DIABETIC Neuropathy

a better way to treat neuropathy

DIABETIC NEUROPATHY Frequently Asked Questions

About 20 million Americans suffer from neuropathy, but many of them don’t receive accurate or timely diagnosis and treatment.

Dr. Darren Silvester and Dr. Gregory Larsen use the latest technology at Next Step Foot & Ankle Clinic in the San Antonio area to correctly diagnose and treat neuropathy to help you live a better life.

The short answer is nobody knows for sure. Researchers are still trying to figure out the EXACT mechanism of injury.

One thing is for sure, and that is that high blood sugar over a period of time is a major contributing factor. One mechanism of injury is the nerve absorbing blood sugar, becoming much more swollen, and being compressed peripherally.

An interesting fact that most people are unaware of is that metformin actually causes neuropathy. So, in some people medication used to treat their diabetes can contribute to their neuropathy.

Neuropathy is a disease that involves damage to the nervous system. The nervous system carries and interprets signals between other parts of our body and brain, so if something happens to it, complex functions come to a halt.

If you have neuropathy, your nerves either don’t send information, send the wrong information, or send distorted information. It usually affects the nerves of the foot and may cause numbness, pain, burning, loss of balance, and deformities in your toes. It’s also a major contributing cause of ulcers and limb loss.

Nerve injury from accidents, falls, sports, arthritis, and medical procedures can cause neuropathy. Some other causes of neuropathy include:

  • Autoimmune diseases
  • Kidney and liver disorders
  • Exposure to toxins
  • Hormonal imbalances
  • Certain cancers and benign tumors
  • Chemotherapy
  • Diabetes (When the nerve damage is caused by diabetes, it is called diabetic neuropathy.)

At Next Step Foot & Ankle Clinic, you get a comprehensive neuropathy exam complete with patient history, thorough physical and neurological exam, and diagnostic testing.

The expert team uses the latest technology in neuropathy diagnosis with SudoScan®, a quick and painless procedure that obtains an accurate evaluation of the severity of your nerve damage.

Your doctor may also suggest a diagnostic ultrasound evaluation to assess the size of your nerves, as neuropathy patients often have enlarged nerves.

Ask about our minimally invasive treatment for neuropathy!

Flat feet can be a major problem for kids. Many people (some doctors included) think it is just something you have to live with. This is not the case.

So if you think your child is struggling with flat feet give us a call and let us discuss which options might be best for you and your child.

Take the next step toward happy feet and schedule today!

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Neuropathy Specialist

minimially invasive

treatment & surgery

for diabetic neuropathy


treatment & surgery options

People with diabetic neuropathy often have nerves that are twice as large as people without neuropathy. The increased size often causes these nerves to get trapped at certain spots in the feet, causing numbness, burning, and pain.

The expert team uses an innovative surgery to release the trapped spots and restore your nerve function.

The podiatrists help you add the correct nutrition to your diet so that your body has the needed support to heal itself. If you desire true freedom from the pain of neuropathy, call or book an appointment online today.

See below to learn more about our advanced treatments used at Next Step for diabetic neuropathy.

Electrical signal therapy (EST) is a highly advanced treatment for neuropathy that provides relief from neuropathy symptoms, including numbness and pain. Medicare and most commercial insurances cover EST.

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MLS (Multiwave Locked System) laser therapy is a noninvasive, pain-free alternative to prescription pain medications. It has no side effects and works by stimulating nerve repair. It also releases endorphins that reduce pain and swelling, increase blood flow, and stimulate repair and regrowth of your nerve tissue. MLS laser therapy is successful in 9 out of 10 patients.

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People who have long-standing or poorly controlled diabetes are also at risk for having damage to the nerves in their feet, which is known in the medical community as peripheral neuropathy. If you have nerve damage, you may not be able to feel your feet normally and you may also be unable to sense the position of your feet and toes while walking and balancing, which can cause even more harm to your feet.

Normal nerves allow people to sense if their shoes are too tight or if their shoes are rubbing on the feet too much. With diabetes, you may not be able to properly sense minor injuries, such as cuts, scrapes and blisters-all signs of abnormal wear, tear, and foot strain.

Nerve Decompression Surgery

When other non-operative treatments fail and compression of the nerve is playing a role in the nerve dysfunction, surgery may be the best option. Sometimes nerve disease is like sleeping on your elbow wrong. You wake up and your hand is numb or tingling. The nerve is just always being compressed.

Nerve decompression surgery allows the surgeon to open the tight area through which the nerves pass by dividing the anatomical structures that encase the nerve. Surgical procedures can be performed in the comfort of our Olympia Surgery Center.

Dr. Silvester and Dr. Larsen have additional certifications in nerve surgery. He has undergone specialized training in the treatment of painful nerve conditions. The organization called The Association of Extremity Nerve Surgeons (AENS) provides advanced training in the medical, physiological, and surgical treatment of nerve conditions. Through this organization and other ongoing medical education, Dr. Silvester chose to specialize in the treatment of these difficult and perplexing conditions. Dr. Silvester achieved adequate surgical experience and demonstrated proficiency in the procedure, and is now a Fellow of the Association of Extremity Nerve Surgeons.

Treat your second toe pain AT THE SOURCE!

Are you experiencing burningtinglingstabbingshooting pain?

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Our Blog

In additional to educating our patients with video’s, we share monthly blogs, with entries from our very own Dr. Silvester and Dr. Larsen.

The “Big Bad Wolf” of Foot Conditions

The “Big Bad Wolf” of foot conditions is Toenail Fungus. Yes, Big, Bad, Loud, Ugly…

Prioritizing Mobility

Mobility is something most of us take for granted until it is compromised. Nothing is…

5 Mistakes of Having Foot Pain

If you want your chronic foot pain to be a thing of the past, then…

success story

Say GOODBYE to nerve pain!

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Listen to a patients story of success with our Neuropathy treatments at Next Step Foot & Ankle Clinic.


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