Why Do Your Feet Hurt?

In the days before modern medicine, someone who lived long enough with diabetes may have had one or both legs amputated. I assumed it did not happen anymore, until I read about people with diabetes who have ignored high blood sugar levels and developed complications requiring amputations.

It seemed impossible that this could still be happening. Then the pain and numbness in my own feet sent me looking for answers. What caused it, and what could I do about it?


I learned that the path from high blood sugar to foot ulcers and amputations often goes through a condition called peripheral neuropathy, the medical term for nerve damage in the hands, feet, arms, and legs that often causes pain and numbness.

Diabetes and nerve damage
High blood sugar damages blood vessels. One doctor described the extra glucose floating in the blood of someone with diabetes as similar to bits of glass scraping along the walls of veins and arteries.

The tiniest blood vessels are easily damaged. That is why eyes, feet, and kidneys are so vulnerable, showing signs of blood vessel damage, sometimes even before a person is aware he has diabetes.

Fingers and toes can become numb or overly sensitive when the blood vessels that supply the nerves are hurt. The longest nerves in your body run down your spine into your feet, ending at your toes. This makes feet an easy target for damage from peripheral neuropathy.

Feet with nerve damage
Because of diabetes we must care more about issues like foot ulcers, infections, ingrown nails, toenail fungus, and sores. The greatest enemy to our feet is numbness, because pain is the thing that warns us something is wrong.

Peripheral neuropathy may make your feet more sensitive to touch while at the same time the numbness it may cause can mask problems like hot spots that are forming from shoes that are too tight or loose. A person who has had Type 2 diabetes for many years may step on a nail and carry it around in his foot without being aware of it, even though his toes are so sensitive he cannot stand a bedsheet touching them.

This is the reason your doctor should examine your feet and legs at every visit. It is also why you ought to find a good podiatrist, or foot doctor. Aging with Type 2 diabetes may mean developing complications from nerve damage, and you need all the help you can get.

Weapons against nerve damage
Here is the good news: There are things you can do to prevent and even stop nerve damage in your feet. Your first and best defense against peripheral neuropathy is to lower your blood sugar levels.

The main reason doctors want you to have a hemoglobin A1C below 7% is this: If your numbers are lower, you will have fewer complications from diabetes. Studies have proven it. Lower blood sugar means less damage.

Another great weapon is exercise. Using your legs and feet encourages blood flow, and that keeps nerves healthy. I have experienced this myself as I have become more active. Swimming, biking, walking, gardening, cooking — anything that makes you move around will protect against peripheral neuropathy.

Third, inspect your feet every day. It is a direct way to lower your risk of amputation. Orthopedic surgeons say this one thing could have saved huge numbers of feet among their patients with diabetes.

Why is foot inspection so helpful? Because foot ulcers are most often the initial cause for a lower-extremity amputation in people with diabetes. Since we may have nerve damage, we must use our eyes to find problems in our feet.

Tighter blood sugar monitoring and daily inspection are the two things health professionals point to when they see lower amputation rates today. It is true that amputation is no longer something you have to accept as part of your future.

People with Type 1 and Type 2 diabetes are living longer. We are also living with the complications for many more years than the generations before us. So guard your feet, and do not take them for granted.

Take care.

  • Dick

    Why no mention of the research that shows Alpha Lipoic Acid and Benfotiamine can help 70%?

  • Dennis Spencer

    amen. good article. right to the point,


  • Cora

    I was using Capzasin HP for pain in my lower back. I read it also can help your foot neuropathy. I was amazed it really works. I can’t take Lyrica or any Gabapentin. My Pharmacist also told me B6 100mg also helps the pain.I will also look into Benfotiamine/B1.
    I also take Alpha Lipoic Acid 300mg/day with food.I know alot of these meds have other purposes, I also have fibro so far all of these help. Cora

  • Nouri Kasheeri

    Good comment, can you put the link to the article Mr Spencer thanks.

  • Jean

    I am a T2 non-insulin diabetic that was diagnosed 14 years ago. When diagnosed the A1c wasn’t used but, my FBS averaged 148. Since the A1c has been used it has never been above 6.1. However, I have severe neuropathy both in my feet and in my hands. I have been on Gabapentin and Cymbalta and now Lyrica and still have very little relief from the pain! Every article I read tells me that I need to have “good” control of my BS to prevent this complication…..well, I really take offense to this statement and am ready to just quit! How much better must I get control of my BS to calm down these symptoms?? I have yet to read an article that tells me anything about any other cause for the neuropathy other than BS Control! So, I am ready to give up because I feel that not only the diabetes is all my fault but, also all the neuropathy pain! This article is a good “generic” read but, it sure isn’t very encouraging for me. Discouraged!

    • Dr. G.I Fabusuyi. MD

      I’m really sorry about your condition sir. Good BS control would only prevent further damage. You need to parliate the damage already done with the pain relieving strategies already mentioned.

  • Joe


    Have you or your doctors considered that your pain may be caused by something other than diabetic neuropathy?

    There are several other conditions that can mimic diabetic nerve pain.

  • Jean

    Thanks Joe, yes my PCP has investigated the pain and I have seen a neurologist. They still are saying it is diabetic neuropathy along with arthritis in my feet. But, the main point I was trying to make is that most all articles that I have read say the very same thing…BS Control, as if this will solve all the pain, etc. I would just like to see an article that does say that there are other reasons for diabetic nerve pain! As far as my pain, I just am at a point that “It is what it is”, and I will just learn to live with it! Because, I will not take pain medication unless it becomes completely incapacitating to the point I can’t function! I have had CDE, RD and physicians that have discouraged me because they not only blame ME for my T2 diabetes and not keeping my BS under control which has caused the nerve pain! Just Had To Sound Off!

  • Martha Zimmer

    Jean, your response touched my heart. I know how frustrating it is to feel these symptoms are all our fault. Well, I can tell you, they are NOT. So many things go wrong, and not all of them are connected to one thing or another.

    Much of my foot pain came from fallen arches that happened suddenly when I was about 50. Some also came from wearing bad shoes and the wrong type of inserts.

    I also tried capsaicin and found it very helpful. It is easy to find at places like Walmart in the foot care section.

    Exercises for plantar fascitis (bottoms of feet inflamed) really helped, but I had to do them a lot before I saw improvement.

    It is also true that foods with B vitamins improve nerve damage. Even getting some sunshine for the vitamin D helps.

    Please do not give up. Let me know how you are coping. Martha

  • Lavender Rose

    Please read Dr. Carolyn Dean’s book called the Magnesium Miracle. People with diabetes are very often deficient in magnesium (Mg). Supplementation with this essential element will really help with the neuropathy (and help manage blood sugar). It really cleared up the problem that I was having (painful heal and numb/tingling toe on right foot). Please Google this book (or the topic of magnesium and diabetes online) to form your own opinion. If you do decide to supplement, try Mg Threonate capsules or ionic Mg (mixed into a smoothie to mask the taste). I am taking 1000 mg daily and my feet have not felt this good in over a year. Do not take other forms of Mg (especially Mg oxide) because it will cause bowel issues! Also, please visit dietdoctor.com. Using the dietary advice found there, I lowered my A1C to about 5.7 and am hoping it will be even better on the next lab. I eat less than 20 grams of carbs/day and lost 50 pounds with diet changes and moderate exercise. I am 50 years old and also feel to young to let T2D screw up my life. You can get control with diet (I have taken zero medications for diabetes). I was diagnosed 7 months ago, but know that I had this problem longer than that. Good luck to you!!!!!!!!!!!