This is one of the most important misconceptions I encounter in my practice, and I want to address it directly: the disappearance of burning pain in the feet of a person with longstanding diabetes is not a sign of improvement. It is very likely a sign of worsening. The burning, tingling, and electric shock sensations of early to intermediate neuropathy are produced by damaged but still partially functioning nerve fibres that are generating abnormal electrical signals. When these nerve fibres are eventually lost entirely, there are no fibres left to generate the burning sensation. The pain stops not because the nerves have healed but because they have been destroyed. What replaces the burning is numbness, which is clinically more dangerous than the pain it replaces, because it removes the protective pain signal that would normally warn a patient about a foot injury. A blister, a cut, a pressure wound from an ill-fitting shoe, all go unnoticed. At Chirayu Multispeciality Clinic, Kasturi Nagar, Bengaluru, if a patient tells me their foot burning has resolved, my first response is a thorough neuropathy assessment rather than reassurance, because the most likely explanation requires urgent attention.
Written by Dr. Santosh Kumar PK, Master's in Diabetes Management (Middlesex University), PGD Clinical Cardiology and PGD Endocrinology (Royal College of Physicians, UK), Consultant Physician and Cardio-Diabetologist, Chirayu Multispeciality Clinic, Kasturi Nagar, Bengaluru. Phone: +91 9164442266.
Related reading:
Diabetic Neuropathy: Why Your Feet Are Sending You a Warning You Cannot Ignore
Type 2 Diabetes: A Complete Guide to Diagnosis, Management, and Preventing Complications
