Semmes Weinstein 5.07 10g monofilament examination as a screening exam for diabetic peripheral neuropathy

Patients with diabetic peripheral neuropathy is an important risk factor for the diabetic foot. Those with diabetic peripheral neuropathy is a major cause of diabetic foot ulcers and amputations. Health professionals need a quick and inexpensive screening tool to identify those patients with diabetic peripheral neuropathy.

Semmes Weinstein 5.07 10g monofilament wire exam on diabetics is an effective screening tool to identify diabetic peripheral neuropathy. It is noninvasive, easy to perform, quick, and repeatable. The most common filament used for this test is the nylon monofilament wire.  The gauge of the most common Semmes Weinstein nylon monofilament is 5.07. This number is determined by the logarithm of the applied force in milligrams. The monofilament bending or buckling force for the 5.07 wire is 10 grams. This is the force that make the Semmes Weinstein monofilament bends in half and the normal sensation the patient should feel it.

How to Perform a Semmes Weinstein Neuropathy Skin Test

1. Have the patient in a sitting position with shoes and socks off.
2. Explain to the patient that you’re screening/testing for neuropathy (loss of skin nerve feeling).
3. Touch the Semmes-Weinstein nylon monofilament wire to the patient’s arm to show what the touch feels like.
4. Tell the patient to respond “Yes” each time he or she feels the pressure of the 5.07 monofilament wire on the foot during the exam.
5. Tell the patient to shut their eyes during the exam.
6. Hold the monofilament wire perpendicular to the patient’s foot. Press it against the foot, increasing the pressure until the monofilament bends into a C shape. (The patient should sense the monofilament by the time it bends.)
7. Hold the monofilament in place for about 1 second. Press the monofilament to the skin so it buckles at one of two times as you say “Time one” or “Time two.” Have the patient identify at which time he or she was touched. Randomize the sequence of applying the filament throughout the examination.
8. Locations for testing: On both feet, use the first, third, and fifth metatarsal heads and plantar surface of the distal hallux and third toe. Avoid callused areas.
9. Record response on foot screening form with “+” for Yes and “–” for No.

Teri Green
Atlas Biomechanics