Can Diabetes Make My Legs Hurt?

Diabetic leg pain may often disturb your sleep at night.

Diabetes, particularly a poorly controlled diabetes where the blood sugars are high, is a major cause of pain and uncomfortable sensations in the legs. Diabetic leg pain may present as a dull ache in the soles, calves, and thighs, or present with a pins-and-needles-like sensation in the lower limb. The pain may often disturb your sleep at night.

Some people experience stabbing pain, making it difficult to walk. This happens due to altered nerve sensitivity. Therefore, for some people, a bedsheet may also cause irritation like pain. As nerve damage gets worse, symptoms can move from the feet up the legs and hands.

Often, the pain in the legs may be due to the formation of sores or diabetic ulcers. The ulcers (diabetic foot) are due to poor healing mechanisms in individuals who have diabetes. The high sugars and poor blood vessel health have been implicated in diabetic leg pain (neuropathy).

Sometimes, there may be entrapment or compression of the nerves of the lower limb beneath the bony structures. This condition is called femoral nerve entrapment, the tarsal tunnel syndrome may also cause leg pain.

Diabetic neuropathy (nerve damage) has different types. Most diabetic neuropathies are irreversible, though you can manage them with medications. Neuropathies generally manifest after about 5 years of diagnosis of diabetes. You can delay the onset of neuropathy with strict sugar control and weight management.

Some uncommon types of neuropathies are treatment-induced neuropathy of diabetes (TIND) and anorexic diabetic neuropathy. TIND happens when the patient attempts to control the sugar levels extremely in a short span, and anorexic diabetic neuropathy presents with reduced appetite, causing a rapid weight loss following the onset of diabetes, which may be self-limiting and get better in a few months. The entrapment neuropathies are also reversible if managed in time.

Most individuals, however, have persistent symptoms and disabilities related to nerve pain; hence, prevention is the best cure.

It is possible to maintain foot hygiene and halt the nerve damage using the following tips. These are recommended by the American Diabetes Association for all individuals with diabetes.

Tips for diabetic foot care

1. Consistently maintaining normal blood sugar levels and glycated hemoglobin or HbA1c in recommended levels goes a long way in maintaining a healthy foot.
2. If you have a foot problem, visit the doctor right away. Early treatment can help prevent more problems that may occur later. For example, if you treat a foot infection early, it can prevent amputation.
3. Metformin, a drug used for diabetes management, is notorious for causing Vitamin B12 deficiency. Vitamin B12 and folic acid are required for good nerve health. Getting tested for Vitamin B12 deficiency regularly and consuming supplements can help keep the nerves and inner lining of blood vessels healthy.
4. Scheduling regular checkups with your doctor for a comprehensive foot examination that includes an examination of ankle pulses, your senses of vibration, pressure, and touch, and ankle brachial index (ratio of blood pressure in the ankle to that in the arm) will detect early changes in the foot.
5. Self-examination of the legs and feet every night with a mirror. You must check for any calluses, corns, blisters, red areas, cold feet, and small cuts over the sole. A callus or corn may invite a diabetic ulcer and must be managed promptly by a licensed podiatrist.
6. Towel the foot dry after every bath. Make sure no moisture is trapped between the webs of the feet. Use a moisturizer to prevent foot cracks. Never use moisturizer in the foot webs.
7. Always use comfortable footwear in and out of the house. Change your socks daily.
8. Avoid using hot water bags to foment the aching legs. If you have numbness due to advanced nerve damage, the hot bags can cause burns.
9. Diabetic footwear is a good investment. It can be custom-designed as per your foot dimensions and pressure points.
10. Quitting smoking and alcohol can halt the progression of peripheral vascular disease (narrowing of blood vessels). This will help in slowing neuropathy progression.
11. Be careful while exercising. Some physical activities are not recommended for people with neuropathy. Talk with your doctor before initiating any new physical fitness regimen.
12. Trim your toenails carefully. Cut straight across and file the nail. Do not cut cuticles or pop boils or blisters. Always get an ingrown toenail removed by a professional.