Why Your Peripheral Neuropathy Feels Worse at Night

Peripheral Neuropathy

The pain, tingling, and burning sensations from diabetic peripheral neuropathy can be debilitating any time of day. But, for some people, these uncomfortable sensations get particularly worse at night, especially when they’re trying to sleep.

If you’re in this category, you might have been told you’re imagining it. But, recent research from the Comprehensive Pain Center at Oregon Health & Sciences University indicates more acute pain at night isn’t in your head. In a study of nearly 650 participants, investigators found patients with diabetic peripheral neuropathy — regardless of age, gender, or other health conditions — reported feeling the most significant pain between 11pm and 8am.

Next time you feel your peripheral neuropathy pain intensifying at night, consider these possible causes. In some cases, you can try to get the discomfort under control.

  1. Fewer distractions: At night, there’s less to take your mind off your pain — no chores, no errands, and no talking as you try to drift off to sleep. That’s when your mind and body become more aware of your surroundings. You notice your pain more, making sleep elusive.

To combat that heightened awareness, try to focus on something you enjoy to take your mind off what you’re feeling.

  1. Cooler temperatures: With peripheral neuropathy, according to Loma Linda University Health, your feet will be far more sensitive to cooler air. As temperatures drop at night, your peripheral nerves can begin to tingle more, and you’ll feel more burning or sharp pains. Your heart rate also slows when you’re colder, slowing your blood and increasing painful sensations.

If you can handle the touch on your feet, wrap up in blankets to warm up.

  1. Stress/Fatigue: Sometimes, physical stress and exertion can increase your nerve pain as your body begins to relax at the end of the day. Vigorous exercise and the soreness that accompanies it can contribute to more night-time nerve pain.

Be sure you alternate your exercise routines so you’re not over-taxing your body, and pay attention to when you need to take a break from exercise and let your body rest.

  1. Medication: Even though your medication might work well during the day, keeping you mostly free from pain, it eventually wears off. This typically happens at night, according to the Innovations Stem Cell Center. When you’ve been comfortable all day, you’ll notice the pain much more when it starts to creep back in.

 

Try these strategies to stay comfortable at night if your have peripheral neuropathy pain:

  • Control your blood sugar. Work to keep your levels between 80-130 mg/dL before eating and under 180 mg/dL after meals.
  • Soak your feet in a warm bath to relax your nerves at night. Be sure to check the water temperature to avoid burning your feet.
  • Exercise regularly. It increases blood flow and oxygen to your feet, reducing pain. Listen to your body, though, and take breaks when needed.

Contact Amputation Prevention Centers of America if you have questions.

Protect Yourself from Charcot Foot

Charcot Foot

If you have diabetes, you face the possibility of developing many foot problems, including ulcers, non-healing sores, and even amputation. But, there’s another condition you should know about and watch out for: Charcot foot.

Also called Charcot arthropathy, this condition weakens the bones in the feet of people who have peripheral neuropathy. It also attacks the joints and soft tissues. Over time, it can cause painful sores and actually change the shape of your foot.

Why does Charcot foot happen?

Your bones naturally lose calcium when injured, and, according to the Cleveland Clinic, that makes the bones weaker and more susceptible to further damage. The numbness from peripheral neuropathy increases the danger. If you can’t feel a sprain, a break, or an infected or lingering sore, you’re more likely to continue walking on your foot normally. In some cases, slow healing from a foot surgery can be responsible.

What happens?

Prompted by injury that often doesn’t get timely treatment, your bones lose the calcium that keeps them strong. At that point, your foot can start to lose its shape, and your arch can drop below your toes or heel. Doctors often call this “rocker bottom.”

Additionally, your toes might curl, and your ankle can become twisted and unsteady. Any misshapen bones can also press against your shoes, creating new sores that can also get infected and lead to amputation.

What to look for?

Diagnosing Charcot foot can be difficult, according to a study published in American Family Physician, because it mimics other conditions, including cellulitis and blood clots. Initial X-rays and lab tests can also often look normal.

However, there are some symptoms, other than the fallen arch, that can make you suspect Charcot foot. If your foot becomes reddish, warm to the touch, or swollen, talk with you doctor. You should also be concerned if you have instability in your ankle, any misalignment of the bones that form the joint, or a strong pulse in your foot.

Can you prevent it?

Yes, you can do things to potentially side-step Charcot foot. Follow this list for better foot health:

  1. Get regular check-ups with a foot doctor who has experience treating diabetic foot problems.
  2. Check your feet daily for swelling, redness, warm spots, and sores. Check between your toes, too.
  3. Wash your feet daily, and dry them thoroughly.
  4. Always wear socks and shoes.
  5. Keep your blood sugar levels under control — between 80-130 mg/dL before eating, under 180 mg/dL after.
  6. Take extra care to avoid injury, particularly while exercising.

 
Overall, if you begin to see these changes in your feet — especially if your foot begins to change shape — contact your doctor immediately. Any delays can result in further damage to your foot that could lead to infection or amputation.

For questions, please contact Amputation Prevention Centers of America.