By Dr. Dorian Jimenez, DPM
If you are like many of my patients, both diabetic and non-diabetic alike, feelings of burning and tingling in your feet present an unwelcome problem. Maybe it’s just the toes or the front of the feet but maybe your entire feet and legs are affected. Patients give descriptions such as:
- My toes are numb
- the bottom of my feet feel like cardboard or deadwood
- sometimes I have crawling feelings in my feet
- my feet are ice-cold even in the middle of the summer
- I stumble because I can’t feel where my feet are
These are all common complaints that likely lead back to a condition called “Peripheral Neuropathy.” And while many diseases and disorders can cause peripheral neuropathy, the most common cause is diabetes.
This is not to say that all patients who are diagnosed with diabetes will get these symptoms in their feet and legs. But those who do not control their blood sugars will likely eventually start to experience feelings of Diabetic Peripheral Neuropathy.
Historically, symptoms of burning and tingling in the feet as a result of diabetes have been treated by medications aimed at limiting those painful, irritating feelings. Thankfully, the world is a changing place. And in our current world of programs aimed more toward disease prevention, a simple way to “test” your nerves has emerged. It’s called Epidermal Nerve Fiber Density Testing. While the name is intimidating, the actual test is very simple.
Your podiatrist will start by evaluating your feet and legs. This should be done at least two times a year even if you aren’t having problems assuming you are diabetic. Once the evaluation is complete, your podiatrist may recommend “testing your nerves.” A simple biopsy performed on the outside of the leg is all it takes. The sample will be sent to a lab and within a week or so, you can have a “real-time” reading of your nerves and the level of disease present.
Of course, as with most medical tests, the ENFD test isn’t perfect, but it is a very useful tool in the fight against those electric shock-like, burning, numb feelings in your feet and legs. Ask your podiatrist whether you’re a candidate for this biopsy and get to know your nerves a bit better.
Related articles
- Peripheral Neuropathy (mayoclinic.com)




