by Lucas
(Virginia)
Written by Dr. Albana Greca, MD, MMedSc
Hi Lucas,
I understand why you are worried. The numbness in your mother's toes makes diabetic peripheral neuropathy a real possibility. Neuropathy often begins in the toes and feet and can cause numbness, tingling, burning, shooting pain, unusual sensitivity, or aching that is often worse at night.
However, I would not assume that every type of leg pain is neuropathy. A person who has lived with diabetes for 13 years may also have circulation problems or another condition affecting the muscles, joints, bones, spine, or feet. Pain brought on by walking and relieved by rest, for example, can suggest reduced blood flow and deserves medical assessment.
Yes. There is no single treatment that works for everyone, but painful diabetic neuropathy can often be reduced. The first step is confirming that the pain is truly neuropathic and checking for other treatable causes.
Good glucose management can help slow further nerve damage, although bringing glucose into target does not usually make established nerve pain disappear immediately. Your mother's clinician may also review blood pressure, cholesterol, kidney function, vitamin B12—especially if she uses metformin—and other factors that can affect nerve health.
When medication is needed for neuropathic pain, current diabetes guidance includes several groups of medicines such as gabapentinoids, serotonin-norepinephrine reuptake inhibitors, certain tricyclic antidepressants, and sodium-channel blockers. The best choice depends on age, kidney function, other medicines, fall risk, sleep, and other health conditions, so this should be individualized by her clinician.
Our guide to diabetic peripheral neuropathy and foot problems explains how neuropathy is diagnosed and managed, while our diabetes leg pain guide compares nerve pain with circulation and other causes.
If your mother has reduced feeling, she may not notice a blister, cut, burn, tight shoe, or other injury. I recommend checking both feet every day, including the soles and between the toes. Look for cuts, redness, swelling, blisters, cracks, calluses, drainage, or color changes.
Wash the feet in warm—not hot—water and dry them carefully. Moisturizer can be used on dry skin on the tops and bottoms of the feet, but it is better not to put lotion between the toes because excess moisture can encourage infection.
She should avoid walking barefoot and should wear well-fitting shoes and socks. Check the inside of the shoes before putting them on. Special therapeutic footwear is useful for some people with deformity, previous ulcers, or high-risk feet, but it is not automatically required for everyone with diabetes; a foot examination can determine whether she needs it.
Because numb feet may not sense temperature normally, she should avoid heating pads, hot-water bottles, and very hot baths on the feet.
Not necessarily. Regular activity is beneficial for many people with diabetes, and walking can be helpful when it is safe. But new or worsening leg pain should be assessed before simply pushing through it.
If walking consistently produces calf, thigh, or buttock pain that improves after stopping, tell her clinician because that pattern can occur with peripheral artery disease. If a foot is injured, ulcerated, red, hot, swollen, or painful in a new way, exercise should wait until the problem has been evaluated.
I would not make cookies the central issue here or tell your mother that she must never eat one again. What matters is her overall eating pattern, carbohydrate portions, glucose levels, medicines, physical activity, and cardiovascular risk factors. Frequent sweets can make glucose management harder, but neuropathy treatment requires more than simply eliminating one food.
Educational safety note: This information is for general education and does not replace an examination or individualized treatment. Do not start, stop, or change pain medicines or diabetes treatment without discussing it with her healthcare professional.
Last reviewed: September 2026
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