The commonest cause of nerve pain in this region, and one where treating the cause genuinely changes the outcome.
What it is
High and unstable blood glucose damages the small nerves, beginning with the longest — hence feet before hands.
It begins in prediabetes, before glucose reaches diabetic range, which is why so many patients are told their sugar is fine.
How it usually presents
- Burning or numb feet, worse at night.
- A sensation of walking on gravel or of invisible socks.
- Loss of balance in the dark.
- Reduced sensation, which raises the risk of unnoticed foot injury.
How we treat it
- EMG and nerve conduction study to confirm and grade it.
- Metabolic treatment, including continuous glucose monitoring — this is the part that changes the trajectory.
- Nerve-specific medication for the pain.
- Foot protection and regular inspection.
To be assessed, call (314) 310-5577 or request an appointment.
Common questions
My A1c is normal. Can I still have this?
Yes. Post-meal glucose spikes damage small nerves while a fasting test and even an A1c can look acceptable.
Can it be reversed?
Early damage can improve substantially when glucose is genuinely stabilised. Long-standing damage is harder, and prevention of further loss becomes the goal.
Hurt in an accident? Start here.
You do not need a lawyer, a police report or a referral to be seen. Bring your symptoms and we will work out the rest.
Monday–Friday, 8:00 a.m. – 4:00 p.m. Same-day appointments are often available for new accident and injury patients.