NERVE INJURY TO LEGS
Foot drop—that is, paralysis of the muscles that lift the foot at the
ankle—occurs from time to time in people with diabetes. It is due to an injury to a nerve called the peroneal
nerve. A person with this condition has to lift the affected leg higher than usual when walking. Many times it
improves, but sometimes it is permanent, and then it is treated with a leg splint.
There is also a rare condition called diabetic amyotrophy, where the
injury is to one of the nerves supplying the muscles of the thigh (femoral nerve) and causes severe pain and
weakness in the thigh. With good glucose and pain control the symptoms get better over a period of twelve to
eighteen months.
Occasionally, a person with diabetic peripheral neuropathy has problems
sensing the position of a joint (that is, a defi ciency in proprioception). This can put signifi cant stresses on
ankle or foot joints leading to fractures and joint dislocation. The person will complain of sudden pain and
swelling of the foot or ankle, often after a minor foot injury (such as tripping on a curb). This condition is
called Charcot’s arthropathy. The doctor will treat this using a non-weight-bearing leg cast. Medicines called
bisphosphonates, such as pamidronate and alendronate (Fosamax), that are usually used to treat osteoporosis can
also help.
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