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Diabetes most commonly causes damage to the long nerves that supply the feet and lower legs, causing numbness, tingling and pain (diabetic polyneuropathy). Although these symptoms may also be present, the pain and weakness of proximal diabetic neuropathy often onset more quickly and affect nerves closer to the torso. [citation needed]
Peripheral neuropathy may first be considered when an individual reports symptoms of numbness, tingling, and pain in feet. After ruling out a lesion in the central nervous system as a cause, a diagnosis may be made on the basis of symptoms, laboratory and additional testing, clinical history, and a detailed examination.
Diabetic peripheral neuropathy can be diagnosed with a history and physical examination. The diagnosis is considered in people who develop pain or numbness in a leg or foot with a history of diabetes. Muscle weakness, pain, balance loss, and lower limb dysfunction are the most common clinical manifestations. [7]
Sural nerve biopsy; biopsy is considered for those patients in whom the diagnosis is not completely clear, when other causes of neuropathy (e.g., hereditary, vasculitic) cannot be excluded, or when profound axonal involvement is observed on EMG. Ultrasound of the peripheral nerves may show swelling of the affected nerves. [32] [33] [34]
The pain is often described as stabbing or burning, or abnormal skin sensations such as tingling or itchiness. In some individuals, the pain is more severe during times of rest or at night. The signs and symptoms of small fiber neuropathy can occur at any point in life depending on the underlying cause.
The diagnosis of polyneuropathy begins with a history (anamnesis) and physical examination to ascertain the pattern of the disease process (such as arms, legs, distal, proximal), if they fluctuate, and what deficits and pain are involved. If pain is a factor, determining where and how long it has been present is important; one also needs to ...
The most commonly affected vessels in peripheral vascular disease are the arteries supplying the legs, so when less blood gets to the muscle tissue in the legs, that tissue sees less oxygen and becomes ischemic. Ischemic cells release adenosine, a type of signaling molecule, which is thought to affect nerves in these areas, which is felt as pain.
Abdominal draw-in (knee to chest) - Lying flat on the back, bend both legs and bring knees towards the chest without lifting the back from the ground and then straighten legs again. For a more difficult version of the exercise, keep one leg bent and feet on the ground and bring the other leg towards the chest.