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Pain in diabetic foot ulcers
R Gary Sibbald1, David G Armstrong, Heather L Orsted
1Department of Medicine, University of Toronto, Dermatology Day Care and Wound Healing Clinic, Sunnybrook and Women's College Health Sciences, Toronto, Canada.
Abstract:
People with diabetes who have foot ulcers require adequate vasculature, infection control, and pressure offloading to heal. Pain is uncommon in diabetic foot disorders, but it may herald the onset of limb-threatening complications such as deep infection, Charcot change, or critical ischemia. Although neuropathy is most commonly painless, a minority of patients experience disturbing burning, stinging, stabbing, or shooting sensations. Using the "preparing the wound bed" model, the cause of pain in the person with diabetic foot problems can be diagnosed systematically and important therapeutic measures can be instituted in an attempt to prevent potential complications, including amputation.
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