Diabetic foot pain has been attributed to neuropathy. But sometimes if you are neuropathic, i.e. not feeling anything, then why do you still get foot pain?
Neuropathy is the lack of feeling within the foot. A person with Diabetes (and many other types of illnesses) can become neuropathic not just when the whole foot is clinically "neuropathic" but when a single part of the foot is neuropathic- that be the tip of a toe, one side of the foot or top of the foot. It just needs to be a single area to be classed as neuropathic.
Also neuropathy doesn't mean as well that you can not feel anything. There are levels to "numbness" and at the start you can not feel light touch, then that goes all the way up to not feeling anything.
One of the reasons which sometimes goes amiss is the idea of infection.
If a neuropathic Diabetic is feeling foot pain then sometimes we have to dig around and figure out why. Sometimes, but not always, it is to do with something that hasn't been identified.
Infection can also be attributed to high blood sugars.
This was the case for one of our patients. They had trouble keeping their blood sugars down and for months the Doctors didn't understand why. They came to us from a simple referral. Upon clipping the big toenail (which felt soggy, looked not right and the toe was slightly red) the nail peeled off revealing a large ulceration that had been hidden underneath.
Sometimes though if you have reduced circulation issues the signs of an infection (red hot and swollen) might not be visible because those signs have been masked. Some popular drugs which also mask infection are steroids.
This is why so many professionals advise patients to monitor their own feet- so that they can identify red areas, cuts or bumps which might cause an issue later on. Diabetic footcare is actually 70% patient and 30% clinician. If there is an issue then the ratio reverses, but a clinician can only advise. They can only do so much and they rely on the patient telling them if there is an issue.
And if you are unsure, go anyway. The simplest way to protect your feet is to be vigilant. Being unsure is OK. I can guarantee that all clinicians will like it that you take care of your feet and ask questions. If they fob you off? Get a new clinician, your feet deserve more.