Pressure-point wounds arising from any cause of peripheral nerve damage.
A neuropathic ulcer is a wound that develops over a pressure-bearing area — most often the plantar surface of the foot — as a result of loss of protective sensation from peripheral neuropathy. Because the patient cannot feel repetitive pressure, friction, or minor trauma, tissue breaks down painlessly and progresses to ulceration. While diabetes is the most common cause, neuropathic ulcers also arise from vitamin B12 deficiency, chronic alcohol use, spina bifida, Hansen's disease (leprosy), chemotherapy-induced neuropathy, and inherited neuropathies. These wounds are classically deep, surrounded by thick callus, and located over bony prominences.
Also known as: Neurotrophic ulcer, Neuropathic foot ulcer, Mal perforans, Trophic ulcer, Pressure-point ulcer.
Common signs and symptoms can vary by wound type and severity.
A clinician evaluates the wound together with the factors that may delay healing.
Seek evaluation for any non-healing wound on a numb foot, or if you notice new redness, swelling, warmth, drainage, or odor. Because neuropathic ulcers are painless, they can hide serious infection or bone involvement — early professional assessment is essential to prevent amputation.
Healix360 supports access to advanced mobile wound care services for patients throughout our coverage area. Services are delivered by licensed physicians and nurse practitioners experienced in the evaluation and management of chronic and complex wounds, including neuropathic ulcers of both diabetic and non-diabetic origin. Care is coordinated and provided directly to patients in private residences, assisted living communities, and skilled nursing facilities.
Our clinicians identify and address the underlying cause of neuropathy — whether metabolic, nutritional, or inherited — while managing the wound itself. Treatment centers on pressure offloading, debridement of surrounding callus and nonviable tissue, and infection control. For persistent wounds, we apply advanced biologics and cellular therapies to stimulate closure. Where diabetes is the driver, care mirrors the coordinated limb-preservation strategy used for diabetic foot ulcers.
With consistent offloading, callus and wound debridement, treatment of the underlying neuropathy, and advanced wound therapies, most neuropathic ulcers can achieve durable closure, substantially lowering the risk of deep infection, osteomyelitis, and lower-extremity amputation.
Diabetic foot ulcers are the most common type of neuropathic ulcer, but neuropathic ulcers are a broader category that also includes wounds from B12 deficiency, alcohol-related neuropathy, spina bifida, Hansen's disease, and inherited neuropathies. The wound biology and offloading principles overlap considerably.
Peripheral neuropathy damages the sensory nerves that carry pain signals, so tissue can break down without any warning discomfort. This is exactly why daily foot inspection is critical for people with numb feet.
Some causes — such as vitamin B12 deficiency or alcohol-related neuropathy — can improve when the underlying problem is corrected, while others are permanent. Even when the nerve damage is fixed, protecting the skin and offloading pressure remain essential to prevent ulcers.
Offloading uses total contact casts, removable boots, or specialized footwear to relieve pressure from the wound. Because these ulcers form from repetitive pressure on an area the patient cannot feel, offloading is the single most important factor in healing.
Yes. Medically necessary in-home wound care for neuropathic ulcers, including clinician visits, debridement, and advanced dressings, is typically covered under Medicare Part B.
Call 877-545-1300 or request a provider to begin care. Healix360 serves Southern California and Nevada and accepts Medicare Part B and most major insurance plans.