There are many possible causes of numbness and tingling in the feet.
IT started with my right big toe. I experienced sharp pains in it, which was kind of like a twitch. It was severe enough to wake me up at night. Then two days later, I experienced the same thing on my other toes, and the ones on my left foot. What is happening to me?
When you have numbness and tingling in your feet, it generally has to do with a condition of the nerves or the circulation (blood vessels). This tingling is also called paraesthesia.
The doctor has to investigate the cause, of which there are many.
What are the causes of numbness and tingling in both feet?
Some of the more common causes include the following:
1. Diabetes can lead to a complication known as peripheral neuropathy, where the nerves to your extremities such as your hands and feet are damaged.
2. Other peripheral neuropathies (more on this later).
3. Spinal cord compression leading to pressure on your nerves – this may be due to a herniated disc or narrowing of the nerve canals in the backbone.
4. Peripheral artery disease, where the arteries supplying your feet are damaged due to narrowing of the blood vessels by lipid plaques. This is pretty much like the narrowing of the blood vessels to your heart, leading to chest pains and heart attacks, only this happens to your legs.
5. Tarsal Tunnel syndrome – where the tibial nerve to your foot is damaged by compression or injury.
6. Nerve damage due to substance abuse, such as alcohol and tobacco.
7. Multiple sclerosis – damage to the sheaths of the nerves in your spinal cord.
8. Fibromyalgia – long term pain and tenderness in your joints, muscles and tendons.
9. Other rarer diseases like infections and Guillain Barre Syndrome.
There may be many specialists involved in diagnosing your condition, such as a physician, an orthopaedic surgeon and a neurologist. You should aim to see one doctor first, and then he will refer you to another if more tests need to be done.
I went to an orthopaedic surgeon for diagnosis. He did an X-ray of my spine and an MRI of my back, but could not find any spinal cord compression. He then told me I had peripheral neuropathy. What is this?
Peripheral neuropathy occurs due to damage in your peripheral nervous system, as opposed to your central nervous system, which comprises your brain and spinal cord. The peripheral nerves refer to the nerves branching out from your spinal cord to supply other parts of the body.
These nerves transmit sensations (touch, heat, cold, pain) and active motor functions (for you to walk, bend, sit, run, etc). Therefore, any damage to them may take the form of numbness, tingling, loss of sensation or muscle wasting, paralysis, etc.
There is also such a thing called autonomic neuropathy, where the autonomic nerves are affected in your body. This may lead to problems with food digestion, blood pressure, sweating easily or difficulty urinating.
Some peripheral neuropathies come on slowly and progress over a long period of time. These are the chronic neuropathies, such as diabetic neuropathy.
Others come on very suddenly, progress rapidly, and resolve slowly as the damaged nerves heal. These are the acute neuropathies, such as Guillain Barre Syndrome.
Other than diabetes, what causes peripheral neuropathy?
Some of the other causes include:
1. Injury – if you fall or were involved in an accident, your nerves can be crushed.
2. Systemic diseases (diseases that affect your entire body) – diabetes, kidney failure, hormonal imbalance (thyroid and growth hormone), vitamin deficiencies (vit B12, B1, B6, E, and niacin). Nerves thrive on the B vitamins, and the doctor will always prescribe you a vitamin B compound if you have any nerve disorder for the nerves to regenerate.
3. Connective tissue disorder.
4. Cancers and benign tumors that impede on the nerves.
5. Infections and autoimmune disorders – herpes virus, HIV, Lyme disease, diphtheria, leprosy.
Is there any cure?
We have to find out the cause of the peripheral neuropathy and treat it first. Then the neuropathy may resolve.
The nerves need to regenerate after being damaged. Nerve drugs and painkillers may help alleviate symptoms. Vitamin B compounds may be used to promote nerve healing.
> Dr YLM graduated as a medical doctor, and has been writing for many years on various subjects such as medicine, health, computers and entertainment. For further information, e-mail starhealth@thestar.com.my. The information contained in this column is for general educational purposes only. Neither The Star nor the author gives any warranty on accuracy, completeness, functionality, usefulness or other assurances as to such information. The Star and the author disclaim all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.