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Monofilaments to Test for Neuropathy

You might have already encountered monofilaments before if your diabetes health care provider is meticulous about screening for peripheral neuropathy, a complication of diabetes that causes pain and numbness in the hands and feet. (We’ve written before about neuropathy – see issue 9’s Test Drive). These simple but super handy little tools usually consist of a nylon filament attached to a handle and are routinely used to test for “protective sensation” in the feet of patients with diabetes. Protective sensation means the level of feeling that a person has to have to be able to avoid injuries to his or her extremities (in this case, the feet). If your health care provider does not use a monofilament when checking your lower extremities for neuropathy, you should ask them about it! It is possible for a patient with neuropathy to maintain a level of general sensation in their feet while losing protective sensation entirely. This is exactly what the monofilament tests for—if you can’t reliably detect the monofilament on the bottom of their feet, you may be at risk for injury. However, with a little education, monofilaments can easily be used at home between checkups, giving you an early warning if you’re beginning to develop neuropathy. Your primary care provider may be able to give you a monofilament for home testing for free. You can also contact the Lower Extremity Amputation Prevention (LEAP) Program at 888-ASK-HRSA for a free test kit and great advice on how to keep your feet healthy.