The “Comfort Paradox”: Why Feeling Good Might Be Bad for the Diabetic Foot
Summary: This blog post discusses the “Comfort Paradox” in diabetic neuropathy: patients select shoes based on comfort/fit, but loss of protective sensation means they cannot detect harmful friction/pressure. Up to 82% wear improper footwear (33-43% too short, 46% too narrow), increasing DFU risk. Cites Carral-Sota et al. review emphasizing therapeutic shoes reduce ulcers/amputations. Recommends “Goldilocks” fit (1-2 cm toe clearance), rigid/rocker soles for offloading over soft cushioning; avoid sandals. Structured shoes > comfort priority for prevention.
Key Highlights:
- Paradox: Comfort perception unreliable without sensation.
- Stats: 33-82% improper fit; ↑ DFU risk.
- Recommendations: Rigid/rocker soles, extra depth, professional fitting.
- Cited: Carral-Sota review (J Clin Med 2025).
- Contributors: ALPSlimb, Keck School USC; #ActAgainstAmputation.
Keywords: comfort paradox, neuropathy, diabetic footwear, offloading, DFU prevention