Allergy, immunity & body
Foot numbness & neuropathy warning signs
If you couldn't feel a pebble in your shoe, how would you know it was there?
Diabetes is the leading cause of nerve damage in the feet. When feeling fades, small injuries go unnoticed, so a daily look, careful foot care and a yearly exam are what protect you.
In 30 seconds
The short answer
Diabetic neuropathy is nerve damage caused by diabetes: over time, high blood glucose and blood fats can damage your nerves.1 The most common kind affects the feet and legs.2 When you lose feeling in your feet, you may not feel a pebble in your sock or a blister, and these can turn into cuts and sores that become infected.16 That is why the daily check matters so much.
- Numbness is the risk, not just the pain. You may have foot problems but feel no pain in your feet.18
- Look every day. Check your feet each evening when you take off your shoes, including between your toes.18
- Never heat a numb foot. With nerve damage you may burn your feet and not know it.26
- Managing diabetes is the foundation. Staying close to your goal numbers can keep nerve damage from getting worse.12
What is happening in the feet
How a small injury becomes a serious one
Why reduced feeling changes everything, following the NIDDK description.
Feeling fades
High blood glucose and fats damage nerves, and feeling in the feet is lost.116
An injury goes unnoticed
A pebble in a sock or a blister goes unfelt and becomes a cut or sore.16
Healing is slow
Lower blood flow makes it hard for a sore or infection to heal.17
Serious infection
Sores and infections can lead to the loss of a toe, foot or part of the leg.6
Where the daily check breaks the chain
An illustration based on the NIDDK descriptions. Bars show direction, not measured values.
Normal feeling
Pain warns you about a pebble, a blister or hot water.
Feeling reduced
Burning, tingling or numbness, often in both feet and worse at night.3
An unfelt sore
A blister or injury you do not notice can become infected.5
Found early
A daily look spots problems early, before they get worse.18
What the research says
- Diabetes is the leading cause of peripheral neuropathy in the U.S.,30 and about one-third to one-half of people with diabetes have it.2
- Most neuropathies start in the feet, the nerve endings farthest from the brain.30
- Symptoms include burning, tingling like pins and needles, numbness, pain and weakness, often worse at night.3 You may also have trouble sensing pain or temperature.4
- Neuropathy can affect balance and make falls, and fractures, more likely.7
- Diabetes can make foot wounds hard to heal and raise the chance of infection.5 Serious foot problems can develop quickly.35
- The outlook depends on the cause: some cases improve if the cause is treated, while in some people the damage may be permanent or get worse.36 The sooner it is diagnosed, the better the chance of limiting damage.37
Daily foot care
| Habit | How | Why it matters |
|---|---|---|
| Look at your feet | Each evening, including between the toes. Use a mirror or ask someone.1819 | You may have foot problems but feel no pain.18 |
| Wash in warm, not hot, water | Test with a thermometer (90° to 95°F is safe) or your elbow. Do not soak.21 | Numb feet can burn without you knowing.26 |
| Keep skin soft, toes dry | Lotion on tops and bottoms; powder, not lotion, between the toes.22 | Moisture between the toes might cause an infection.22 |
| Leave corns to a professional | Do not cut them or use corn plasters or liquid removers.23 | These can damage the skin and cause an infection.23 |
| Trim nails straight across | Not into the corners. A foot doctor can do it if you cannot see, feel or reach your feet.24 | Helps prevent cuts and ingrown nails.24 |
| Shoes and socks, always | No bare feet, even indoors. Check inside shoes first.25 | You could step on something and not feel it.25 |
At least once a year, get a thorough foot exam, including a check of the feeling and pulses in your feet.28
Call your health care provider right away if you have
What changes the outlook
Not everything offered for neuropathy does the same job. Some steps protect your nerves and feet; others only ease symptoms.
What changes the outlook, and what does not
Protects nerves and feet
Eases symptoms only
- Staying close to your goal numbers can keep nerve damage from getting worse.12
- Pain medicines help the pain, not the damage. If one does not help, another may be tried.13
- Other causes matter too: low vitamin B12, alcohol and some medicines can cause neuropathy.31
- Smoking lowers blood flow to your feet.27
The clinic's approach
Numb feet and foot wounds are related but different problems. Neuropathy is nerve damage: you stop feeling injuries.15 Ulcers and gangrene are wounds and tissue death, made worse by poor blood flow and infection.176 The clinic whose documents inform this site, the Pakistan Institute of Medical Advancement in Karachi, focuses on the second: avoiding amputation.
The clinic's approach to diabetic foot wounds, and what the evidence shows
Each card gives the clinic's own words first, then independent evidence.
Saving legs from amputation in diabetic gangrene with EDTA, lumbrokinase, chlorine dioxide, calcium hypochlorite and DMSO
Proposed instead of standard careEvidence points the other way- Where the clinic says this
- Brochure set, page 6, "Diabetic Gangrene Saving Amputation".41
- The clinic's stated rationale
- The page argues that seven decades of conventional treatment have been "unsuccessful".42 The Urdu brochure reports "hundreds of legs" saved but gives no records.44
- Evidence and limitations
- Gangrene and ulcers that do not get better with treatment can lead to amputation, which surgeons may perform to stop a dangerous infection spreading.51 Standard ulcer care removes dead tissue, takes pressure off the wound, and can take weeks to months.454647 For the products listed: drinking chlorine dioxide is, in the FDA's words, the same as drinking bleach,49 and the FDA warns that unproven chelation can delay proven care and cause kidney failure.50 ProperHealth found no NIH or FDA evaluation of lumbrokinase for gangrene.
- What this means for you
- A foot wound with diabetes needs a clinician or podiatrist promptly, and right away if it is not healing after a few days or looks infected. Wanting to avoid amputation is reasonable: ask about every option, but do not let an unproven regimen delay wound care.
Ozone therapy to clear germs in foot ulcers and gangrene "on which no antibiotic works"
Proposed instead of standard careRegulator safety warning- Where the clinic says this
- Urdu trifold brochure, side 2 (ProperHealth translation).43
- The clinic's stated rationale
- Ozone is described as the "best antibacterial" and as reactivating "dead cells", so that wounds heal quickly.43
- Evidence and limitations
- U.S. federal regulation describes ozone as a toxic gas with no known useful medical application.48 Diabetes lowers blood flow to the feet, which is one reason infected ulcers heal slowly.17 Dead tissue is removed by a clinician, not reactivated.45
- What this means for you
- Signs of infection in a foot (spreading redness, warmth, swelling, pus, fever) need care the same day.
From the Dr. Majid Ali archive
A historical perspective
“The common symptoms (usually first appearing in feet, legs, and hands) include burning, tingling, numbness, throbbing, pulsating, and pain.”— Dr. Majid Ali, 2015-03-06Dr. Ali wrote about neuropathy many times, and almost all of it is treatment and reversal material: remedy lists, an article claiming insulin neuropathy reversed with natural remedies, and a piece proposing ozone. This is the one topic where almost none of his writing can be carried forward, and we would rather say so plainly.
One observation is consistent with current guidance. He treated neuropathy as a signal about metabolic control rather than an isolated nerve problem, and NIDDK describes the same link: high blood glucose and fats damage nerves, and managing diabetes can keep the damage from getting worse.112
Where ProperHealth stops, which here is almost everywhere. We do not carry his neuropathy remedy protocols, his reversal claims, or ozone therapy in any form. Pain medicines help the pain but do not change nerve damage,13 and in some people the damage may be permanent.36
What to do next
Look at both feet tonight
Tops, soles, heels and between the toes. Use a mirror or ask someone.1819
Tie the check to taking off your shoes
Checking each evening when you take off your shoes is an easy way to remember.18
Test bath water with a thermometer or your elbow
90° to 95°F is safe. Numb feet cannot judge heat.21
Check inside your shoes before every wear
The lining should be smooth and free of pebbles.25
Book your yearly foot exam
At least once a year if you have diabetes. Take off your shoes and socks at every visit.28
Medicines, supplements and safety
A pharmacist can review medicines that may be contributing, raise vitamin B12 questions, advise on foot-care products and check supplement interactions. A pharmacist does not diagnose neuropathy, test sensation or treat foot wounds.
- Nerve-pain medicines are prescriber decisions. They can help the pain but do not change the nerve damage; if one does not help, another may be tried.13
- Over-the-counter painkillers such as acetaminophen and ibuprofen may not work well for most nerve pain and can have side effects.14
- Some medicines can cause neuropathy, including drugs for cancer, HIV/AIDS, heart or blood pressure, infections and seizures.31 If symptoms began after a new medicine, mention it, but talk with a doctor before stopping any medicine.33
- Metformin and vitamin B12. Metformin might lower B12 levels, and low B12 can make hands and feet numb or tingly.39 If the deficiency is due to metformin, metformin can be continued with B12 supplementation.11
- Supplements. Diabetes experts have not made special recommendations about supplements; talk with your doctor first.15
- Foot products. Corn plasters and liquid corn removers can damage the skin and cause an infection.23
Compared
Conventional and integrative care, compared
What controls nerve damage and heals foot ulcers, what pain medicines cannot do, what causes neuropathy, and what the clinic's amputation-saving page proposes against the evidence.
What conventional treatment does
- Managing diabetes means managing blood glucose, blood pressure and cholesterol; staying close to your goal numbers can keep nerve damage from getting worse.12 Doctors may prescribe medicines for nerve pain; they can help the pain but do not change the nerve damage, and if one does not help, another may be tried.13 If B12 deficiency is due to metformin, metformin can be continued with B12 supplementation.11
- Standard ulcer care includes debridement, in which a provider such as a podiatrist removes dead tissue so the wound can heal,45 with special shoes, a brace or a cast to take pressure off the ulcer.46 Gangrene and ulcers that do not get better with treatment can lead to amputation, which a surgeon may perform to stop a bad infection spreading and to save a life.51
Limits and adverse effects
- Over-the-counter pain medicines such as acetaminophen and ibuprofen may not work well for most nerve pain and can have side effects.14 Foot ulcers can take weeks or even several months to heal.47
- Some cases improve if the underlying cause is treated; in some people the damage may be permanent or slowly get worse,36 so the sooner it is diagnosed, the better the chance of limiting it.37
What contributes to the condition
- Over time, high blood glucose and high levels of blood fats damage the nerves;1 about one-third to one-half of people with diabetes have peripheral neuropathy.2 B12 deficiency and excess B6 are the best-known vitamin causes; alcohol, toxins and some medicines can cause it too.31 Diabetes can also lower blood flow in the feet, which makes a sore or infection hard to heal.17
Integrative and naturopathic approaches, by evidence
Evidence levels: EstablishedEmergingHypothesisNot supported
- Established
Managing diabetes and other conditions, healthy eating and exercise can help prevent peripheral neuropathy and reduce symptoms;32 controlling blood sugar every day is the best way to protect your feet.34 Check your feet each evening,18 wash in warm not hot water and do not soak,21 trim nails straight across,24 and never walk barefoot or in just socks.25 Choose activities easy on the feet — walking, swimming, cycling; smoking lowers blood flow to the feet.27
- Hypothesis
Diabetes experts have not made special recommendations about supplements; talk with your doctor before using supplements or alternative treatments.15 Blood tests can rule out thyroid problems, kidney disease or low vitamin B12 as other causes.10
- Not supported
A clinic page headed "Diabetic Gangrene Saving Amputation" proposes EDTA, lumbrokinase, chlorine dioxide, calcium hypochlorite and DMSO;41 its brochure calls ozone "the best antibacterial" that reactivates "dead cells",43 and says hundreds of legs were saved, with no records or follow-up.44 U.S. regulation describes ozone as a toxic gas with no known useful medical application;48 the FDA urges people not to use MMS (chlorine dioxide) for any reason,49 and warns that relying on unproven chelation can delay proven care and cause kidney failure and death.50
A foot sore that is not healing after a few days, or skin that is red, warm or painful, is a same-day call to your provider — not a trial of anything from a leaflet.52
When to get help now
Each warning sign cites the official guidance behind it. The wording still needs pharmacist sign-off.
- A cut, blister or sore on a foot that does not start to heal after a few days, or skin on the foot that becomes red, warm or painful (signs of infection) — call your health care provider right away.5253
- A foot that is red, hot and swollen, skin turning black, a bad smell, or fever — call your health care provider right away.5455
- A cold, pale or blue foot, or sudden severe pain in the foot or calf — get emergency care now.5657
- Sudden numbness or weakness, especially on one side, or with face drooping or trouble speaking — call 911.5859
- Numbness that spreads quickly, or legs that keep getting weaker — seek medical help right away. Loss of bladder or bowel control — call 911.6061
- Numbness in the groin, buttocks or inner thighs with back pain — contact your provider right away. With leg weakness or loss of bladder or bowel control — call 911.6263