Complete Neuropathy Evaluation: Biothesiometry and 4 Complementary Tests
If you or a loved one lives with diabetes, you know how important it is to keep your blood sugar in check. But have you ever thought about the health of your feet?
Diabetic neuropathy is a common, and often silent, complication of diabetes that can cause nerve damage, typically in the feet and legs. This nerve damage can lead to a loss of feeling, meaning you might not notice a cut, a blister, or a burn. What seems like a small, harmless injury can quickly turn into a serious infection, a difficult-to-heal ulcer, and in the worst-case scenarios, a foot or leg amputation.
The key to preventing these serious problems is early detection. But a quick, basic check-up might not be enough. The best way to protect your feet is through a complete neuropathy evaluation that looks at all the different ways nerve damage can show up.
This blog post will walk you through the essential tests your doctor should be performing during a comprehensive foot exam, including a vital vibration test (biothesiometry) and four more crucial checks that provide a full picture of your foot health.
What Is Diabetic Neuropathy? A Simple Explanation
Think of the nerves in your body as a network of electrical wires that send signals back and forth from your brain. They tell you when something is hot, cold, sharp, or soft. They are your body’s built-in warning system.
When you have diabetes, high blood sugar over time can damage these “wires.” This damage, known as diabetic neuropathy, can cause the signals to become weak, slow, or even stop altogether. You might experience tingling, numbness, or a burning sensation. But often, and most dangerously, you feel nothing at all.
Because of this, regular and thorough evaluations are the first line of defense. The goal is to catch nerve damage as early as possible—before a serious injury happens.
The Problem with a Simple Check-Up
Many people are familiar with a basic foot exam where a doctor might check for pulses or just poke the foot briefly. While these are good starting points, they may not be a complete picture of your nerve health. Different types of nerve fibers handle different sensations (like temperature, touch, and pressure).
A truly comprehensive evaluation needs to check all these different nerve functions. This is why a simple, single test isn’t enough. The best practice involves a series of tests to get a complete report card on your feet.
The 5 Essential Tests for a Complete Neuropathy Evaluation
Your doctor should be checking your feet for more than just one type of feeling. Here are the five key tests that make up a complete, modern neuropathy evaluation:
- The Vibration Test (Biothesiometry):
What it is: This test checks your ability to feel vibration. Your doctor will use a small device called a biothesiometer, which looks like a pen, and apply a gentle vibration to different areas on your feet. You just have to say when you feel the vibration and when it stops.
What it tells you: This test checks for damage to your large nerve fibers, which are important for balance and knowing where your feet are in space. It’s a standard, foundational test for many years. - The Pressure Test (Monofilament):
What it is: This is perhaps the most important test for protecting your feet. Your doctor will use a small nylon filament that looks like a thin piece of fishing line. They will gently press it against different spots on the bottom of your foot until it bends.
What it tells you: This test checks for a very specific type of feeling called “protective sensation.” If you can’t feel the monofilament, it means you might not feel a pebble in your shoe or a tack on the floor. This is a crucial warning sign that you are at high risk for a foot injury that you won’t feel. - The Hot & Cold Test:
What it is: This test checks your ability to tell the difference between hot and cold. Your doctor will use a tool that can be heated and cooled to a specific temperature and apply it to different areas on your skin.
What it tells you: This test checks for damage to your small nerve fibers. These are often the first nerves to be affected by diabetes. If you can’t feel hot or cold properly, you might not notice if you step into a hot shower or get a minor burn. This is a key indicator of early nerve damage that a vibration test alone might miss. - The Skin Temperature Check:
What it is: Your doctor will use a special device to take a quick temperature reading on different spots on your feet.
What it tells you: A sudden increase in temperature in one specific area of your foot can be an early warning sign of inflammation or an impending ulcer, even before any visible signs appear. This is like a “hot spot” alarm system for your feet. It’s also an indirect way to check for a type of neuropathy that affects your body’s ability to regulate temperature.
The Power of Integration: Why All 5 Tests Together Are Best
Each of these tests provides a unique piece of the puzzle about your foot’s health. The vibration test checks one type of nerve, the hot and cold tests check another, the pressure test checks for a specific type of sensation, and the temperature check looks for signs of trouble you can’t see.
When your doctor performs all five of these tests together, they get a complete, holistic view of your feet’s nerve function. This full report card allows them to:
Catch Problems Early: Identify nerve damage at its earliest stages, when it’s easiest to manage.
Understand Your Risk: Get a clear picture of your specific risk for developing ulcers or other foot injuries.
Create a Better Plan for You: Give you the best advice for protecting your feet, from choosing the right shoes to knowing when to see a specialist.
The Modern Solution: A Simple, Single Device for a Complete Check-up
You might be thinking, “My doctor is already busy. How can they do all five of these tests at every visit?” This is where modern medical technology comes in.
An innovative company called Yostra Labs has developed a device called Neuro Touch. This incredible device combines all five of these essential tests into a single, easy-to-use tool. Instead of your doctor fumbling with multiple tools, they can perform a complete and comprehensive evaluation in just a few minutes with a single device.
This technology makes it easier for doctors to do the complete check-up your feet deserve, without taking up a lot of extra time.
What You Can Do: Be Your Own Advocate
Your foot health is in your hands—and your doctor’s. The best thing you can do is to be aware and proactive.
Ask Your Doctor: At your next appointment, ask your doctor about your diabetic foot exam. Ask them if they perform a comprehensive evaluation that includes a pressure test, a vibration test, and checks for hot and cold sensation.
Look for Modern Technology: You can even ask if they use a modern, all-in-one device like the Neuro Touch to make the process quicker and more thorough.
Check Your Feet Daily: In between appointments, remember to check your feet every day for any cuts, blisters, redness, or swelling. If you see anything unusual, call your doctor.
By being informed and advocating for a complete neuropathy evaluation, you’re taking a powerful step toward preventing serious complications and keeping your feet healthy for years to come.
