Pain and the diabetic foot

Nurses General Nursing

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Some books and websites stated that diabetic foot ulcers are not painful due to neuropathy. But I wonder maybe they experience pain at times still, especially during and after debridement? How about after VAC therapy that can help revascularize the tissues?

I dont have enough experience with diabetic pts with foot ulcers?...

What has been your experience thus far?

Specializes in Pediatrics and geriatrics.

my husband is a type 1 diabetic. one day he woke up with an ulcer on his ankle. this ulcer literally popped out of nowhere. he is very deligent in checking his feet on a daily basis for sores and etc. he stated that the ulcer didnt hurt at all. interestingly enough he has suffered with foot pains for years. he has been tested for neuropathy, which has been negative. fortunately the ulcer healed with almost daily visits to the his dr and diligent wound care.

Specializes in Med/Surg.

I've found about 90% of the patients have no pain as long as they are kept on their medications for neuropathy. However you start taking those away and all the dilaudid in the world isn't going to help.

Some books and websites stated that diabetic foot ulcers are not painful due to neuropathy. But I wonder maybe they experience pain at times still, especially during and after debridement? How about after VAC therapy that can help revascularize the tissues?

I dont have enough experience with diabetic pts with foot ulcers?...

What has been your experience thus far?

I have neuropathy and its just plan odd my feet and legs are num to the point I can not fell them or tell hot and cold but at the same time I can fell the nervie pain (burning , electric pain) I also have a heal spear and I can fell the pain of that . I fell down some steps and spanned both my ankles and did not know it for 12 hours . so theres no one ancer

Now my mom on the other hand could fell nothing AT ALL I found her cutting out the ten dent in her hand once and she could not fell a thing .:confused:

I once had a diabetic patient in the nursing home who had a stage 4 ulcer on his foot. He was in terrible pain and the strongest of narcotics did little to help. All methods of wound healing, including VAC and hyperbariac chamber failed to heal it. He begged his doctor to amputate his foot. When he came back from the BKA he had a smile on his face. He said this was the first time in a year, that he had no pain. He did not miss the leg at all.

There can definitely be pain, although there often is not.

I think some little nerve fibers get damaged by poor circulation and some don't. That's why, I think, some parts of a person's feet/hands burn, itch, have electric shock - type pain and some parts of the same feet/hands do not.

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