first sign of a problem is key to preventing severe complications from developing. In addition, it is essential to check your feet daily for any signs of an abnormality or injury. You should also make sure that the shoes you wear fit correctly and avoid walking barefoot.

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