#72 Find a Perfect Fit – in Shoes

Calgary Neuropathy Association
August 24, 2024

Introduction: Neuropathy and Footwear

Research has found that repetitive foot injury and inadequate foot care are factors which contribute to the development of peripheral neuropathy and its further complications.¹ Acting as both a mould for our feet as well as a protective barrier for injuries, having quality shoes is pertinent for everyone. The type of shoes we wear matters. Whether we are running, walking the runway, or heading to the office, those with peripheral neuropathy need certain protective features. Similarly, ensuring that you are wearing proper shoes that best suit your feet is imperative to the management of your neuropathic pain and symptoms.²

The Importance of a Good Pair of Shoes

While there is no cure for peripheral neuropathy, proper footwear has the potential for some to alleviate pain and aid in minimising the severity of symptoms.²

Yellow running shoes gif with the caption below: Your feet deserve a good pair of shoes.

Well Cushioned for Shock absorption

It has been reported that proper footwear which is well cushioned and suited for the individual will minimise the pressure points on the feet and provide adequate support. On the other hand, shoes which are not suited for neuropathic individuals may be harmful to them by exerting more pressure in already sensitive areas, worsening their symptoms. Applying unnecessary pressure will exacerbate pain within the foot and restrict the blood circulation, complicating symptoms further.³

Well Fitted for Comfort and Protection

Blood circulation is essential in allowing for the nerves to gain the proper nutrients and vitamins so that they can function and operate, and having well-fitted footwear will both encourage blood flow to the feet and make it more comfortable when walking. This increased sense of comfort when walking may make it easier to complete physical activity throughout the day, which in turn also helps to alleviate pain.⁴

Additionally, within North America, the most common reason for peripheral neuropathy is diabetes mellitus, commonly leading to insensate feet (individuals having no feeling in their lower extremities).^5,6 When this numbing sensation occurs, many individuals are unaware of the surroundings around the numbed area, meaning they could be blind to minor or major injuries that are developing or already present. Well-fitted shoes, as well as comfortable socks, provide a barrier which prevents the risk of attaining any subtle injuries on the foot which could go unnoticed. In this instance, even sandals or any open-ended shoes, would not be beneficial for peripheral neuropathy as they provide little support and can result in poor foot health and thus the increased severity of pain.⁶

Well Built Treads for Stability

For individuals with peripheral neuropathy, having good shoe treads is crucial for safety and mobility. Due to the reduced sensation in the feet, it can be difficult for people to detect changes in surface texture or balance. Quality treads provide better grip and stability, reducing the risk of slips and falls, which are common and can be particularly dangerous for those with peripheral neuropathy. Good treads also help distribute weight more evenly across the foot, minimizing pressure points and preventing further foot complications, such as sores or ulcers which are often long in healing. Choosing shoes with treads specifically created to enhance traction, grip, and stability on various surfaces is essential for maintaining independence, protecting your overall foot health, and preventing slips and falls.

Next Steps: Choosing the the Right Shoes

When looking for a shoe suited for your neuropathy, it’s different for each person. An important tip is that shoes should not be overly tight, especially in the toe box. Tight shoes can compress the feet, intensifying numbness or pain. Instead, wide, cushioned shoes with adjustable closures, are ideal for individuals with neuropathy allowing room for potential swelling. Ideally, the toes should not be curled up when wearing the shoe as this continues to put unnecessary pressure on the foot. Instead, toes should always be straight with some extra space to move around.⁶

A graphic of a show with labels pointing to the:
Wide Toe Box
Room to add insoles or orthotics
Large, shock absorbing cushion

A soft, larger cushion is ideal providing more support and absorbs more shock, making it much more comfortable especially for those with neuropathy. A cushioned shoe sole taking the lion’s share of the shock means less pounding on those sensitive nerves. Rocker type soles are also the best for neuropathic patients because they put pressure on the forefront of the foot, once again reducing the friction and pressure on the feet.^2,7

It is recommended that when buying shoes with neuropathy, go shopping when the feet are swollen to have a better idea of which shoes are ideal and eliminate the need to “break into them”. Bring socks and/or any needed orthotics, insoles, or braces when trying on different shoes to ensure the shoes are a proper fit that will promote the very important circulation of blood to the feet.^2,6 On the internet there are many websites which focus on creating shoes specifically suited for those with neuropathy. Whether looking in a generic shoe store or opting to order online from a specific clinic, neuropathic shoes are generally accessible. Finding the ones which are personally suited for may require some experimentation.

Just as Important as Your Shoes

While attaining a well-fitted piece of footwear is important to managing neuropathic symptoms, making sure you are taking adequate care of your feet whenever your shoes are off or on is equally valuable. Small tasks such as making sure to not wear the same shoes constantly and protecting your feet by wearing shoes and socks even indoors, are good practices for foot health and managing neuropathic symptoms. This is particularly true when engaging in physical activities. Lastly, it is essential, particularly for those with insensate feet, to consistently check for blisters and red spots, making sure to point out those and callouses to a podiatrist or a foot specialist and learn how to best take care them.^2,5,7 While it may seem overbearing or unnecessary to take such measures, maintaining one’s foot condition is necessary for both the management of peripheral neuropathy and maintaining your daily functionality.

Conclusion

While wearing proper shoes will not cure neuropathy, they may play an essential role in alleviating common symptoms of striking pain and numbness by providing your feet with more protection and support,⁷ while also making it easier to complete day-to-day activities. Purchasing a good pair of shoes may seem like an overly simple approach; however, they have proven to be effective in helping individuals overcome pain step by step.

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