Why do heels hurt in diabetes

For many years, unsuccessfully struggling with pain in the joints.

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The stop acts as a shock absorber. While walking or running, the legs experience a lot of stress, and a considerable part of it falls precisely on the heel. And since there are many nerve endings, blood vessels in it, with certain diseases or injuries heel pain can occur.

External factors

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Many women are faced with the fact that when walking, the heels are very sore. The reason is that girls prefer stylish shoes (many high-heeled models). The load in such cases on the foot increases, and therefore, with prolonged walking, shooting pain may occur. The problem also arises if you change your shoes to ballet shoes, flip flops and other shoes at low speed. But not only poorly selected shoes can become a provocateur of painful sensations that occur in the legs.

Heels are very sore with short walking, not only in the beautiful half of the population, but also in men. Therefore, this problem cannot be called purely female.

Removable causes that a person can provoke heel pain:

  • Spend a lot of time on your feet (for example, standing work).
  • Increased load on the legs. In most cases, this applies to those people who have started running. If there is a mild, rapidly passing pain in the heel, it is advisable to stop your studies for a while or reduce the time of jogging. In cases where soreness occurs again, you need to change the sport.
  • Thinning of subcutaneous fat.

The most common reason when the heel hurts, even with light walking, is injuries sustained in everyday life, in sports or at work. What you should pay attention to:

  • Bruised heel. If the patient complains to the attending physician that he has intense pain in the heel of a stitching nature, then, most likely, the doctor will suspect a heel injury. The diagnosis is confirmed by edema and hematoma at the site of tissue contusion around the calcaneus. A bruise most often occurs if a person after a jump unsuccessfully lands on the foot.
  • Tendon rupture. Damage to the tendon in the foot occurs after applying a direct blow to it with a solid object. Also, the cause can be called a sharp contraction of the leg muscles. Symptoms characteristic of the injury are severe severe pain, as well as swelling in the area where the Achilles tendon is located. The foot practically does not bend. The doctor, on palpation, discovers a violation of its integrity.
  • Fracture of the heel. Deformation (movement in any direction) of the calcaneus is a fracture. Characteristics of it: swelling of the entire foot, thickening of its arch, expansion around the heel, bruising. There is also a heel tendon tension, soft tissue swelling, due to which the movements in the ankle joint are very limited, and the subtalar joint is completely immobilized.

If the doctor has any doubts about the diagnosis, he asks for an X-ray of the foot. In case of injury, a patient may be cast on the leg in order to maximally immobilize the foot.

If you are sure that in the last days there was no leg injury, there were no heavy loads on the foot, but your heel hurts further - perhaps the reason for this lies in the disease.To confirm or refute, it is necessary to undergo a diagnosis, donate blood for analysis.

When a person experiences severe acute pain on the side of the heel when walking, the attending physician may suspect:

  • Infection. Pain in the heel can be with bone tuberculosis, osteomyelitis, etc.
  • Systemic diseases. This category includes ankylosing spondylitis, rheumatoid and gouty arthritis.
  • The inflammatory process of any origin.
  • Neoplasms.
  • Neuropathy.

In order to find out exactly why the heels hurt in the morning, it is necessary to donate blood for analysis, if necessary, intraarticular fluid. The doctor will prescribe treatment only after receiving the results.

Of the instrumental methods, X-rays, electromyography, MRI and ultrasound are used.

The main causes of heel pain when walking

Many people who begin to worry about heel pain while walking, hope that this problem will be solved by itself. This is their biggest mistake. The heel, unlike other parts of the musculoskeletal system, is constantly amenable to loads, therefore, a person cannot provide it with functional peace. Sometimes it is simply impossible to get rid of heel pain without special treatment.

Heel and its function

Like the entire foot, the heel plays the role of a shock absorber when walking or running, provides a person with the opportunity of upright posture. The human heel is based on the calcaneus, which is the largest bone formation of the foot. The calcaneus is surrounded by a large amount of fatty tissue, has a specific and ideal form for its functions.

This makes it possible to withstand heavy loads on the heel. When walking or running, the force of the shock is absorbed (absorbed) by the heel tissues, which protects the spine from injury. If the anatomical integrity or shape of the calcaneus changes, this leads to a violation of its cushioning capabilities, which is fraught with damage to the structures of the spine and spinal cord.

The calcaneus is a spongy bone. Due to its relatively large size, the bone is more fragile than other bones of the foot (their structure is more compact). In addition, blood vessels and nerves stretch through the bone tissue itself. All these anatomical features create the prerequisites for the defeat and development of pain in the heels when walking.

Causes of pain

There is an erroneous opinion among the population that the heel hurts only with the formation of a heel spur. This is far from the case. There may be several reasons for this symptom.

The main causes of pain:

  • plantar fasciitis,
  • rheumatoid arthritis,
  • heel spur,
  • tendonitis - inflammation of the tendons of the foot,
  • bursitis - inflammation of the synovial bags of the foot,
  • osteoporosis,
  • traumatic injuries
  • wearing uncomfortable and wrong shoes,
  • long stays
  • reactive arthritis, which has an infectious etiology (chlamydia, gonorrhea, campylobacteriosis, etc.),
  • gout,
  • psoriatic arthritis,
  • erythromelalgia,
  • polyneuropathy (“burning heel syndrome”), damage to nerve endings in diseases such as diabetes mellitus, hereditary and acquired neuropathies.

As you can see, there are many causes of heel pain when walking. Therefore, it is important to consult a specialist for such signs. Indeed, in each individual case, the treatment will differ depending on the cause. Below are the most common causes of heel pain.

Plantar Fasciitis

This is a disease that is characterized by the appearance or intensification of heel pain during exertion. The development of pathology is due to inflammatory and degenerative changes in the fascia of the sole. The plantar fascia (aponeurosis) is a connective tissue, very durable plate that connects the calcaneus with the metatarsal bones of the foot. It plays the role of a kind of cable that supports the arch of the foot, performs cushioning functions and absorbs stress when walking and running.

With excessive overloads of the feet, the aponeurosis does not stand up, microcracks and tears develop in it. The body responds to such a situation by activating inflammatory reactions, which leads to the development of heel pain when walking.

The main manifestation of the disease is pain along the heel during exertion, especially after sleep.

Treatment principles

  • limitation of loads on the feet,
  • orthopedic shoes,
  • taking painkillers and anti-inflammatory medications, locally - anti-inflammatory ointments and gels,
  • ice massage
  • a complex of therapeutic gymnastic exercises,
  • putting on night special orthoses, braces that fix the foot at right angles.

Heel spur

This is a consequence of untreated plantar fasciitis on time. Damaged plantar aponeurosis tissues, which originate from the calcaneus, calcify over time. A peculiar bone growth on the calcaneus is formed, which is called the calcaneal spur.

The main symptom of a heel spur is pain in the heel, which occurs or worsens in the morning after sleep at the first steps, after a person stays upright for a long time, when climbing stairs, after a long walk or run.

Reactive arthritis

This disease has an infectious etiology and is provoked by pathogens such as Yersinia, Salmonella, Shigella, Campylobacter, Clostridia, Chlamydia, Mycoplasma, etc.

The characteristic signs, in addition to heel pain, are the symptoms of inflammation - edema, redness, and an increase in local temperature.


As you know, osteoporosis is a systemic disease. With it, the density of all bones of the body, including the calcaneus, decreases. As a result, heel pain occurs. Another cause of heel pain in osteoporosis is an excessive load on the feet due to damage to the spine, as a result of which the load is distributed unevenly.

  • taking drugs that slow down bone resorption and promote bone formation,
  • medicines that have calcium and vitamin D.

Achilles tendonitis

This is an inflammation of the tendon that attaches the calf muscles to the calcaneus. This disease can be suspected by the following symptoms. The pain occurs along the tendon and spreads to the heel, the affected area turns red and swells, when standing on the legs, especially on the socks, there is a sharp pain, limiting foot mobility.


Diabetic heel pain is burning or shooting in nature. The patient is disturbed, both during exercise and during rest. Often accompanied by numbness of the limbs, a sensation of tingling and crawling “goose bumps”, dry skin, peeling, fungal infections, trophic ulcers.

It often happens that a person doesn’t know that he has diabetes, but the heel pain is so pronounced that it makes her seek medical help.

The principles of treatment are to compensate for diabetes and symptomatic therapy (oral hypoglycemic drugs, insulin therapy, vasodilator, metabolic drugs), physiotherapy.

Diabetic heel pain

For people with diabetes, a violation of blood circulation in the lower extremities is characteristic, as a result of which sensitivity to fungal infections and bacteria increases. The foot itself can withstand tremendous loads when walking and running, however, it is the calcaneus through which the blood vessels pass that is very vulnerable and sensitive to various injuries. The complexity of the treatment of this disease lies in the fact that nerve damage, characteristic of neuropathy, reduces sensitivity to pain, not allowing to detect wounds and cracks in the skin at the initial stage. Cramps can bother at night, the skin becomes dry, which leads to flaking. Periodic numbness and tingling of the lower extremities are also characteristic.Most often, the leg of a diabetic patient looks healthy, but shooting pains in the heels bother the patient.

Diabetic heel pain: causes, symptoms and treatment

  • Stabilizes sugar levels for a long time
  • Restores pancreatic insulin production

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Diabetes mellitus is dangerous consequences, which can lead to an uncontrolled course of the disease. Moreover, many complications progress unnoticed, which subsequently ends with disability or even death.

A common consequence of diabetes is skin problems with itching and dryness, pigmentation, and other symptoms. Another common complication of chronic glycemia is neuropathy, which is accompanied by severe heel pain.

At the beginning, such a condition can practically not bother a diabetic, only occasionally causing a feeling of discomfort. But subsequently, unpleasant symptoms become more severe, which significantly impairs the patient's quality of life, preventing him from even moving normally.

The specific structure of the heel and the causes of pain in it

Like the foot, the heel is a shock absorber when running and walking, thanks to which a person can walk straight. In the foot is the largest bone formation - the calcaneus, which is surrounded by fatty tissue. This bone has a special and ideal structure that allows it to perform the functions assigned to it.

Therefore, the heel can withstand heavy loads, and the impact force when running or walking is absorbed by its fatty tissues, thereby preventing damage to the spine. If the shape or anatomical integrity of the heel is changed, then its functions will be violated, which can lead to damage to the structures of the spinal cord and spine.

The calcaneus has a spongy structure, and its large size makes it quite fragile. Moreover, nerves and blood vessels pass through the calcaneus. Therefore, heel pain when walking can occur not only as a complication of diabetes, but also with minor damage.

The causes of discomfort in the heel are quite diverse. Conventionally, they can be divided into several groups. So, factors that are not related to diseases are:

  1. gradual obesity or a sharp increase in weight,
  2. prolonged overstrain of the foot structures (wearing uncomfortable shoes, flat feet),
  3. standing on your feet
  4. atrophy of the fatty subcutaneous calcaneal “pillow” that develops during excessive physical exertion or in the case of sudden weight loss.

Diseases of the foot structures that are accompanied by heel pain include bursitis, plantar or plantar fasciitis, hallux valgus deformity of the foot, tendonitis of the Achilles tendon, sensory hereditary neuropathy. Also included in these diseases are calcaneus papysitis or North disease, compression neuropathy of the plantar nerves or Morton neuralgia, tarsal canal syndrome and achillodynia.

Another cause of heel pain lies in the presence of injuries. This can be a bruise, a stretch or rupture of a tendon, a crack and a fracture of the calcaneus.

Common diseases that cause damage to joints and bones include:

  • cracks in the heels,
  • erythromelalgia,
  • infections
  • malignant formations in the bones of the legs,
  • gout,
  • metastatic disease
  • bone tuberculosis
  • rheumatoid arthritis,
  • osteomyelitis,
  • Ankylosing spondylitis.

The causes of pain in the heels of diabetes are poor blood circulation in the legs, which leads to increased sensitivity and the development of bacterial and fungal infections.

In addition, all this can be supplemented by various injuries, because the calcaneus is pierced by blood vessels, sensitive and very vulnerable.

Pain and cracks in the heels of diabetes

In diabetics, when nerve damage occurs during neuropathy, pain sensitivity decreases. Therefore, cracks and wounds at the initial stage of development practically do not cause discomfort.

But at night the patient is sometimes disturbed by cramps, and the skin on the legs peels and dries. Tingling and numbness in the extremities also periodically occur.

It is noteworthy that the leg can be healthy in appearance, but the shooting pain in the heels sometimes disturbs the patient.

The presence of cracks in the heels often speaks of metabolic disorders that occur in diabetes. Moreover, the patient may develop diabetic foot syndrome, which may even result in amputation of the limb. However, the symptoms of such a complication do not always make a person worry, because they are present even in healthy people:

How to prevent heel problems in diabetes

If there are cracks in the heels, the “healing cake” helps very well. To prepare it in the same amount, you need to mix aloe juice, onions, flour and fish oil.

The resulting mixture is applied to the heel at night, and a warm toe is put on top of the cake. The sutra compress should be removed, and then wipe the heels with a decoction of oak bark, and when they dry, apply a nourishing cream to them.

However, so that diabetes does not develop neuropathy and other complications, it is necessary to carry out not only local, but also general treatment. For this purpose, it is important to follow the principles of diet therapy for diabetes and exercise, and most importantly, regularly monitor the level of sugar in the blood stream, not allowing it to exceed the established range.

In addition, so that heel pain with diabetes becomes less intense, it is important not to forget about hygiene rules. So, every day you need to wash your feet with warm water and alkaline soap and then carefully dry your feet, paying close attention to the area between the toes.

Also, you need to carefully approach the choice of shoes. Diabetics should wear comfortable shoes, shoes, or sandals for people with foot problems.

Wearing slippers without a heel is not recommended, as the sole will spank when walking, creating an additional load for the heel.

As a result, the skin thickens, cracks form, and various foot diseases can develop.

To prevent the onset of DS syndrome, every diabetic should know how to properly care for his legs. For preventive purposes, the skin of the limbs should be regularly moistened with special creams, which will prevent the development of cracks.

The heel needs to be cleaned of excess skin and the corns appearing on the heels should be removed. But it is worth noting that with diabetes it is forbidden to soar your legs to soften the skin or apply chemical peeling agents. Also, it is impossible to leave the remains of a fat cream on the skin of the legs, because a moist and nutrient medium will become favorable for the development of a bacterial infection.

In the presence of spurs on the heels, topical corticosteroids and massage are indicated. Also an effective method of treatment is physiotherapy for diabetes and in advanced cases, surgical operations are performed.

However, in order not to be bothered by heel pain, diabetics should normalize their weight, which will solve several problems at once. Firstly, it will allow normalizing the level of glycemia, secondly - improving tissue regeneration, and thirdly, activating blood circulation in the limbs.

The video in this article talks about foot care for diabetes.

  • Stabilizes sugar levels for a long time
  • Restores pancreatic insulin production

Why are cuts and wounds so dangerous for this disease?

Diabetes mellitus is associated with an increase in blood sugar, because of this, the condition of small vessels deteriorates. Over time, they can completely collapse, leading to insufficient blood circulation in the lower extremities. In this case, long-term non-healing wounds may occur.If the appropriate treatment is not scheduled in time or if it is incorrect, gangrene may develop, leading to amputation.

Diabetes mellitus often causes a complication such as diabetic neuropathy. In this condition, prolonged healing of wounds and cuts is observed. This disease causes pathological changes in the nerve endings, as a result of which the lower extremities are most affected. In places of damage to nerve endings, the skin dries, which means a wound or cut that affects this area will heal worse. In addition, an infection that has penetrated the body can complicate the matter, and cracks in dry skin make the path much easier. The worst thing is that a person with impaired blood circulation loses sensitivity to pain, he may simply not notice that he was burned or scratched, and as a result, time is lost and nothing can be done.

A purulent ulcer that does not heal for a long time can occur on the body of a diabetic, even because of a slight injury to the foot, burn, callus or scratch. If an infection gets into the wound, this will be a big problem for the patient. Therefore, you must constantly monitor the condition of your skin and carefully examine the limbs and other places for wounds or calluses. If even the most minor defects occur, you should urgently seek help from a doctor.

Treatment of cuts and wounds with this disease

As soon as any wound or scratch appears on the body, it must be immediately treated with an antiseptic. At the same time, a patient with diabetes can have a fever, the affected area can hurt, swell, blush and oozing pus. Such signs should alert the person and encourage them to include an antibiotic ointment and other external agents that can draw moisture out of the wound for treatment with antiseptics. If necessary, the doctor may prescribe antibiotic tablets, as well as vitamins. At the first signs of improvement, treatment can be continued with other medicines, in particular, the doctor may recommend smearing the purulent wound with an ointment with a high concentration of fat, which improves tissue nutrition.

For the prevention and treatment of diabetic angiopathies and neuropathies, it is recommended to regularly take antioxidant drugs. They are able to prevent damage to blood vessels, strengthen and improve the condition of nerves.

In order not to bring the matter to such consequences and do without heavy treatment, diabetics need to follow these rules:

  1. Do not walk on the floor or the ground with bare feet.
  2. Do not wear shoes with a jumper between your toes in summer (slates).
  3. Buy and try on new shoes only in the afternoon, when the legs are already slightly swollen.
  4. Before you put on your shoes carefully inspect your shoes for foreign objects, sticking out studs, downed insoles, etc.
  5. For each season, buy several pairs of shoes and alternate them.
  6. Every day, carefully inspect the legs to timely detect wounds, abrasions, cracks in the heels and inflammation between the fingers. For convenience, you can take a mirror. If damage is found, consult a specialist immediately.
  7. Wash feet every day using products that do not dry the skin. It is impossible to smear the feet with petroleum jelly and other means with the addition of mineral oils, since they are not able to be absorbed into the skin.
  8. To quit bad habits is to give up cigarettes, because they worsen blood circulation, and therefore complicate the process of restoration of skin cells and healing of purulent wounds.
  9. Patients with diabetes need to carefully use a heating pad, fireplace or radiator, because you can accidentally get a burn.
  10. It is necessary to go out into the cold and frost only in warm shoes and be on the street in such weather for no more than 20 minutes.
  11. Do not lie in the bath for too long and do not wash in the shower for a long time.Water promotes swelling and loosening of the skin, which means an increased risk of damage.
  12. Do not treat wounds with pus with hydrogen peroxide, salicylic acid and iodine. Such treatment is dangerous for the skin of diabetics.
  13. In no case do not remove corns, warts and corns from the skin.
  14. With increased dry skin, the physician may prescribe the use of hypotonic drugs, in which there are no beta-blockers that can disrupt the excretory function of the skin.
  15. Examine the feet and nails regularly for fungal infections and purulent wounds.
  16. Do not wear underwear that squeezes the skin and rubs it with rubber bands and seams.

If you follow these recommendations, the risk of getting an ulcer or injury that does not heal well is minimized.

Diabetic foot syndrome: symptoms, signs and treatment

Diabetic feet are problems with the legs that occur due to high blood sugar. Diabetes, which is poorly controlled, disrupts the sensitivity of nerves (neuropathy), and also impairs blood flow in the vessels of the legs. This increases the risk of injury and infection. Diabetic foot syndrome - a patient develops ulcers, damage to joints and even bones on his legs. Wounds heal poorly, pathogenic microbes multiply in them. In advanced cases, this causes gangrene and amputation. The following describes the causes, symptoms, prevention and treatment of diabetic foot. Learn how to treat leg ulcers at home and in a healthcare facility. Gangrene, amputation and subsequent disability are a real threat to diabetes. But you can prevent it if you follow the rules of foot care.

  • The reasons
  • Symptoms
  • Signs
  • Diagnostics
  • Charcot's foot (diabetic osteoarthropathy)
  • Prevention
  • Foot Care: Detailed Instructions
  • How to buy shoes
  • Foot hygiene
  • Diabetic foot treatment
  • How to treat ulcers on the foot
  • Dressings Total Contact Cast
  • Medications - Antibiotics
  • Surgery, amputation
  • Orthopedic shoes
  • findings

If you have had diabetes for several years now, and even more so, if you have been controlling it poorly all this time, then there is a significant risk of damage to your leg. As you know, any wounds and injuries in patients with diabetes do not heal well. Even small damage can fester, develop gangrene, and the foot will need to be amputated. This is a common scenario. To avoid it, study and carefully follow the rules for foot care, which are listed below. If your legs hurt due to neuropathy, then read the article “Feet hurt in diabetes - how to be treated.” The following describes what to do if the sensitivity in the legs is, on the contrary, lowered. This happens more often. The diabetic does not feel pain in the legs, changes in temperature, load, cuts, blisters, pebbles falling into shoes, etc. You can live with this problem carefree, and then suddenly it turns out that the leg has begun to rot, and you need to lie down on the table to to the surgeon. Follow the recommendations below to maintain the ability to walk “on your own.”

The number of diabetes patients with leg problems is increasing all the time because the incidence of type 2 diabetes is increasing. On the territory of the Russian Federation and the CIS countries, more than 200 specialized offices of the diabetic foot work in regional centers. With the help of new modern methods, doctors are increasingly able to prevent amputations.

Endocrinology Research Center of the Ministry of Health of the Russian Federation, Department of Diabetic Footst. Dm Ulyanova, building 11(495) 500 00 90 Endocrinological Dispensary, Department “Diabetic Foot”st. Prechistenka, 37(495) 246-6573 Moscow center "Diabetic foot"st. Ivan Susanin, 3(495) 905-1666 Clinic of Endocrinology MMA named after THEM. Sechenova, cabinet of diabetic footst. Pogodinskaya, 5(495) 248-3866 Central Clinical Hospital of the Medical Center of the Office of the President of the Russian Federation, Department of Purulent Surgery with a profile of Diabetic Footst. Marshal Tymoshenko, 15(495) 414-0300 Center for the treatment of critical lower limb ischemiaMoscow region, Odintsovo, st. Marshala Biryuzova, 1(495) 599-72-41

Diabetic foot syndrome is treated by a special doctor called a podiatrist. Do not confuse it with a pediatrician.

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Center for Surgery of the Neuro-Ischemic Form of Diabetic Foot Syndrome and Critical Lower Limb Ischemiast. Leo Tolstoy, d. 6-8, building 38 - clinic of faculty surgery(812) 91-7-91-91 War Veteran Hospital, Diabetic Foot Cabinetst. Narodnaya 21a+7-911-225-72-65 Vascular Center. T. Topper at Clinical Hospital No. 122Culture Ave., 4+7 (812) 962-92-91 City center for limb rescue on the basis of St. Petersburg City Public Health Institution “City Hospital No. 14 ″st. Kosinova, d.19+7 (812) 786 76 76 City Diabetes Center №2st. Leni Golikova, d. 29-4(812) 757-30-78 City Diabetes Center №3st. Novocherkasskaya, d. 56, building 1(812) 444-14-63 City Diabetes Center №426 Obukhov Defense Ave.(812) 368-44-67 Territorial Diabetes Center GKDC No 1st. Siqueirosa 10-D(812) 296-35-06

To find specialists who are close to you, type in the search center “diabetic foot center your city, regional center” or “cabinet of your diabetic foot your city, regional center”. After that, you will immediately see what are the state medical institutions and private clinics.

Let's look at what causes foot problems in diabetes. In diabetics, blood circulation in the vessels that nourish the legs is often disturbed. Not getting enough nutrition, the skin on the legs becomes especially vulnerable to damage, and they heal slowly. Frost also negatively affects the skin of a person with diabetes, although healthy people tolerate winter cold without problems.

Since diabetic blisters, burns and abrasions are painless, they may not pay attention to their leg problems until gangrene begins.

Another manifestation of diabetic neuropathy is that the skin on the legs loses the ability to sweat and stays dry all the time. A dry skin, as you know, often crack. Cracks in the skin of the heels can turn into ulcers. Since these ulcers do not hurt, the diabetic does not take therapeutic measures, and the process moves to gangrene. Another form of diabetic neuropathy is one that blocks the functioning of the muscles in the feet. An imbalance of muscles occurs, which leads to deformation of the bones of the foot. This type of deformation includes bent toes or claw-shaped toes, as well as a high arch and a curved foot.

If diabetes has impaired vision, then developing foot problems becomes even more likely. Because a person does not see well where he steps when walking. Also, the risk of a diabetic foot is increased if the patient's legs swell due to kidney problems. Because edema increases the volume of the feet. Shoes become cramped, squeeze and injure the feet when walking.

What to do? The main remedy is to bring blood sugar back to normal with a low-carbohydrate diet. This is an essential tool to control type 1 and type 2 diabetes. Normalize your sugar - and the manifestations of diabetic neuropathy will pass. You will get rid of them within a few months, in severe cases - in 2-3 years. Study and follow a type 2 diabetes treatment program (see below) or type 1 diabetes treatment.

  • How to be treated for type 2 diabetes: a step-by-step technique
  • Type 2 diabetes medications: detailed article
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Persistent pain can be a symptom of sprains, foot deformities, bruising, overload, improper footwear, or infection.

Redness of the skin is a sign of infection, especially if the skin around the wound turns red. Also, poorly selected shoes or socks can rub the skin.

Leg swelling is a sign of inflammation, infection, improperly selected shoes, heart failure, or impaired blood circulation in the vessels.

An increase in temperature on the surface of the skin means an infection or inflammation that the body is trying to suppress but cannot cope with because the immune system is weakened by diabetes.

Any damage to the skin is serious because an infection can enter it.

Corns means that the shoes are improperly selected, and when walking the load on the foot is not properly distributed.

Fungal diseases of the nails and skin of the feet, ingrown nails - can lead to severe infections.

Pus flows from the wound - a symptom of an infectious infection.

Lameness or difficulty walking may indicate joint problems, a severe infection, or that the shoes are improperly selected.

A fever or chills combined with a wound on the leg is a sign of a serious infection that threatens death or amputation of the limb

Redness of the skin spreads around the wound - which means that the infection intensifies, the body cannot cope with it, and it needs help.

Numbness in the legs is a sign of impaired nerve conduction (diabetic neuropathy).

Leg pain is also a symptom of a diabetic foot, but it is treated separately. Read the article “Leg sore with diabetes: how to treat.”

Additional symptoms of circulatory disorders (intermittent claudication):

  • pain in the legs, which intensifies when walking and subsides at rest,
  • hair stops growing on the ankles and feet,
  • the skin on the legs coarsens and becomes dry.

  • calluses
  • blisters
  • nail ingrowth,
  • thumb bursitis
  • plantar warts,
  • hammer curvature of fingers,
  • dry and chapped skin
  • fungal disease of the skin of the feet (epidermophytosis of the foot),
  • nail fungus.

Corns arise when some part of the foot is subjected to excessive pressure or rubbing something. As a rule, the reason is poorly selected shoes. It is officially recommended that corns be carefully removed with a pumice stone after a bath. Dr. Bernstein objects: Do not remove corns at all! Do not do this yourself and do not let anyone, including a doctor. Because the wound will remain at the place of removal of the corn, which is highly likely to turn into an ulcer.

Dr. Bernstein points out that removing corns is the main cause of ulcers, which the infection then infects. Next - gangrene and amputation ... Instead of removing corns, order and wear good orthopedic shoes. After that, the load on the foot when walking will be distributed correctly, and the corns will gradually pass by themselves.

Blisters are bulging skin areas filled with fluid. The blister is formed due to the fact that the shoes constantly rub the same area on the foot. A blister may also appear if you wear shoes without socks. To avoid blisters, shoes should be well sized, and don’t go without socks. If there is a blister on the leg, a diabetic patient must definitely see a specialist. The doctor will apply the bandage correctly. If an infection develops, the doctor will remove pus from the blister and prescribe antibiotics.

Nails grow if a person does not cut them properly or wears too tight shoes. Do not cut the nails around the edges. It is advisable not to cut them with scissors, but to process them with a nail file. A patient with diabetes cannot be left without an ingrown nail; he needs to see a doctor. Perhaps the doctor decides to remove part of the nail to prevent further ingrowth. This is a lesser evil than an infected wound, gangrene and amputation. If an infection has already appeared in the toe, the doctor will prescribe antibiotics.

Bursitis is a bulge on the outer edge of the big toe. Over time, it can fill with bone tissue and fluid. Bursitis is formed if the thumb deviates to the side of the other fingers. This could be a hereditary problem.High heels and pointed toe shoes also increase your risk. To prevent bursitis from growing, the doctor may suggest using soft insoles for shoes. Pain and inflammation are relieved with medication. If bursitis causes frequent bouts of severe pain, then it is removed surgically. For prevention, wear shoes that fit your size well.

Plantar warts are small growths of flesh-colored. Sometimes they have tiny black dots. Plantar warts cause the human papillomavirus. This virus penetrates through minor lesions on the skin of the legs. Warts can be painful and interfere with walking. To reduce their spread, wash your hands every time you touch your soles. Feet should be clean and dry. Do not go barefoot in public places. Your doctor may suggest removing plantar warts with a laser, liquid nitrogen, or surgically under local anesthesia.

The hammer-like curvature of the fingers occurs due to the fact that one or two joints of the small toes bend unnaturally. This is because the muscles in the foot weaken due to diabetic neuropathy. If there is a problem of bending the fingers, then the shape of the feet changes. There may be difficulty walking. It’s hard to find the right shoes. The main danger - wounds and ulcers that are susceptible to infection can occur. Treatment - orthopedic insoles in shoes, as well as medicines for pain and inflammation. In extreme cases, a surgical operation.

Dry and cracked skin is rough and peeling. Skin color changes, it can itch. There are various causes for this problem — high blood sugar, nerve damage, and poor blood flow to the legs. Cracks in the skin are dangerous because an infection settles in them. Maintain the moisture and elasticity of your feet skin. Lubricate it regularly with oil as described below in the “Foot Care: Detailed Instructions” section. If you can not cope and the skin condition worsens, see a doctor. You may be prescribed a prescription for a powerful ointment. Talk with your doctor about vitamin A and zinc supplements. Do not arbitrarily take these funds! Of course, the main thing is to lower blood sugar and keep it stably normal.

Fungal diseases of the skin of the feet are manifested by symptoms - itching, burning, redness, cracks in the skin. The fungus multiplies on the soles and between the toes. To prevent it, keep your feet as dry as possible. Do not wear the same pair of shoes all the time. Have a few pairs of shoes to alternate them. While you wear one, the other dries. During the night, the shoes do not have time to dry. In public places do not go barefoot, wear slippers. Socks should be made of natural material - cotton or wool. The pharmacy sells creams and sprays against the fungus on the legs. If necessary, the doctor will prescribe a prescription for potent pills.

Nail fungus - the same preventive measures as for fungal diseases of the skin of the feet. The fungus makes the nails tight, it becomes difficult to cut them. The color of the nail changes. Sometimes the nails affected by the fungus fall off. The doctor may prescribe pills, remove the nail surgically or chemically. The nail fungus is also treated with a laser, but there is still debate among experts about how well this method helps.


Leg problems in diabetes can be caused by impaired nerve conduction, clogging of blood vessels that feed the legs, or both. This is called a neuropathic, ischemic, or mixed form of diabetic foot syndrome. The doctor determines the form of the disease and makes a diagnosis in order to prescribe the optimal treatment.

What the doctor usually does

Visually inspects the patient's legsIdentify what are the signs of a diabetic foot (see above)X-ray or magnetic resonance scan of the feetCheck for bone damageTest for sensitivity to vibration, temperature, touch, and knee reflexes.To establish how severe diabetic neuropathy is in a patientInspects Patient's ShoesTo evaluate how the shoe is suitable in size and fullness, whether there are foreign bodies in it, if the sole is not stoppedSends wound contents for bacteriological analysisFind out which antibiotics can help and which ones can't.

  • Ultrasound of the vessels of the lower extremities,
  • M-mode ultrasound dopplerography (USDG),
  • measurement of the ankle-brachial index,
  • transcutaneous oximetry.

There is another study - radiopaque angiography. A radioactive contrast agent is injected into the patient’s blood, which “glows” through the walls of the vessels. This study is the most informative, but may cause side effects from the kidneys. Therefore, it is prescribed with caution. However, if a surgical operation is planned to restore blood flow in the vessels, then it is mandatory.

0There are no ulcers yet, but the risk is high - corns, foot deformity 1Superficial ulcers 2Deep sores. Tendons but not bones may be affected. 3Deep ulcers with bone damage 4Gangrene on toes 5Full-foot gangrene

The prognosis depends on the length of diabetes, how well the patient is treated, whether he is motivated to comply with the regimen. Concomitant diseases are also important - atherosclerosis, hypertension, complications of diabetes in the kidneys and eyesight, senile dementia. Therefore, when a diabetic goes to the doctor because of leg problems, the examination should be comprehensive.

  • Diabetes Tests - Detailed List
  • Blood sugar standards - what you need to strive for

Charcot's foot (diabetic osteoarthropathy)

Charcot's foot (diabetic osteoarthropathy) is a complication of diabetes, as a result of which joints and soft tissues of the foot are destroyed, its shape changes. At an early stage, the joints become stiff and swell. Later, the muscles weaken and cease to cope with the load. Because of this, there are problems with bones, the foot is deformed. All this usually happens quickly.

The reason for the development of Charcot's foot is diabetic neuropathy. Damaged nerves cannot transmit signals from the leg to the brain. Therefore, a person incorrectly puts his foot while walking. The destruction of joints and bones causes pain, but the diabetic does not feel it. He continues to exert pressure on the affected foot until a change in the shape of the leg becomes clearly noticeable.

  • the skin of the foot turns red, the temperature on its surface rises,
  • the leg swells
  • pain can be felt, but more often absent due to neuropathy.

Treatment of diabetic osteoarthropathy - the leg is placed in a special bandage made of polymer materials. This makes it possible to relieve the affected areas of the foot. It is likely that the doctor will prescribe the patient to walk with crutches or even get into a wheelchair. Sometimes the curved shape of the bones is brought back to normal with surgery.

North Disease

The second name is epiphysitis. The disease occurs mainly in 9-14 year old children (especially often in athletes), because the calcaneus has not yet completely ossified.

Such a diagnosis is made if there is a gap between the body of the calcaneus and the apophysis. Symptoms

  • Heels hurt when walking, running.
  • It hurts a child to get up on his toes.
  • At the place of separation, swelling can be noticed.
  • Limited movement in the calf muscle of the leg.
  • Sometimes the temperature rises.


Prevention is the careful implementation of the rules of foot care and daily inspection of the feet. Foot care recommendations are given below. Now we will discuss how to examine the feet of a patient with diabetes, what to look for. Feet should be inspected daily, first from above, and then from the side of the sole. Check the skin between your toes carefully. You may need a mirror for this. It is advisable that someone else participate in the examination of the feet, and not just the diabetic himself.

The task of the examination is not to be missed if new corns, swelling, bruising, painful areas, skin lesions, or any other changes appear. The shape, color and temperature of the foot may vary. Sensitivity to touch - weaken or vice versa intensify. If you notice that the changes are proceeding for the worse - the next morning, consult a doctor, do not pull. There may be small fractures and fissures of bones, due to which the foot swells, its shape changes. This requires urgent attention from the doctor.

Even minor damage can turn into a trophic ulcer, which will be long and difficult to heal. In the case of bacterial infection of the wound, gangrene will develop, and it may turn out that only amputation will save the diabetic from death.

If the skin of the feet becomes darker or vice versa lightens, hair disappears on it - this means that the blood supply to the legs is deteriorating. The worse the supply of oxygen and nutrition to the cells, the longer the damage to the skin heals. Check if the skin's sensitivity to touch is getting worse. To do this, you can use, for example, feathers. Make sure that a diabetes patient can feel the difference between warm and cold water when they lower their foot into the water. Before taking a bath, you need to check the temperature of the water by hand. In any case, a bath thermometer must be had and used.

Diabetic foot syndrome usually develops because the patient has a leg injured, but he does not feel it. The purpose of the daily examination is to identify negative changes that the diabetic did not notice at the moment they occurred. Doctors now have effective modern dressings and ointments. These are tools that help heal wounds on the legs, prevent infection, gangrene and amputation. But still, you need to consult a doctor on time. When gangrene has already begun, there is no other way than amputation.

Follow the rules for foot care, inspect the feet daily and consult a doctor as soon as something seems suspicious to you. The main way to prevent and treat a diabetic foot is to lower blood sugar to normal, and then maintain it stably normal, as in healthy people. This can be achieved with type 1 and type 2 diabetes with a low-carb diet. Control your metabolism - and most of the symptoms of diabetic neuropathy will pass over time. In particular, the sensitivity of the legs will be restored. Also damage to the skin on the legs will heal. But, unfortunately, if the blood vessels are clogged, then their patency just can not be restored. Also, if you had fractures or dislocations of the bones of the foot, then this is incurable.

Foot Care: Detailed Instructions

The following are the rules for foot care for type 1 and type 2 diabetes. If the sensitivity of the legs to temperature, pain and pressure is largely lost, then they must be performed especially carefully. This is the only way to not get on the operating table to the surgeon who is engaged in amputations.

At the same time, if you carry out a type 1 diabetes treatment program or a type 2 diabetes treatment program and keep your blood sugar stable and normal, then over time, nerve sensitivity is restored. After that, the risk of fatal leg problems in diabetes is reduced to zero. The restoration of nervous sensitivity takes at least several months, and usually 1-2 years.

Quit smoking! Smoking worsens the blood circulation in the legs and, therefore, increases the chances that amputation will need to be done sooner or later.

The danger of burning your legs is high, because the sensitivity of the feet to temperature is weakened. Keep your feet as far away from heat sources as possible. This means no fireplaces, heaters, hot water bottles or electric blankets. In a bath or shower, the water should be cool, not even warm.

In cold weather, wear thick warm socks and shoes of sufficient width so that it does not put pressure on your feet in socks. Whether blood circulation is disturbed in the vessels of the legs can be checked at the doctor’s appointment with the help of a painless study called “transcutaneous oximetry”. If it turns out that it is broken - do not stay in the cold for longer than 20 minutes in a row. Never go barefoot, neither on the street, nor even indoors.

If you lubricate your feet with any medicine, then do it only as directed by your doctor. Many common products that are sold over the counter in a pharmacy are dangerous for the skin of the legs of a diabetic patient. For example, iodine, hydrogen peroxide and salicylic acid. Do not use iodine or hydrogen peroxide to disinfect leg wounds, even if your doctor advises it. Buy a special iodine in the pharmacy that does not burn the skin, and keep it handy.

If you have dry skin on your legs, then ask a cardiologist or therapist to not give you beta-blockers for high blood pressure or heart problems. Because taking drugs from the beta-blocker group will further complicate the hydration of the skin of your legs. How to treat cardiovascular disease without harmful “chemical” pills, read here - this is a site for the treatment of hypertension, akin to Diabet-Med.Com.

If corns appeared on your legs, then do not try to remove them! Do not use nails, a scalpel, or other objects. Do not remove corns yourself and do not let anyone do this, including the podiatrist. Rough skin on calluses is the protection of the soles of the feet from damage due to poorly selected shoes. If you remove the corns, then this protection disappears.

Removal of corns in patients with diabetes is the most common cause of ulceration, which then leads to amputation of the foot. In case of calluses on the legs, you need to switch to comfortable orthopedic shoes. If the shoes were chosen correctly, then there will be no excess load on the soles of the feet, and with time the corns will disappear themselves.

If a diabetic patient has thinner toenails, then you need to find out if the fungus is the cause of this. If it turns out that this is really a fungal infection, then the doctor will prescribe a remedy that needs to be applied to the affected nails twice a day. Unfortunately, the fungus usually has to be treated for 12 months or even longer. Not only local remedies may be needed, but also taking anti-fungal tablets.

It is advisable to print on the printer the rules for foot care, which are given above, as well as the section "How to observe foot hygiene." Re-read this material periodically and introduce family members to the diabetes patient with it. If you diligently follow a type 1 diabetes treatment program or type 2 diabetes treatment program, you can keep your blood sugar stable and normal. After a few months, the sensitivity of the nerves in the legs begins to recover gradually. Not later than after 2-3 years, she will recover completely. The risk of diabetic foot syndrome or gangrene will decrease to almost zero.

How to buy shoes

Buy or order all shoes not in the morning and not during the day, but in the evening, because in the evening the maximum foot size. Shoes should be comfortable as soon as you try on them for the first time. It should not be necessary to wear new shoes. Shoes with pointed toes should not be worn. You need shoes with wide and deep space for the toes. Orthopedic shoes are a good choice. It does not look very aesthetically pleasing, but it is comfortable and increases the likelihood that you will be able to save your legs without damage.

Never wear a sandal with a strap between your toes. Because the strap can rub your skin. Blisters will appear, which will then turn into an ulcer. Do not wear the same shoes for several days in a row. Have a few pairs of comfortable shoes to alternate them every other day. Each time, before putting on a shoe, inspect it from the inside.There should not be any third-party objects - pebbles, etc.

Do not wear stockings or socks with tight elastic bands that compress the legs and impair blood circulation in the vessels. Do not wear socks with holes or darned. Do not wear socks that are too sore or with thick stitches. Problematic socks can damage the skin of the legs, cause a blister first, then an ulcer and then up to gangrene and amputation. Saving on linen can result in irreparable losses due to disability.

Foot hygiene

Every day you need to examine the feet of a patient with diabetes, whether there were any new injuries or signs that the shoes were uncomfortable. Make sure that there are no blisters, corns, cracks, traces of fungus or other damage to the skin of the legs. Also check the skin between your toes. Inspect the soles with a mirror. If a diabetes patient cannot do this himself, then he needs the help of another person. If you find any damage to your legs, contact your doctor immediately.

Do not check the temperature of the water in the bathroom with your foot, but only with your hand, even better - buy and use a bath thermometer. The water temperature in the bathroom should not be higher than 33 degrees Celsius. Because even a water temperature of 34 degrees Celsius can cause a burn if blood circulation in the vessels is disturbed.

Never immerse your feet in water for longer than 3-4 minutes. Otherwise, the skin on the feet will get wet, and for soaked skin, the risk of damage increases. To comply with this rule, do not stay too long in the bathroom or in the shower. Wash quickly and go out. Try not to get wet. If there is a threat of developing a diabetic foot, then rainy weather is dangerous. Wet shoes and feet - not advisable.

If you like to swim in the pool, then before climbing into the water, apply mineral oil (petroleum jelly) to the skin of your feet to protect them from water. After you finish swimming, remove the petroleum jelly from your feet with a towel.

If your skin on your feet dries up, lubricate it at least once a day, as often as possible. This will reduce the risk of cracking. Greasy creams and ointments are suitable.

In cold weather, wear warm socks made of natural material and comfortable shoes of the appropriate size. Do not wear socks with tight elastic that compresses blood vessels and impairs blood circulation. If you have poor circulation in your legs, do not stay in the cold for longer than 20 minutes in a row.

Cut toenails only if you see clearly what you are doing. If not, ask outside help for this. If you suspect that your toenails are affected by a fungus, show the doctor and he will prescribe treatment. Your feet should be dry and warm all the time, not freeze, not overheat, and not sweat.

Diabetic foot treatment

Diabetic foot treatment is a set of measures in several areas:

  1. Training the patient in skills - daily examination of the feet, changing dressings and other necessary actions.
  2. Control of sugar, blood pressure and blood cholesterol.
  3. Wound treatment - dressing, surgical removal of non-viable tissue.
  4. Antibiotics to fight infection.
  5. The Total Contact Cast dressing, which relieves the affected areas of the foot from excessive pressure.
  6. Restoration of blood circulation in the legs, including through vascular surgery.

Often in patients with diabetes, nerve sensitivity is impaired and therefore the legs do not hurt, despite the damage. At the same time, treating a diabetic foot is a lot of trouble. Therefore, some patients are tempted to let the disease drift. As a result, they will be on the operating table to the surgeon. Because if microbes freely propagate in the wounds on the legs, then they cause gangrene. Amputation can only be prevented if treatment is started on time and the regime is disciplined.

How to treat ulcers on the foot

Ulcers on the feet of patients with diabetes often do not cause pain due to neuropathy - impaired nerve sensitivity. But this is not good news, but rather a problem. Because the lack of pain leads patients to the temptation not to be treated. Such irresponsible diabetics catch on only when the leg begins to rot. Pay attention to the treatment and prevention of diabetic foot in order to prevent amputation, to maintain the ability to walk normally.

  1. Careful control of blood sugar is needed, otherwise there will be no success.
  2. It may be necessary to remove non-viable tissue. For this, there is not only a surgical scalpel, but also other methods (see below).
  3. The wound must be kept clean and protected from external influences.
  4. Inspect the damaged area daily, change the bandage, and follow other doctor's instructions.
  5. Try to walk less until the ulcer on the foot heals.
  6. Walking barefoot is strictly prohibited.

Since the 2000s, doctors have appeared in the arsenal of many different types of dressings for treating foot wounds in diabetics. A dressing can absorb pus from a wound and contain a disinfectant. Using a dressing, you can apply enzymes to the ulcer that remove non-viable tissue, instead of removing them surgically. Modern dressings are an effective tool that significantly speeds up healing.

It used to be that wounds should be left open because air helps them heal. Doctors now know that wounds heal faster, and the risk of infection is less if you keep them moist and cover them with bandages. Since the early 2000s, treatment for foot ulcers has improved significantly. There are even bandages in the form of foam or a transparent film, instead of good old bandages. The choice of a specific treatment option is carried out by the doctor. However, the importance of good blood sugar control has not been canceled.

If the patient is not admitted to the hospital, but sent home for treatment, then, in addition to dressings, antibiotics in tablets may be prescribed. They must be taken exactly as prescribed by the doctor. You can neither reduce the dose nor increase them arbitrarily. Before prescribing antibiotics, the doctor can send tissue samples for analysis to find out which microbes specifically caused the infection. You will need to visit a doctor every few days for repeated examinations.

Ulcers on the feet often appear due to the fact that the load is not properly distributed when walking. To cure a patient from an ulcer, it may be necessary to reduce pressure on the affected part of the foot. To do this, use the Total Contact Cast dressings, which are described in detail below. In addition to the bandage, the patient will need to order orthopedic shoes. Perhaps the doctor will insist that you temporarily wear crutches or even move into a wheelchair. If this helps prevent amputation, do not refuse.

Dressings Total Contact Cast

To ensure the unloading of the affected foot from excessive pressure is an important condition for the successful healing of wounds on the sole. And even more so, for the treatment of diabetic neuroosteoarthropathy (Charcot's feet). Studies have convincingly proven that an effective tool is to use the Total Contact Cast individual polymer dressing.

This bandage limits the mobility of the foot and leg. Today, it is the first tool to reduce the frequency of complications: chronic ulcers, deformations and destruction of joints, as well as gangrene, which leads to amputation. The total contact cast can be applied by an endocrinologist or surgeon at a clinic or hospital.

Total Contact Cast is a semi-rigid bandage on the shin and foot, which is made of modern polymeric materials. When using it, the affected area of ​​the diabetic foot is unloaded, due to the following mechanisms:

  1. Up to 30% of the load is transferred from the foot to the lower leg.
  2. The area of ​​the supporting surface of the foot increases by 15-24%.In this case, the load on different sections is distributed more evenly. Thus, the peak load on the main reference points is reduced by 40-80%.
  3. The dressing protects wounds from horizontal friction.
  4. Swelling of the legs is reduced.
  5. After dressing for extra protection and patient resilience, Total Contact Cast wears Cast Shoe, a platform with clasps.

For movement on the street individually made orthopedic shoes are used. In this case, the patient is instructed to limit walking to 30% of his usual distance.

Indications for use of an individual polymer dressing Total Contact Cast:

  • acute stage of diabetic osteoarthropathy,
  • the chronic stage of osteoarthropathy, which was complicated by the development of a foot ulcer,
  • bilateral localization (on both legs) of osteoarthropathy and / or foot ulcers.

An absolute contraindication to the use of Total Contact Cast is an active infectious process in the deep tissues of the foot, as well as gangrene or sepsis.

    severe ischemia (circulatory disturbance) of the extremity, if the ankle-brachial index Medications - antibiotics

If the wound is infected or there is a high risk of infection of the diabetic foot, antibiotic therapy is prescribed. Its success depends not only on the correct choice of antibiotic and method of administration, but also on the surgical treatment of the wound. This treatment should be timely and adequate, especially when the infection is severe and deep. Surgical treatment of the foot should not be postponed, but should be carried out at the same time when antibiotic therapy is prescribed. It should be radical, i.e., affect all infected and non-viable tissues.

If the patient has these signs, then it is obvious that he needs to be treated with antibiotics, and in adequate doses, and start quickly. But in diabetes mellitus, especially in elderly patients, the immune system often turns out to be hyporeactive, i.e., it weakly responds to infection. In such cases, the symptoms mentioned above do not appear, and the doctor has to prescribe antibiotics, focusing on the local manifestations of the infection.

In acute and chronic wounds, the signs of infection are different. In the first case, it is a tumor, swelling, pain, fever of the skin surface, pus is released from the wound. In chronic wounds, signs of infection are the appearance of pain in the wound and surrounding tissues, an unpleasant odor, an increase in the size of the wound, a change in the color of the “crust”, and discharge of pus or blood from the wound.

For the treatment of diabetic foot, antibiotics can be administered intravenously in a hospital setting, or the patient can take them at home in pill form. The first method is necessary if the infection is severe, and it threatens the patient's life or the safety of the limb. If a diabetic patient is diagnosed with phlegmon, deep abscesses, wet gangrene or sepsis, then antibiotic therapy is carried out intravenously. It is combined with surgical drainage of purulent foci, detoxification and measures to normalize blood sugar. All this is done in a hospital.

If the purulent foci are not deep and there are only local signs of infection in the wound, then the patient can take antibiotics in the form of tablets and not go to the hospital. It is important to note that due to autonomic neuropathy, the absorption of nutrients and drugs in the gastrointestinal tract may be impaired. In this case, it is necessary to switch to the intravenous administration of antibiotics.

(end of 2011)
Attention! This information is a “cheat sheet” for doctors only! Patients - do not take antibiotics yourself. Consult a qualified doctor!

Orally (tablets, by mouth)IntravenouslyStaphylococci (Staphylococcus aureus)

  • Clindamycin 300 mg 3-4 times a day
  • Rifampicin 300 mg 3 times a day
  • Flucloxacillin 500 mg 4 times a day
  • Clindamycin 150-600 mg 4 times a day
  • Flucloxacillin 500 mg 4 times a day
Methicillin-resistant Staphylococcus aureus (MRSA)
  • Trimethoprim 200 mg 2 times a day
  • Rifampicin 300 mg 3 times a day
  • Doxycycline 100 mg / day
  • Linezolid 600 mg 2 times a day
  • Vancomycin 1 g 2 times a day
  • Linezolid 600 mg 2 times a day
  • Daptomycin 300-600 mg 1 time per day
  • Amoxicillin 500 mg 3 times a day
  • Clindamycin 300 mg 3-4 times a day
  • Flucloxacillin 500 mg 4 times a day
  • Erythromycin 500 mg 3 times a day
  • Amoxicillin 500 mg 3 times a day
  • Clindamycin 150-600 mg 4 times a day
  • Amoxicillin 500 mg 3 times a day
  • Amoxicillin 500 mg 3 times a day
  • Metronidazole 250 mg 4 times a day
  • Clindamycin 300 mg 3 times a day
  • Metronidazole 500 mg 3 times a day
  • Clindamycin 150-600 mg 4 times a day
Coliform (E. coli, Proteus, Klebsiella, Enterobacter)
  • Ciprofloxacin 500 mg 2 times a day
  • Cefadroxil 1 g 2 times a day
  • Trimethoprim 200 mg 2 times a day
  • Ciprofloxacin 200 mg 2 times a day
  • Ceftazidime 1-2 g 3 times a day
  • Ceftriaxone 1-2 g / day
  • Tazobactam 4.5 g 3 times a day
  • Trimethoprim 200 mg 2 times a day
  • Meropenem 500 mg-1 g 3 times a day
  • Ertapenem 500 mg-1 g per day
  • Ticarcillin clavulanate 3.2 g 3 times a day
Genus Pseudomonas (P. aeruginosa)
  • Ciprofloxacin 500 mg 2 times a day
  • Ceftazidime 1-2 g 3 times a day
  • Meropenem 500 mg-1 g 3 times a day
  • Ticarcillin clavulanate 3.2 g 3 times a day

Often, patients with diabetic foot syndrome are combined with impaired renal function. In such a situation, if antibiotics or other drugs are prescribed in standard therapeutic doses, significant harm can be done to the patient's health. Why is there such a risk:

  • if the excretory function of the kidneys is reduced, then the likelihood that the drug and its metabolites will have a toxic effect on the body increases,
  • in patients with impaired renal function, tolerance to side effects of drugs is often reduced,
  • some antibiotics do not fully show their properties if the excretory function of the kidneys is weakened.

Given these factors, if a patient has diabetes complications of his legs combined with nephropathy, then the doctor should individually adjust the choice of antibiotic and its dosage

Surgery, amputation

Surgical treatment of a wound is the removal of dead skin and pus. It must be done so that tissues that have died out do not serve as a haven for harmful bacteria.

How is this procedure carried out:

  1. The skin is cleaned and disinfected.
  2. It is determined how deep the wound is and whether any foreign object fell into it.
  3. The doctor removes dead tissue with a scalpel and surgical scissors and then flushes the wound.

At the end of the surgical treatment, the wound may appear larger and deeper than before. It should be pink or red, looking like fresh meat.

In addition to surgery, there are other ways to treat a wound:

  • Enzymes can be applied that dissolve non-viable tissue.
  • Even special insect larvae are used, which eat only dead cells. At the same time, they secrete substances that stimulate the healing of ulcers.

The method with larvae has been known since the First World War. Since the 2000s, interest in him has returned again.

Wound treatment is not considered a surgical operation. Real surgery comes into play only if all other treatments have failed. A description of the intricacies of amputation is beyond the scope of this article. Healing after surgery may take several weeks or months, depending on how well the patient controls his diabetes.

Orthopedic shoes

Orthopedic shoes are the most important preventive measure for diabetic foot syndrome. If the patient wears orthopedic shoes suitable for him, then this reduces the likelihood of ulcers on the foot by 2-3 times.

A toe cap is a piece of solid material that reinforces shoe socks. In orthopedic shoes there should not be a hard toe cap. The top of the shoe should be soft, comfortable and safe for the diabetic toe. There should be no seams in the interior of orthopedic shoes so that there are no scuffs.

The sole should be rigid, i.e. solid, not elastic.Thus, the pressure in the area of ​​the front plantar surface of the foot is reduced, and the load on the sections of the foot is distributed more evenly. Orthopedic shoes should be ideally convenient and comfortable from the first fitting.

After reading the article, you have learned everything you need about diabetic foot syndrome. Numerous photos are presented that will help you assess the situation - how badly your legs are affected and what is the prognosis. Diabetic foot is a formidable complication of diabetes that can lead to amputation. However, not all patients are doomed to become disabled. Follow the recommendations given above - and guaranteed to save the opportunity to move "on your own." The main thing is to see a doctor on time as soon as you discover any damage to your legs. Doctors now have effective dressings and ointments in their arsenal that fight infection and stimulate healing.

Do not count on any miracle pills. Do not take antibiotics on your own initiative! The main thing is that the patient begins treatment on time, even if his legs are not yet sore. You can try alpha lipoic acid to relieve diabetic neuropathy and restore sensitivity in the legs. But the best thing you can do is switch to a low-carbohydrate diet to normalize your blood sugar. Read more about the treatment for type 2 diabetes and the treatment for type 1 diabetes. A low-carbohydrate diet lowers sugar and helps keep it stably normal, as in healthy people. Due to this, diabetic neuropathy goes away. Sensitivity in the legs is fully restored. This is a real way to recover from a diabetic foot and other complications.

Cracks in the heels of diabetes and treatment

Pharmacies once again want to cash in on diabetics. There is a sensible modern European drug, but they keep quiet about it. It.

Cracks in the heels can indicate a serious metabolic disturbance in the body, characteristic of diabetes. Symptoms such as dry skin, calluses, peeling and itching of the skin can occur in any person. But in people with diabetes, such manifestations can lead to a disease such as a diabetic foot, which often leads to amputation. Therefore, timely treatment to a doctor and treatment are very important.

The so-called “healing cake”, which is prepared as follows, helps very well with cracked heels in diabetes mellitus.

It is necessary to mix equal amounts of onion juice, aloe, add the same amount of fish oil and flour. The prepared cake should be applied to the heel at night, putting on a sock over it. In the morning, removing the healing mixture, it is necessary to wipe the heels with a decoction of oak bark, allow to dry and grease with a nourishing cream.

In general, patients with diabetes with such symptoms should follow a diet recommended by a doctor. It is also necessary to control blood glucose, adhering to the required range.

Particular attention should be paid to hygiene. In particular, you should wash your feet daily in warm water with soap that does not contain alkali, and be sure to thoroughly dry your feet, especially between your toes.

The choice of shoes should also be approached thoroughly: wear only comfortable shoes that are sold in special stores for people with foot pathologies. Wearing slippers without backdrops is not recommended, despite their convenience. The sole splashing when walking increases the load on the heels, which contributes to thickening of the skin and the formation of cracks and other diseases of the legs.

I had diabetes for 31 years. He is now healthy. But, these capsules are inaccessible to ordinary people, they do not want to sell pharmacies, it is not profitable for them.

Symptoms and treatment of diabetic foot, foot care for diabetes

Diabetes mellitus is a serious chronic disease, which is accompanied by a huge number of complications.The most formidable of them can be considered diabetic foot syndrome (SDS). According to the World Health Organization, this syndrome occurs in 15% of patients with diabetes 5 years or more.

Diabetic foot syndrome - pathological changes in the nervous system, arterial and capillary beds, which can lead to the formation of ulcerative necrotic processes and gangrene.

About 85% of such cases are trophic foot ulcers, the remainder are abscesses, phlegmon, osteomyelitis, tendovaginitis and purulent arthritis. This also includes non-purulent destructive damage to the bones of the extremities - diabetic osteoarthropathy.

The main causes of diabetic foot syndrome

In diabetes, there is insufficient production of the hormone - insulin, the function of which is to help glucose (sugar) reach the body's cells from the bloodstream, so when it is deficient, glucose rises in the blood, eventually disrupting blood flow in the vessels, affecting nerve fibers. Ischemia (lack of blood circulation) leads to impaired wound healing, and nerve damage leads to a decrease in sensitivity.

These disorders contribute to the development of trophic ulcers, which in turn develop into gangrene. Any cracks, abrasions turn into open ulcers, and also hidden ulcers form under calluses and keratinized layers.

The reason for the late start of treatment and amputation of the extremities is that the patient for a long time does not notice the changes that occur, since most often he does not pay attention to his feet. Due to poor blood supply to the legs amid decreased sensitivity, pain from cuts and scuffs is not felt by the patient and even an ulcer can go unnoticed for a long time.

Usually, the foot is affected in places where all the load is necessary when walking; cracks form under the skin layer, into which the infection gets, creating favorable conditions for the appearance of a purulent wound. Such ulcers can affect the legs up to the bones, tendons. Therefore, ultimately, the need arises for amputation.

In the world, 70% of all amputations are associated with diabetes, and with timely and constant treatment, almost 85% could be prevented. Today, when the Diabetic Foot offices are operating, the number of amputations has been halved, the number of deaths has decreased, and conservative treatment is 65%. However, the actual number of patients with diabetes mellitus is 3-4 times higher than the statistical data, since many do not suspect that they are sick.

So, the causes of the development of diabetic foot syndrome are:

  • decreased limb sensitivity (diabetic neuropathy)
  • circulatory disorders in arteries and small capillaries (diabetic micro- and macroangiopathy)
  • foot deformity (due to motor neuropathy)
  • dry skin

Decreased Sensitivity - Diabetic Distal Neuropathy

The main cause of nerve damage is the constant effect of high glucose levels on nerve cells. Such a pathology in itself does not cause tissue necrosis. Ulcers occur for other, indirect reasons:

Ulcers formed after mikrossadin, cuts and abrasions, heal very poorly, acquiring a chronic course. Wearing uncomfortable and tight shoes exacerbates damage to the skin. Trophic ulcers, growing and deepening, pass to muscle and bone tissue. According to studies, the development of neuropathic ulcers in 13% of cases leads to excessive thickening of the stratum corneum of the epidermis (hyperkeratosis), in 33% - the use of inadequate shoes, in 16% - the treatment of the foot with sharp objects.

Blood flow disorder - diabetic macroangiopathy

The deterioration of blood flow in the arteries of the legs is associated with atherosclerotic plaques (see how to lower cholesterol without drugs). Atherosclerosis, which causes damage to large vessels, with diabetes is difficult and has a number of features.

  • affected lower parts of the leg (lower leg arteries)
  • damage to the arteries of both legs and in several areas at once
  • starts at an earlier age than patients without diabetes

Atherosclerosis in a patient with diabetes mellitus can cause tissue death and the formation of trophic ulcers on their own, without mechanical stress and injuries. An insufficient amount of oxygen enters the skin and other parts of the foot (due to a sharp violation of blood flow), as a result, the skin dies. If the patient does not follow safety precautions and additionally injures the skin, then the damage zone expands.

Typical clinical symptoms are pain in the foot or peptic ulcer, dryness and thinning of the skin, which is highly susceptible to microtrauma, especially in the fingers. According to studies, the trigger mechanisms of neuroischemic lesions are in 39% of cases fungal lesions of the feet, in 14% the treatment of the legs with sharp objects, in 14% - careless removal of ingrown nails by the surgeon.

The most dramatic consequence of SDS is amputation of the limb (small - within the foot and high - at the level of the lower leg and thigh), as well as the death of the patient from complications of the purulent-necrotic process (for example, from sepsis). Therefore, everyone with diabetes should know the first symptoms of a diabetic foot.

Signs of diabetic foot damage

  • The first sign of complications is a decrease in sensitivity:
    • vibrating first
    • then temperature
    • then painful
    • and tactile
  • Also, the appearance of leg swelling should be alert (causes)
  • A decrease or increase in foot temperature, i.e. a very cold or hot foot, is a sign of a circulatory disorder or infection
  • Increased leg fatigue when walking
  • Shin pain - at rest, at night, or when walking at certain distances
  • Tingling, chills, burning in the feet and other unusual sensations
  • Change in skin color of the legs - pale, reddish or cyanotic skin tones
  • Leg hair reduction
  • Change in the shape and color of nails, bruises under the nails - signs of a fungal infection or nail injury that can cause necrosis
  • Long healing of scratches, wounds, corns - instead of 1-2 weeks 1-2 months, after healing of the wounds there are non-disappearing dark traces
  • Ulcers on the feet - not healing for a long time, surrounded by thin, dry skin, often deep

Weekly, you should inspect the legs, sitting on a chair in a mirror set from below - fingers and upper part of the foot can simply be inspected, pay attention to the interdigital space, feel and inspect the heels and sole with a mirror. If any changes, cracks, cuts, non-ulcer pathologies are found, you should contact the podiatrist (foot specialist).

Patients with diabetes should visit a specialist at least once a year and check the condition of their lower extremities. If changes are detected, the podiatrist prescribes medication to treat the feet, the angiologist performs operations on the vessels of the legs, if special insoles are required, then an angiosurgeon is required, and special shoes - an orthopedist.

Depending on the prevalence of one reason or another, the syndrome is divided into neuropathic and neuroischemic forms.

Pain inside the heel: causes, consequences and treatment recommendations

Many people try to avoid pain, believing that they are the worst enemies for the body. In fact, pain indicates the presence of an inflammatory process. The heel inside hurts at the initial stage of joint destruction or the presence of a serious disease. This problem must be resolved immediately.

What's happening?

The heel performs a cushioning function. She has an increased sensitivity. This is due to the fact that it contains a large number of nerve fibers and blood vessels.Even with a minor bruise or disruption, a person may experience severe pain.

For people who spend a lot of time on their feet, this problem becomes a real challenge. Discomfort is especially intense in the morning after a person wakes up.

The first step to solving the problem is to find the cause of the pain. After this, treatment should only be started. It can be both medications and alternative methods.

Chronic inflammatory processes

The inflammatory process in the tendons can occur due to metabolic disorders in gout, diabetes mellitus or arthritis and other diseases.

Diseases that can lead to heel pain:

  • Haglund deformation.
  • Spur.
  • Diabetic foot.
  • Heel injury.
  • Bursitis.
  • Tuberculosis.
  • Osteomelitis.

Haglund Warp

In this case, the disease appears a growth in the heel. It can be detected by a doctor during examination. It is located slightly above the Achilles tendon and during movement, friction and damage to the fibers constantly occur. It can be painful only with an advanced stage of the disease.

the cause of such a deformation has not yet been established. In most cases, it occurs in women who wear heels for a long time.

Diabetic Angiopathy

In the presence of diabetes, a large number of blood vessels are damaged. In medicine, there is a diagnosis of diabetic foot. This disease occurs due to a violation of the production of insulin by the pancreas.

Blood becomes thick, clogs blood vessels. The kidneys, eyes and feet are at particular risk. There is a violation of nerve fibers and blood vessels. Due to blood flow disturbance, trophic disturbance occurs and trophic ulcers appear.

They can appear most often on the foot.

Calcaneal apophysitis

A disease in which a tuber in the calcaneus is inflamed is called calcaneal apophysitis. The pain syndrome does not appear from its inside, but from the back.

2 factors can provoke inflammation in an adult:

  • Wearing uncomfortable footwear.
  • Prolonged standing.

In 8-14 year old children, heel apophysitis can also be detected. The fact is that until the apophysis is finally formed, it is very sensitive. Children are constantly on the move, running and jumping, which makes the bone inflame.

Pain in the heel when walking is characteristic of arthritis of the joints of the foot. The inflammatory process affects the joints of the foot. At the same time, a person has growing pains in the heel (they pester mainly in the morning).

How can pain in the heel be removed? A light foot massage helps. You need to do it until the pain subsides. But this measure is only temporary: the pains return if you tiptoed for a long time, climbed the stairs, etc.

  • Soreness, swelling around the heel. In the later stages, the joints of the foot are severely limited in movement.
  • General weakness and rapid fatigue.
  • A person's appetite is lost.

As soon as pain appears, it is urgent to consult a doctor. Arthritis treatment: balneotherapy, mud therapy, physiotherapy, NSAIDs.

With arthritis, it usually hurts to step on the heel, and when calm, there is no pain. But if you ignore the doctor’s recommendations, then painful sensations arise in a calm state.

One of the reasons that the heel hurts greatly when walking is inflammation of the mucous bags of the joints - bursitis. To provoke the disease can not only injury, but also wearing uncomfortable shoes, heavy loads on the legs.

  • Anti-inflammatory drugs: Ketoprofen, Ketonal, Meloxicam, Nimesulide.
  • Compresses with pharmacy bile or with dimexide.
  • Physiotherapeutic procedures.
  • You can also put orthopedic insoles in shoes.

Treatment will be ineffective if the cause of the disease is not eliminated. In this case, the pain will be constant.

Most often gouty arthritis affects the big toe, but can affect other joints of the foot. Urate (uric acid salts) is deposited in the joint, which leads to pain, swelling and redness of the joint. If the disease affects the foot, then the heel also hurts when walking.

Infectious diseases

Reactive arthritis. The inflammatory process in the joints occurs shortly after the infection. This pathological condition is associated with autoimmune disorders. In most cases, it can be a urogenital infection. It is characterized by an inflammatory process in different joints of the lower extremities.

Urogenital infection can cause the development of reactive arthritis and, as a result, heel pain.

Tuberculosis. This disease occurs due to infection of the Koch bacillus. It can affect not only the lungs, eyes, but also bones. This form of tuberculosis is most often found in children with weakened immunity.

Other diseases

The above diseases are among the more common reasons that the heel hurts. But there are other diseases that can also affect the foot. Therefore, a rheumatologist necessarily sends for additional diagnostics and only after receiving the results prescribes treatment.

Overweight people suffer heel pain (often found in patients with diabetes). Therefore, doctors recommend losing weight. As a rule, soreness in the legs is significantly reduced as soon as weight is reduced.

Why can there be pain in the heel when walking:

  • Ankylosing spondylitis is an inflammatory process in the spine.
  • Osteoporosis.
  • Osteochondrosis.
  • Reactive arthritis. May be due to infections.
  • Tendonitis (tendons become inflamed).
  • Gaglund-Sinz disease. Due to necrosis in the cancellous bone, unbearable heel pains appear; a person can hardly stand on his feet.
  • Osteomyelitis. Purulent necrotic processes occur in the heel bone, as well as in all soft tissues around it.
  • Tuberculosis.

The treatment for heel pain during walking caused by the disease is not only based on the elimination of symptoms - you need to know the exact cause. If the disease cannot be completely cured (for example, arthrosis, arthritis, gout), you need to try to remove the external factors that cause irritation in the foot.

If the cause of the pain on the side of the heel is a general disease, then a specialized doctor is involved in the treatment. A traumatologist is consulted in case of injury or other damage caused by an external factor.

If the heel hurts in the morning

Often the doctor is complaining that in the morning, when he steps on his leg, the heel starts to hurt from the side. What to do with it?

There are several effective ways to remove sore heels:

  • If pain occurs due to inflammatory diseases, then doctors advise taking anti-inflammatory and analgesic drugs.
  • It can be treated with cold. To do this, you need to do heel massage with an ice cube for about 7 minutes, until it is numb. The procedure is carried out 4 times a day.
  • Many also prefer to use heel inserts - they allow you to evenly distribute the load on the entire heel. This is due to the fact that the back of the leg rises by about 6 mm, thereby reducing the load on the area around the heel.

But if your heels hurt every morning, you must definitely find out the reason. Perhaps the cause is a disease, or maybe you hurt your foot somewhere.

For the treatment of joints, our readers have successfully used Artrade. Seeing the popularity of this product, we decided to offer it to your attention.

Special therapeutic exercises will help not only reduce pain, but also prevent its occurrence in the morning. It is also advisable to change the shoes to a more comfortable, with a low heel.

What to do if walking causes severe pain on the side of the heel? Many people prefer to use folk remedies: apply ice to a sore spot, give a minimum load on the foot (that is, restrict movement). They also try to make various foot baths, according to old recipes, to make tinctures for rubbing, etc. But the fact is that it is necessary not only to remove the pain syndrome, but also to eliminate the cause. Therefore, in addition to folk remedies, it is mandatory to use medication.

What does the doctor prescribe if in the mornings (as well as when walking) heels bother:

  • To relieve pain, it is necessary to drink painkillers and anti-inflammatory drugs: Ibuprofen, Paracetamol, Ketorol, etc.
  • Be sure to prescribe drugs designed to treat the underlying disease, the symptom of which is heel pain.
  • Corticosteroid injections are recommended only if other medicines and folk remedies do not help relieve pain. Up to three such injections can be made per year.

For the treatment of heels, as a rule, complex therapy is prescribed. It also includes:

  • Physiotherapeutic methods of treatment. The doctor recommends doing ultrasound, electrophoresis, shock wave therapy (4 sessions will suffice).
  • It is imperative to do massages, as well as conduct physical therapy.
  • Peace is created for the foot.
  • Special insoles are inserted into shoes.

Heel pains are treated. The main thing is not to diagnose yourself and not to self-medicate. Only a doctor can tell you what drugs and other procedures can treat your heel.

Injections and tablets Meloxicam - instructions for use, reviews of doctors and patients

At one time, Meloxicam was a breakthrough in pharmacology, especially in the treatment of rheumatic diseases, treatment of joint pain, osteochondrosis and varicose veins.

This drug is not only more effective among its analogues, but also costs much cheaper.

Today, such varieties of the drug are distinguished as meloxicam, meloxicam-STADA, meloxicam-TEVA, meloxicam-SZ, meloxicam-PRANA, meloxicam Pfizer, meloxicam DS, meloxicam-OBL, meloxicam-Pharmaplant.

In addition, such drugs as Amelotex, Liberum, Chondroxide Forte are ranked in the same group. All these drugs basically contain the active substance - meloxicam (meloxicam).

Among the drugs in which several active substances are combined and one of them is meloxicam, they are called: Oksikamoks, Moviks, Movalis, Movasin, Bi-xikam, Mirloks, Mataren, Meloksam, Arthrosan, Melox, Melbek-forte, Lem, Mesipol, M- Kam, Meloflam, Mixol-OD, Exen-Sanovel, Melofleks Romfarm, Melbek, Medsikam and Mataren-plus.

The composition of the drug includes:

  • meloxicam
  • regular and corn starch,
  • lactose monohydrate,
  • silica, also called aerosil,
  • microcrystalline cellulose,
  • sodium citrate
  • magnesium stearate.

Most varieties of the drug have the same components. Differences are present only in some of them:

  • the composition of meloxicam-TEVA, meloxicam-SZ and meloxicam-PFIZER includes povidone and crospovidone,
  • Meloxicam STADA contains croscarmellose sodium and talc.

In addition, there is Meloxicam - a solution for intramuscular injection. In addition to the main element, it consists of glycofurol, meglumine, sodium chloride, poloxamer 188, sodium hydroxide, glycine and water for injection.

Among foreign manufacturers of these products, such companies and manufacturers:

  • TEVA Pharmaceutical Industries (Israel),
  • Help (Greece),
  • Pfizer (USA),
  • Aurobindo pharma (India),
  • DANH son trading pharmaceutical company (Vietnam),
  • Zhangjiakou kaiwei pharmaceutical (China),
  • Mekophar chemical-pharmaceutical (Vietnam).

In the Russian Pharmacology, the production of this type of product is carried out by:

  • Nizhpharm
  • Makiz Farm
  • Stad of the CIS,
  • North Star,
  • Pranapharm
  • Canonpharma Production,
  • Altpharm
  • ALSI Pharma ZAO,
  • Avexima
  • Irbit KhFZ,
  • Altivitamins,
  • OZONE,
  • Verteks CJSC.

Pharmachologic effect

Meloxicam is used as an anesthetic, which also lowers fever and affects inflammatory processes. When taken orally, it is completely absorbed by the body and after 6 hours, the presence of the drug in the blood reaches its maximum.

After a course of treatment for at least a week, the indicator of the availability of the drug stabilizes and returns to normal.

Indicators of the normal content of this drug in the blood are as follows: from 0.4 d 1 mg per liter, provided that the patient took tablets with a content of the main active element of 7.5 mg.

Pharmacokinetics of the drug

This drug is 89% absorbed by the body. It easily spreads through the gastrointestinal tract and eating does not affect this process.

The drug settles in the blood. Also, the residual elements of the drug can be traced in the liver, but they are not dangerous to the body. All these elements are gradually eliminated from the body in a natural way.

Indications for use

As follows from the instructions for use, tablets and injections Meloxicam is prescribed for painful manifestations of inflammatory processes and other diseases of the joints:

  1. Arthritis of all kinds is the joint name for all joint diseases that are both the main and the consequence of other diseases.
  2. Constant joint disease in the spine and paravertebral soft tissues, the so-called ankylosing spondylitis.
  3. Pain in osteoarthritis. Another name - deforming, is a disease of the joints, which leads to damage to cartilage.
  4. Sciatica as a manifestation of spinal cord lesions.


Among the contraindications are the following:

  1. Taking the drug in combination with aspirin or any other anti-inflammatory drugs without steroids increases the risk of developing stomach ulcers and other diseases of the digestive system.
  2. Any allergic manifestations, as a reaction to drugs with melaxicam or other anti-inflammatory drugs.
  3. Bleeding in the cavity of the stomach and / or intestines.
  4. Bleeding in the brain.
  5. Any other internal bleeding.
  6. Problems with the functioning of the kidneys and / or liver.
  7. Heart diseases.
  8. Medication is prohibited for children under 15 years old inclusive.
  9. Medication is prohibited for pregnant and young mothers until breast-feeding is complete.

Mode of application

For different diseases, doctors prescribe a different dosage:

  1. So, in the treatment of arthritis, it is necessary to take 15 mg, and after improvement, reduce the dose to 7.5 mg. In the case of treatment of osteoarthritis, everything is exactly the opposite.
  2. In the treatment of ankylosing spondylitis, the dosage should be constant - 15 mg and in no case exceed. In those same patients who have a tendency to very pronounced side effects from this drug, the required dose per day is a maximum of 7.5 mg.

The course of treatment with Meloxicam requires preliminary preparation, especially if a person suffers from diseases such as gastritis, esophagitis, peptic ulcers of the stomach and duodenum.

Overdose and additional instructions

An overdose is manifested by nausea, possibly a gag reflex, pain in the abdomen. It can also pull to sleep. Symptoms go away gradually themselves. In rare cases, bleeding may begin.

If the patient manifests high blood pressure, impaired liver function, shortness of breath, or renal failure, as well as cramps or collapse, then rapid intervention by doctors is necessary, as cardiac arrest may occur or a person will fall into a coma.

Side effect

Among the side effects of the drug:

  • digestive system problems or their aggravation as a result of such treatment,
  • problems with the cardiovascular system,
  • allergic reactions to the skin may occur,
  • vision problems
  • problems with the nervous system
  • malfunctioning of the respiratory tract,
  • complications of the urinary system.

Special instructions

In addition to the contraindications already indicated, it must be remembered that with the first symptoms of an allergy, it is necessary to stop treatment with the drug and undergo repeated analyzes.

In those cases when the patient takes a “whole mountain of drugs”, special attention must be paid to their compatibility and the amount of water consumed.

Why do heel pains appear?

Sometimes pain occurs in two heels, namely in one. Why is this happening? In most cases, this is due to uncomfortable shoes or the structure of the foot.

Pain in the morning. If intense pain occurs immediately after awakening, the cause may be the fascia of the sole. This is a thick strip of muscles that occurs next to the calcaneal tuber. Under intense loads, fiber breakage may occur. In parallel, symptoms such as intense pain and impaired ability to move normally appear. Puffiness is also observed.

Pain in the calcaneus. They can occur due to the presence of a deformed foot, warts, corns, as well as flat feet. Painful sensations can be both short-term and long-lasting.

Pain in the left or right leg may occur due to a foot injury.

Pain in young children

Pain can be not only in an adult, but very often even in a child. The main cause of this disorder may be Schinz disease. In girls, this disease occurs at the age of 8 years, and in boys at 10 years of age. A characteristic feature of this disease is painful sensations that appear on the back of the heel.

If there is pain in the heel of a child, you need to immediately see a doctor.

Sometimes pain can occur with severe flat feet. Additionally, scoliotic posture appears.

Heel treatment

Why does the heel deeply hurt and what needs to be done? It all depends on the cause of the appearance. The most important thing to do is to eliminate the pain. For this, Butadion, Fastum Gel are suitable. If these drugs do not give a lasting effect, then a blockade should be made.

Butadion is prescribed to relieve pain.

The reason is the pinch of the sciatic nerve. To resolve this problem, stretching the spine is necessary. It is advisable to turn to the chiropractor.

He can recommend sleeping soon on a hard surface.
If the reason lies in flat feet, then you need to choose the right shoes.

If it is formed on one leg, then the pain can only be on this side.

  • With rheumatoid arthritis, it is recommended to take the following drugs: Ketoprofen, Ibuprofen.
  • Folk remedy helps to eliminate inflammatory processes.
  • Ointments for external use. For example, Ketorolgel, Butadion.

Treatment of cracked heels in diabetes

People with high blood sugar have a higher risk of skin, nail, or corns diseases than others. Treatment of cracked heels with diabetes is very important from the first minutes, as this is fraught with serious consequences. From a small crack, which people usually do not attach much importance to, a deep wound arises. Bacteria join this wound.

CD and skin problems

In diabetes, patients have various skin problems, such as dryness, itching, pigmentation, neuropathy (causes severe pain in the heels, in advanced cases it becomes a black heel).

At the initial stages of the disease, there are practically no symptoms, except for a little discomfort, the limbs can go numb at night and shoot at the heels.

But soon the pains become stronger, the heels crack, it comes to the point that it becomes painful to walk.

The heel is a shock absorber that helps with running and walking, it has the greatest formation of bone, surrounded by fiber fat.A healthy foot also protects the spine, thanks to its cushioning functions. With heel injuries, or any illnesses, all these functions are violated, especially the spine, and with it the spinal cord. A lot of diseases cause dryness on the heels.

Why do cracks appear

Cracks can occur not only from diabetes, but also from a lack of water in the body.

People suffering from diabetes have poor blood circulation, especially in the legs, as a result, cracks appear on their heels.

Also, these injuries appear with a lack of vitamin A in the body. It is very difficult to get rid of these symptoms, all because the patient’s blood contains an elevated glucose norm.

There are several reasons that affect the condition of the legs:

  • a very large amount of sugar in the blood vessels, due to which various infections multiply,
  • a small amount of fluid in the body,
  • damage to nerve endings, which results in dry heels.

What treatment for cracked heels is necessary for diabetes?

To begin treatment, a mandatory consultation with a specialist is needed. He will do an examination and prescribe the necessary tests to confirm the diagnosis, after which he will prescribe the necessary drugs.

Most of them are made on a natural basis, which is suitable even during pregnancy. They cost an order of magnitude higher than usual, but much more efficient.

In addition to the main treatment, additional treatment with folk remedies and a diet may be necessary.

Cracking preparations

There are many creams for cracks in the heels, but "Zazhivin" is considered more common.

There are many creams that help nourish the legs based on herbal remedies (tea tree oil, urea, coconut, etc.).

d.). They have antiseptic properties, relieve inflammation, itching, reduce flaking, soften and moisturize the skin, and also help to heal cracks (which is important for diabetes).

The most common ones are:

Home recipes

To maintain good heels every day, you can use different home remedies. They complement the main treatment.

“Healing cake” of onion juice, fish fat and aloe juice in equal proportions has a beneficial effect on cracked heels.

Put this cake on the heel under the toe, and in the morning rub the heel with a decoction of oak bark and anoint with a cream with nutrients.

It is also very important to use natural vitamin A in your diet, it is found in whey, you can also make a salad of shabby raw carrots with sour cream. Improvements appear after 5 days of use.

Or apply homemade foot cream. It consists of sunflower oil (1.5 tbsp) and raw carrot juice (1 tbsp. L.), This mixture needs to be boiled in a water bath for 15 minutes, cool and smear the heels or apply inside for 1 tbsp. l

A bath for legs at room temperature with the addition of salt and soda also well affect the condition of the heels. After the bath, dry the legs and grease with pork fat, wrap with a film and put on top of the socks. It is advisable to do at night so that the legs rest. The use of the golden mustache plant is also useful, its juice very well promotes wound healing in diabetes mellitus.

Heel Socks

Silicone-based heel socks are saturated with everything needed to heal cracks.

Special silicone-based socks also help very well. They are saturated with special essential oils.

These oils very well help in healing and disinfecting wounds, and they also reduce pain symptoms. These socks will still cost less than ointments and creams, and the effect of them is the same.

But before using any means you need to consult your doctor, especially if you have an allergy.

Foot Care for Crack Prevention

The main thing is not to start the cracks that appear and do the fungus test on time. For very deep wounds, use preparations containing propolis and an antibiotic.It is also necessary to abandon the use of antiperspirant for heels, do not wash your feet with hot water, as this reduces moisture in the body.

The main role, of course, in diabetes is played by a special diet. You need to monitor your blood glucose weekly. Adhere to foot hygiene, wash with cool water and dry them thoroughly. Take seriously the choice of comfortable shoes, buy them in special stores for people with foot pathologies.

And henceforth he is very attentive to his health.

Interaction with other drugs

The drug Methotrexate in combination with meloxicam increases problems with the circulatory system. The study drug reduces the effectiveness of contraception.

Also, with the wrong combination of drugs, without consulting a doctor, this can lead to undesirable complications in the functioning of the body systems, up to the death.

During pregnancy and lactation

Meloxicam passes through the placental barrier. However, there are no complete data on the study of the effect of the drug on pregnant and lactating mothers.

Moreover, taking into account all contraindications, the ban on the use of such a drug for children under 15 years of age, its use in the treatment of infants and infants is not advisable.

Doctors reviews

Prigogine EE, rheumatologist: The difficulty with using meloxicam is that it is not advisable to take it in combination with certain drugs, because only then it will act in accordance with the description.

Unfortunately, the option of using only one medicine is almost impossible, since most patients have in their arsenal a whole "bunch" of diseases that simply need to be treated in combination.

Patient Reviews

  1. Vera, 45 years old. The drug helped me. At the same time, during the course of treatment I was going to refuse him a couple of times, especially at the beginning, when complications appeared.
  2. Peter, 51 years old. The drug has a depressing effect on digestion. I tried to take it for a long time, but could no longer endure and stopped. Obviously, side effects overwhelm the positive effect of the drug.

Forms of release and cost

Meloxicam is available in tablets of 15 and 7.5 mg in blister packs. There are 20 tablets in a blister.

On 10 tablets in a blister strip packaging from a film of polyvinyl chloride and foil printed aluminum varnished.

20 or 30 tablets in a jar of polymer or lightproof glass.

Solution in ampoules for intramuscular injection of 1.5 ml, 5 ampoules per box.

The price range from 120 to 600 rubles per plate of tablets.

How can diabetics treat cracked heels?

Cracks in the heels are a fairly common problem in diabetics.

This ailment applies not only to cosmetic defects, but also has purely negative consequences if it is not treated promptly. When small cracks appear on the heels, a person must immediately take appropriate methods of healing the disease, since deep cracks can become a source of infections and bacteria.

Causes of cracking on the heels

The main reason for the appearance of this ailment is the dehydration of the body, which is observed in almost all people suffering from diabetes. Due to the general lack of fluid in the human body, the patient's skin begins to coarse and dry. After this, the skin loses its elasticity, so cracks in the heels appear instantly.

Doctors noted that diabetes itself provokes the appearance of cracks in the heels, since the increased content of sugar substances in the blood is an activator for the development of various infections.

Another common cause of this disease in diabetes is damage to the nerve endings on the lower extremities.

Such traumatic conditions lead to increased dryness of the skin.

Treatment of cracked heels in diabetics

When the first symptoms of the disease manifest, a person should consult a specialist in a timely manner.

After examining the body and making a diagnosis, the patient is prescribed an individual treatment based on the characteristics of the diabetic organism.

Most often, doctors prescribe special ointments and creams with a moisturizing effect to their patients. In each case, an ointment or cream is selected individually for each patient.

Effectively, the treatment of the disease can be carried out with alternative recipes.

  • Paraffin compress. It is necessary to melt the amount of paraffin in a water bath, cool the preparation a little and apply on sick limbs. Put on socks from above and leave a compress for the whole night.
  • Honey wraps. Heat the honey to a semi-liquid state, grease the entire surface of the heels with it, then wrap the legs with a plastic bag and warm with a sock. Keep the product on your feet for at least a couple of hours.
  • Oil rubbing. With cracks, apricot, olive, almond oils have a great effect. Apply a small amount of the necessary oil to the feet and gently massage the sore feet.
  • Egg mask. Make a mixture of 1 raw egg and 100 gr. olive oil. To smear the sick feet with the resulting mixture, wrap with a plastic bag, insulate with a terry sock and leave this mask for several hours.
  • Starch bath. Take 2 basins, one should have cool water, and the other should be warm water mixed with potato starch. Alternately lower the sore feet into warm and cool water.
  • To treat painful cracks in the heels, special pedicure socks for skin lesions are widely used. He produces socks Japanese company SOSU. Their use is quite simple: you need to wear socks on sore feet for a couple of hours a day, but the positive effect can be observed after a few days.

Preventative measures

Any disease is easier to prevent than to cure it.

For the prevention of cracking on the heels, it is important to follow several basics:

  • observe thorough hygiene of the lower body, after washing the feet, use moisturizers and ointments with preventive actions (petrolatum, essential oils),
  • carry out daily inspection of the feet for the slightest skin damage,
  • use only high-quality and comfortable shoes made of natural materials,
  • avoid corns and calluses
  • use the recommended amount of water every day (for diabetics, this amount is at least 2.5 liters per day),
  • monitor the intake, along with food, of the necessary fortified and mineral substances in the human body.

In diabetes mellitus, problematic cracking on the heels is a common problem, but it can also be avoided by following the necessary preventive requirements and leading a healthy lifestyle.

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Burning feet in diabetes? Urgent start the fight against neuropathy!

The problem of diabetic neuropathy today is one of the first places in the general list of complications of diabetes. According to studies, more than 90% of all patients with diabetes suffer from it.

Causes and symptoms of diabetic neuropathy

This disease is a typical complication that causes diabetes. The main causes of the development of diabetic neuropathy are functional and structural changes in capillariesresponsible for the blood supply to nerve fibers. In addition to them, this problem is caused by such serious metabolic disorders in the body, such as:

● Violation of fructose metabolism, causing swelling of the nervous tissue,

● Violation of the conduction of nerve impulses and a decrease in energy metabolism,

● The accumulation of free radicals, which has a toxic effect on nerve cells,

● Activation of autoimmune complexes.The body produces antibodies to insulin, which impair nerve repair. This leads to atrophy of nerve fibers.

The duration of the development of this ailment can be from two to three months to several years. Due to multiple lesions of the peripheral nerves, neuropathy leads to impaired motor and sensory functions of the nervous system.

The initial stage of neuropathy manifested by painful symptoms in the distant extremities. First, tingling, burning, goose bumps, pain when pressing on the toes. A little later, the disease grabs the hands. It becomes more difficult for the patient to put on shoes and perform other minor movements.

Leather with diabetic neuropathy getting dry and begins to peel off. In especially severe cases, sores may appear on it. Violation of the sensitivity of the limbs gradually leads to impaired coordination of movements - instability develops in a standing position, and the gait becomes shaky.

Nerve damage with diabetic neuropathy, it causes not only painful sensations in the form of burning, but it can also bring other unpleasant surprises to a person: a decrease in sensitivity to wounds and cracks in the skin, high temperature of water, etc.

Herbal Diabetic Neuropathy Treatment

Since diabetic neuropathy is a direct consequence of diabetes mellitus, then for its treatment, first of all, it is necessary normalize carbohydrate metabolism.

For this, the patient must constantly monitor the blood sugar and be observed by the attending physician.

Equally important are motor activity (except for jogging and long walking), adherence to a diet prescribed by a doctor, and maintaining optimal body weight.

It should be remembered that in the treatment of diabetes, the restoration of nerve structures is very slow. According to the Russian Academy of Medical Sciences, even if diabetes is completely compensated, it will take at least two years to restore normal functioning of nerve receptors and fibers.

In order to get rid of neuropathy, the main drug treatment for diabetes is necessary supplement with herbal medicine.

Medicinal herbs will reduce the severity of pain symptoms, slow down the progression of the disease and improve the function of nerve fibers.

For the successful treatment of diabetic neuropathy, plants are used - metabolic correctors, as well as herbs with neuroprotective, analgesic and antioxidant properties.

Here herbal recipe, which relieves pain in diabetic neuropathy and has a comprehensive therapeutic effect. It includes analgesic plants (angelica and St. John's wort). The anti-inflammatory effect of this collection is attached to the Scutellaria baicalensis.

Melilotus officinalis acts as a plant anticoagulant.Milk Thistle regulates glycemia level and ginger supports the activity of antioxidants in the body.

Celery contains the substance apiin, which slows down the negative effect of aldose reductase, an enzyme that increases blood glucose.

To prepare the infusion, you need to take 10 grams of angelica root, melilot, St. John's wort, milk thistle, celery root, Scutellaria baicalensis and 5 grams of dried ginger root.

This amount of medicinal raw material is calculated for 1 day of admission. The collection must be brewed in a thermos of 300 ml of boiling water and insisted for half an hour, occasionally shaking.

The infusion is drunk warm during the day in equal portions 15 minutes before meals. The course of admission is 10 days.

Be sure to familiarize yourself with the composition and detailed description of the main medicinal herbs collection No. 58 For diabetes.

Also a good remedy for the early stages of diabetic polyneuropathy is the infusion of ginkgo biloba leaves. For treatment, you need to brew 500 ml of boiling water 2 tablespoons of the leaves of this plant.

After insisting for 3 hours, the infusion should be drunk in equal portions per day.Or take ginkgo leaves for brewing in filter bags, which may be more convenient, brew according to instructions and drink 2 cups of infusion throughout the day.

Or take ready-made alcohol tincture of ginkgo 20-30 drops 3 times a day before meals.

Familiar to everyone onion peel - Another useful remedy for neuropathy. It contains the most valuable antioxidant - quercetin, which blocks the development of inflammatory processes and has a beneficial effect on the whole body.

Preparing a healing infusion is easy. To do this, pour a glass of boiling water 1-2 teaspoons of onion husks and let it brew for 10 minutes. Then strain and drink before bedtime.

To plants that regulate well glycemia levels and useful in the treatment of neuropathy, refers hibiscus.

It should be used in an amount not exceeding 10-15 grams of dry raw materials per day (we use dried flowers). To prepare the infusion, this amount of flowers is poured with 200 ml of boiling water and kept in a thermos for 15 minutes.

After cooling and straining, take 15 minutes before meals 3 times a day. The course of treatment with hibiscus is 10-14 days.

Dandelion root also should not be forgotten in the treatment of diabetic polyneuropathy. 1 tablespoon of the dry roots of this plant is poured with 1 glass of boiling water, boiled for 15 minutes and insisted for 45 minutes. Take 2 tablespoons of the broth 3 times a day before meals.

Spicy cloves have a good antioxidant effect, useful in diabetic neuropathy. A tablespoon of this spice needs to be brewed with 600 ml of boiling water and infused for 2 hours. Take 200 ml of infusion throughout the day. The course of admission is 2 weeks, then a break is taken for 10 days. The total duration of clove treatment is 4-5 months.

And here is another useful integrated herbal, all of which are aimed at combating diabetes and reducing the severity of neuropathy.

St. John's wort and knotweed - 40 grams each, a blueberry and immortelle leaf - 30 grams each, a centaury and a birch leaf - 20 grams each, chamomile flowers, a stevia and peppermint leaf - 10 grams each. 4 tablespoons of the collection pour 1 liter of boiled water at room temperature and leave for 8 hours. After this, boil for 5 minutes and insist 20 minutes. Drink in equal portions throughout the day.

Stone oil (brashun) will not only help lower blood sugar, but will also help restore nerve structures, preventing the development of burning feet and other unpleasant symptoms. But to achieve a lasting effect, a solution of stone oil must be taken for at least six months: 3 g of stone oil dissolved in 2 liters of water and take 1 cup of solution 3 times a day.

Read more about the properties of stone oil in the treatment of diabetes and other diseases, as well as the exact methods.

Outdoor facilities

With diabetic neuropathy, warm baths with sage, motherwort, Jerusalem artichoke leaves and oregano will be useful. To prepare the bath, you need to take 100 grams of these herbs and pour them with 3 liters of boiling water. Insist 1 hour. After filtering, the diseased limbs are lowered into a warm infusion and kept for 15 minutes.

In the summer, neuropathy can be treated with fresh nettles. To do this, three times a day for 15 minutes, you need to walk bare feet on its stems and leaves.

At night, a compress can be made on the soles of the feet, consisting of lemon essential oil mixed with horse chestnut macerate (an oil extract of chestnut fruits and flowers in grape seed oil). Lemon will relieve burning sensations in the limbs and cramps, and chestnut oil will improve vascular elasticity and capillary circulation, as well as soften dry skin.

Exercises to Relieve Symptoms of Neuropathy

In addition to the use of herbs, with diabetic neuropathy it is necessary exercise dailythat improve blood circulation in the legs and arms.

Exercise number 1

Pull your toes with your hands towards you and hold them in such a stretch for 10-15 seconds. After this, rotate your feet with your feet left and right for a few minutes, and then massage the soles and tips of all your fingers.

Exercise number 2

Wait a few seconds, standing on your toes, then roll from sock to heel.

Exercise number 3

Squeeze your fingers into the fist and alternately make rotational movements of each hand to the right and left, and then unclench and squeeze the hands for 2 minutes.

Exercise number 4

Several times a day for 1-2 minutes with variable pressure, squeeze an elastic rubber ball in your hands.

I sincerely wish you good health and, I hope, my recipes will help alleviate the unpleasant symptoms of diabetes and neuropathy!

author of the article Veselova M.V.
specialist of Russian herbalism

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Watch the video: Foot problems common among diabetics (March 2020).