As skilled specialists in the treatment of issues affecting the foot, ankle, and lower legs, podiatrists play an essential role in the diagnosis and management of peripheral neuropathy.
Understanding peripheral neuropathy
When nerves outside of the brain and spinal cord are damaged, it can cause decreased or abnormal sensations in the arms, hands, legs, and feet. Because these nerves are part of the peripheral nervous system, the condition is referred to as peripheral neuropathy. While diabetes is the most common cause of peripheral neuropathy, there may be other reasons for the condition. In some cases, certain medications, genetics, old age, arthritis, alcoholism, neurological disorders, or injury are contributing factors.
Symptoms of peripheral neuropathy can run the gamut from burning, tingling, sharp, dull, or searing pain to numbness, loss of balance, weakness, stiffness, and heaviness in the legs. The condition also causes other issues, including ones that affect the skin, hair, and nails.
Peripheral neuropathy testing and ENFD
To evaluate patients for the presence of peripheral neuropathy, we review their history, check for signs or symptoms, and perform a thorough clinical exam. One important test we may recommend when patients report pain, abnormal sensation, tightness, or coldness in the foot and ankle is an epidermal nerve fiber density analysis (ENFD).
ENFD testing offers a highly accurate way to demonstrate the presence of small fiber peripheral neuropathy. A simple, quick, and comfortable procedure for both the patient and the podiatrist, an ENFD requires a very tiny and superficial tissue biopsy for analysis. In addition to providing an objective diagnosis of peripheral neuropathy, the test also monitors the therapeutic effect of treatment.