Editor's note: Board-certified specialists from a panel of Yuma-area physicians provide to-the-point answers to questions submitted by Sun readers. The answers are only the opinions of the answering physicians and are not meant to be a substitute for medical consultation or physician care. Submit questions by e-mail to medicalopinion@yahoo.com or via regular mail at Yuma County Medical Society, P.O. Box 4476, Yuma AZ 85366.

Q — Recently, my feet began to burn and occasionally they feel numb and sometimes tingle. They are worse at night. What is wrong?
 
A — You may be suffering from peripheral neuropathy. Neuropathy is any type of nerve damage, and peripheral neuropathy is nerve damage to the feet or hands.
 
When nerves are irritated, they can stop working or overwork, causing numbness, a burning sensation, pins and needles or even sharp shooting pains. They always seem worse at night because when you are being quiet in bed, they are not masked by other stimuli.

There are many causes for peripheral neuropathy. The most common is diabetes. In fact, neuropathy can even occur before elevated blood sugars are detected. It is an indicator of diabetes.
 
Other possible causes include:
 
• Diseases that hinder the absorption of certain vitamins from the intestine, such as Crohn's disease, diverticulitis and colitis.
 
• Sexually transmitted diseases such as syphilis.
 
• Direct injury to the nerves themselves, either locally in the feet or legs, such as pressure or resting on a nerve, or in the spinal column.
 
• Excessive exposure to herbicides and pesticides, such as Agent Orange, and some other poisons.
 
• Excessive exposure to heavy metals such as arsenic, bismuth or lead.
 
• Thyroid disease.
 
• Some rheumatoid-like autoimmune diseases.

• Some types of anemia.
 
• Decreased circulation in the feet of peripheral arterial disease.
 
There is a large group of patients who have peripheral neuropathy for which we cannot find a cause. This is called idiopathic neuropathy.
 
Not all peripheral neuropathy can be cured but most can be controlled. There are several different types of medicines available which can decrease the unusual symptoms.
 
If your neuropathy is caused by a vitamin deficiency, high doses of the needed vitamin will reverse the symptoms. If your neuropathy is due to diabetes, then good control of your blood sugar can decrease or possibly reverse the symptoms. Pain medications often lessen the symptoms.
 
Whatever is the cause of the neuropathy, it can signify a severe disease and you should seek medical care from your primary care provider, a podiatrist or a neurologist.


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Stanton Cohen, DPM, is a board-certified podiatrist who has had a successful practice in Yuma for the past 30 years.