Long covid & peripheral neuropathy

peripheral neuropathy

Peripheral neuropathy: Weeks to months after having a covid infection some people are experiencing neurological changes to their feet.

What is peripheral neuropathy?

Peripheral neuropathy is where nerves in the body’s extremities, (hands & feet) become damaged. If damaged, they may not be able to send signals between the central nervous system (the brain & spinal cord) and all other parts of the body.

Are all nerves the same?

We have different types of nerves with their own specific functions:

  1. sensory nerves are responsible for transmitting sensations, such as touch, sight, hearing, taste and pain.
  2. motor nerves control the movement of muscles, such as walking, talking and grasping.
  3. autonomic nerves control organs to regulate activities that people do not control consciously, such as breathing, digestion, and heart and gland functions (automatic functions).

What are the symptoms of peripheral neuropathy?

The symptoms depend on which nerves are affected:

  1. The symptoms of sensory nerve damage can include loss of sense of touch, temperature, and pain or a tingling sensation. 
  2. Damage to the motor nerves can cause muscle weakness and cramps.
  3. Common autonomic nerve symptoms include excess or absence of sweating, heat intolerance, and drop in blood pressure upon standing. Postural orthostatic tachycardia syndrome (also known as POTS) can increase heart rate when standing up and cause such symptoms as lightheadedness (or fainting) or difficulty concentrating.

How can podiatry help you?

As podiatrists we can assist you with peripheral neuropathy by recognising the extent of numbness through testing sensations with special fibres and then providing advice on how to care and manage your feet in the future. 

The following things we test include:

  • Numbness or tingling
  • Diminished or absent temperature sensitivities
  • Reduced sensations to include temperature, sharp and blunt, light touch, and vibration.
  • Altered muscle strength and reduced proprioception leading to imbalance.

If you are concerned and are a new client to Zest Podiatry, please book an initial assessment where we can fully assess your feet.

What else may cause peripheral neuropathy?

Other conditions that cause someone to be at risk of peripheral neuropathy include:



Previous reports have focused on covid toes during the covid viral infection.

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It’s all about MSK


MSK (Musculoskeletal) is the diagnosis and treatment of problems arising from the musculoskeletal system. This includes injuries and diseases affecting the muscles, bones and joints of the limbs and spine. Traditionally linked with biomechanics the MSK podiatrist is the “go-to” person for functional pain in the foot and ankle.

What is an MSK Podiatrist?

This is sometimes referred to as a Biomechanical Podiatrist and the two terms are often used interchangeably, so what is biomechanics? Biomechanics in its broadest sense is the application of mechanical principles to biological systems. Within the foot and lower leg the application of mechanical principles is vital in addressing pain within the musculoskeletal system.

At Zest we are trained in assessing the joints in the lower limb through our knowledge of biomechanics. By using this knowledge alongside our in-house diagnostic techniques, equipment we can offer a full musculoskeletal treatment plan.

Common MSK conditions we treat include:

  • plantar fasciitis
  • morton’s neuroma
  • achilles tendonopathy/tendonitis
  • other tendonopathy/tendonitis
  • osteoarthritis
  • painful flat feet
  • heel pain
  • joint pain
  • bursitis
  • big toe pain
  • ankle pain

What does an MSK assessment look like?

Assessment is a combination of assessing clients on the couch, standing on the floor and observing walking (gait analysis). Gait analysis is often assisted by video gait analysis technology, in clinic we use Run3D (external site of Run3D.co.uk).

The mixture of clinical examinations and ultrasound imaging are to aid diagnosis, and then advise on treatment options.

What are the treatment options?

A combination of MSK treatments can include:

  • footwear advice
  • exercise therapy
  • orthoses/insoles
  • taping
  • focus rehabilitation
  • injection therapy (including steroid injection)

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Is it a verruca?


Got an unusual lesion/spot on your foot. If you don’t like the look of it or it gives you pain, chances are that its a verruca.

Verrucae or warts are caused by Human Papilloma Virus (HPV). The hpv virus causes an excess amount of keratin to develop in the top skin layer (epidermis). The extra keratin produces the unsightly and rough texture of the verruca.

They are picked up by barefoot contact on floors and surfaces. Most common in wet changing room floors or shower areas. In these areas the virus can survive for up to 3 weeks without a host.

They are harmless in that they don’t invade the body any deeper than the top layer of skin. They can however spread to other parts of the foot or onto the hands.

The body should recognise a virus on the body and kill it naturally. Verrucae and warts can lie undetected on the outer layer of skin for years until it is recognised.

Available treatments

Here at Zest we have the latest treatment for Verrucae and warts, such as the SWIFT microwave therapy. SWIFT uses microwave technology to kill the infected skin cells and provoke an immune response by the body (to kill the virus naturally). This is a non invasive treatment that is quick to deliver and comes as a package of 3 treatments, over a 3 month period. (Swift emblation external site)

In addition to SWIFT , we also offer traditional verruca and wart treatments such as cryotherapy (freezing), needling surgery or salicylic acid based treatments. If neither treatment is for you but you want us to manage the painful callus on a verruca, we can do that too. Click here for all the verrucae treatments we offer.

What is Podiatry?


Podiatrists are foot healthcare experts.

They are university trained to prevent, diagnose, treat and rehabilitate medical and surgical conditions of the feet and lower limbs. The College of Podiatry.

Podiatrists (formerly named Chiropodists) are the healthcare professionals responsible for delivering podiatry both in hospital and clinic settings. They study a degree course and are registered with the HCPC (Health Care Professions Council).

They deal with a broad range of conditions that affect the foot and ankle. Treatments include specialist treatments such as swift microwave verrucae therapy, sports podiatry, injection therapy, musculoskeletal and nail surgery.

Foot health provision is available on the NHS to those who long term conditions that affect their feet. Conditions may include Diabetes, Peripheral Arterial Disease and Rheumatoid Arthritis (NICE guidelines).

We have 3 full-time and 2 part-time podiatrists who are able to provide general podiatry alongside musculoskeletal. We treat those in pain, have reduced mobility or just want to improve aesthetics. Musculoskeletal podiatry includes the use of ultrasound imaging, injection therapy, extracorporeal shockwave therapy (ESWT), Run3D and orthoses.

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