When you hear the term neuropathy, as a diabetic, numbness and tingling in the feet probably comes to mind. As neuropathy affects 60 to 70 percent of diabetic patients, your doctor may have warned you about the signs and symptoms in your feet to watch out for.

But what happens if you begin to experience numbness and tingling in your fingertips? Is this the same thing? While neuropathy most commonly affects the feet in diabetics, it can also affect the hands and fingers, and can be a sign that your diet and medications are not adequately controlling your blood sugar levels.

What is Neuropathy?

Neuropathy, or peripheral neuropathy, is not a single disease but rather damage that other diseases and conditions inflict on the body’s peripheral nervous system. Your body consists of two parts: the central nervous system (brain and spinal cord) and the peripheral nervous system. The peripheral nervous system consists of many nerves that connect your brain and spinal cord to the rest of your body.

These nerves send messages to your arms, legs, hands, feet, internal organs, and even your skin. When damage occurs to these nerves, the nerve’s ability to send signals to areas of the body becomes disrupted.

When those signals become disrupted, peripheral neuropathy occurs. Where it occurs in the body depends on the location and cause of nerve damage, as well as which types of nerves affected. Peripheral nerves fall into three different categories: motor, sensory, and autonomic. Peripheral neuropathy can affect only one nerve or nerve groups (mononeuropathy) or multiple nerves and groups (polyneuropathy). While most diabetics suffer from polyneuropathy, damage to the sensory nerves is responsible for the burning sensations you may experience in your fingertips.

Symptoms of Neuropathy

When it comes to neuropathy symptoms, it again depends on what nerves are damaged. For example, motor nerve damage can cause muscle weakness, muscle cramping, and muscle shrinking. Damage to the autonomic nerves can cause excess sweating, heat intolerance, unregulated blood pressure, and gastrointestinal symptoms. It is sensory nerve damage, however, that causes the burning sensations you may experience in your fingertips, so we will focus on those symptoms. The sensory nerves have both large and small fibers and

damage to each cause different symptoms.

Large Sensory Fiber Damage

When damage occurs to the large sensory fibers, it affects your ability to feel sensation and touch. This typically occurs in the hands and feet, leaving you feeling as though you are wearing gloves or socks. This loss of sensation can make movements such as walking or fastening buttons difficult.

Small Fiber Damage

Damage to the small fibers affects pain and temperature sensations. This damage is what causes the burning sensations in your fingers. This burning sensation is often stronger at night. In addition to the burning sensations, you may also experience numbness and touch sensitivity. The damage to the fibers alters your body’s pain signaling, and, in many cases, you may also experience allodynia, or

severe pain from a simple light tough. For example, you may get into bed at night and the touch of your bed sheets on your skin may feel like razor blades. In contrast, this damage can also limit your ability to feel pain. For example, you may not be able to feel that your bath water is too hot, or you may not feel pain when you have cuts, blisters, or infections on your hands or feet.

Living with Neuropathy

If you are experiencing a burning sensation in your hands or feet, it is essential to talk with your doctor about treatment options. For diabetics, proper blood sugar control is often enough to allow the damaged nerves to recover and regenerate and prevent further nerve damage. It is essential to maintain a healthy lifestyle and optimal weight, as well as regular exercise. If you are a smoker, smoking cessation is important as smoking constricts the blood vessels that support the nerves. Regular exercise helps the nerve endings in the hands and feet receive more blood and oxygen, helping to improve sensation and reduce the risk of potential complications.

For chronic neuropathic pain, medications such as Nortriptyline, gabapentin, pregabalin, or serotonin-norepinephrine reuptake inhibitors are often prescribed by a physician. In some cases, topical lotions and creams can help reduce the burning pain in the hands and feet. The Neuropathy Action Foundation even lists the use of Vicks Vapor Rub as an effective alternative treatment option for neuropathic pain.

Complications of Diabetic Neuropathy

While the burning sensations in your hands, fingers, feet, and toes may seem like nothing more than a mild discomfort, if left untreated, neuropathy can progress and contribute to numerous severe medical complications. The loss of sensation can contribute to complications with wound healing and the development of ulcers. Without proper pain sensation, you may experience an injury to your hand or feet that you do not feel. An infection can get out of control before you are even aware of it. If wounds like these continue to go unchecked, they can progress into the bone or cause gangrene, often resulting in the need for amputation. If you experience any changes in sensation or burning, tingling, and numbness and suspect neuropathy, talk with your doctor immediately to begin treatment.

“6 Neuropathy Complications and How They're Treated: Everyday Health.” EverydayHealth.com, 15 May 2018, https://www.everydayhealth.com/neuropathy/complications-how-treated/.

“Complementary and Alternative Medicine (CAM) Treatments for Peripheral Neuropathy (PN).” Neuropathy Action Foundation, 20 Aug. 2015, http://www.neuropathyaction.org/downloads/CAMTreatmentsFinal.pdf.

“Peripheral Neuropathy.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 22 May 2019, https://www.mayoclinic.org/diseases-conditions/peripheral-neuropathy/symptoms-causes/syc-20352061.

“Peripheral Neuropathy.” National Institute of Diabetes and Digestive and Kidney Diseases, U.S. Department of Health and Human Services, 1 Feb. 2018, https://www.niddk.nih.gov/health-information/diabetes/overview/preventing-problems/nerve-damage-diabetic-neuropathies/peripheral-neuropathy.

“Peripheral Neuropathy Fact Sheet.” National Institute of Neurological Disorders and Stroke, U.S. Department of Health and Human Services, https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Peripheral-Neuropathy-Fact-Sheet.

“Peripheral Neuropathy Symptoms: Pain In Fingers, Toes, & Feet.” The Foundation For Peripheral Neuropathy, https://www.foundationforpn.org/what-is-

peripheral-neuropathy/symptoms/.

“What Is Peripheral Neuropathy?: Living With Peripheral Neuropathy.” The Foundation For Peripheral Neuropathy, https://www.foundationforpn.org/what-is-peripheral-neuropathy/.

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