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Updated: Jun 8, 2026
07:28
A Protocol of Manual Tests to Measure Sensation and Pain in Humans
Published on: December 19, 2016
What you can't feel can hurt you.
1Manchester Diabetes Centre, 193 Hathersage Rd, Manchester M13 0JE, England. ABoulton@med.miami.edu
Journal of the American Podiatric Medical Association
|September 18, 2010
Summary
Diabetic peripheral neuropathy, a loss of feeling in the feet, significantly increases the risk of foot ulcers. Regular screening is vital, as symptoms do not always indicate sensory loss or risk.
Area of Science:
- Podiatry
- Diabetology
- Neurology
Background:
- Medical training often neglects managing asymptomatic patients with peripheral neuropathy.
- Peripheral neuropathy, a loss of sensation in the feet, is a major risk factor for diabetic foot ulceration.
- Up to 50% of older type 2 diabetes patients exhibit sensory loss, increasing ulcer risk.
Purpose of the Study:
- To highlight the critical need for managing asymptomatic peripheral neuropathy in diabetic patients.
- To emphasize the importance of regular screening for peripheral neuropathy in diabetes management.
- To underscore that the absence of neuropathic symptoms does not equate to a lack of risk for foot ulceration.
Main Methods:
- Review of clinical training practices regarding asymptomatic neuropathy.
- Analysis of risk factors contributing to diabetic foot ulceration.
- Correlation assessment between neuropathic symptoms and sensory loss.
Main Results:
- Peripheral neuropathy is a primary risk factor for diabetic foot ulceration, affecting up to 25% of patients lifetime.
- Neuropathic symptoms poorly correlate with actual sensory loss, meaning asymptomatic patients are still at high risk.
- Reduced pain sensation diminishes motivation for injury prevention and healing.
Conclusions:
- Regular screening for peripheral neuropathy is essential for all diabetes patients to prevent foot ulcers.
- Patients with risk factors need specialized education and frequent podiatric review.
- Effective management requires recognizing that loss of pain sensation increases ulceration and recurrence risk.
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