Who has Foot Neuropathy?
A lot of people I’ve met actually have foot neuropathy but they’ve never been diagnosed by a doctor. Why do you think that is?
It’s because doctors don’t usually look at your feet!
Your doctor may check your blood pressure and your heart rate. They may look at your eyes if they look up from their computer, but nobody is looking at your feet.
I bet they probably aren’t asking you to take off your socks and shoes and looking at your feet to check your blood flow. Or to check for foot neuropathy.
Foot Neuropathy Causes Falls and Dizziness
When I see a patient of advanced age or with falls, I always make sure to test the pulses, sensation and strength of the feet. That gives me an understanding of blood flow in the feet and ankles.
If I detect foot neuropathy during my assessment, that can sometimes explain chronic falls.
Foot neuropathy can also explain dizziness with standing. This is usually due to the change in blood pressure due to foot neuropathy, especially if the neuropathy is related to blood flow problems.
Blood Pressure can Drop with Standing
When figuring out the blood pressure relation to foot neuropathy, one test that I do is to check positional blood pressures.
This means that I check blood pressure either lying down or sitting as a baseline. Then I check it again when you stand up, and a few times over the next few minutes. I check to see if your blood pressure dropped when you stood up. If it does, it may mean that you have a foot neuropathy that is contributing to it.
It could also mean that you are dehydrated or maybe you have a medication that causes that blood pressure to drop when you stand, or it could be something else.
Foot Neuropathy can Cause Blood Pressure to Drop with Standing
Since one cause of blood pressure dropping when you stand is foot neuropathy, I want to make you are aware of this.
If you are getting dizzy with standing whether it be from foot neuropathy, dehydration, medication side effects or one of the other causes of blood pressure dropping when you stand, your health provider can do a screen for you.
The screen is as I described above, it’s called postural vital signs.
Your healthcare provider would need to take multiple blood pressure readings.The first one while sitting or lying down. Then take it again after you stand and see how it changes.
The blood pressure should not drop when you stand, but it does do that sometimes for people with dizziness upon standing. Testing you this way can really help us understand the blood pressure relation to foot neuropathy.
If the drop in blood pressure after standing reaches a certain level, then it is called orthostatic hypotension.
Talk to Your Doctor
You and your doctor can take the proper steps to take care of your feet.
Your primary doctor may refer you to a Podiatrist or a Cardiologist for further testing as needed.
In my blog post How to stay safe if you have Foot Neuropathy, I discuss practical things you can do to take care of your feet as well as an exercise program you can do to try to reduce your symptoms of foot neuropathy and your risk of falling.
This blog is provided for informational purposes only. The content and any comments by Dr. Kim Bell, DPT are not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. The details of any case mentioned in this post represent a typical patient that Dr. Bell might see and do not describe the circumstances of a specific individual.