Foot numbness most often occurs with neurological and vascular pathologies, diabetes mellitus. Sometimes the cause of the symptom is trauma, angiotrophoneurosis, mental disorders. Numbness can be temporary or permanent, cover one or both feet, combined with pain, paresthesia, walking disorders. The nature of the disease is established on the basis of survey data, general and neurological examination, ultrasound and electrophysiological techniques, and other studies. Treatment includes antispasmodics, B vitamins, anticoagulants, blockades, physiotherapy.
Numbness of the foot is detected with neuropathies of the peripheral nerves of the lower extremities. As a rule, there is a local decrease in sensitivity in a certain area of the foot. The topic is determined by the affected nerve:
Unlike mononeuropathies, in which one limb is affected, polyneuropathies are characterized by symmetrical involvement of the legs and arms with reduced sensitivity in the form of "socks" and "gloves". Multiple nerve damage occurs in the following diseases:
It is possible to damage the nerves against the background of tumors, severe diseases of the liver and kidneys. Sometimes polyneuropathies of alimentary, toxic-infectious origin are detected. The most common cause of toxic polyneuropathy is alcoholism.
Foot numbness accompanies spinal cord injuries, damage to peripheral nerves. In patients with spinal cord injury, the severity of the symptom, the prevalence and nature of neurological disorders are determined by the severity of the injury. In patients with violation of the integrity of the peripheral nerves, the zone of loss of sensitivity corresponds to the area of hypesthesia in case of neuropathy of the corresponding nerve trunk.
Another possible cause of numbness is compression of the neurovascular bundle by bone fragments at the time of injury, too long preservation of the tourniquet during bleeding, and significant swelling of the limb. In severe cases, myofascial compartment syndrome may develop with severe pain, followed by loss of sensation in the distal limbs.
Due to the increase in edema, the risk of compression remains in the first days after the application of the cast, especially if the patient does not provide an elevated position of the leg. Numbness in such cases is complemented by cyanosis, the foot takes the form of a pillow, the patient complains about the strong pressure of the cast.
foot numbness
Finger numbness occurs in the later stages of Morton's disease. Due to the thickening of the plantar nerve sheath, patients suffer for a long time from burning pains, shootings in the distal part of the foot. The pain is markedly reduced after removing the shoes. The constant nature of the pain syndrome, hypesthesia of the fingers, as a rule, indicate the need for surgical intervention, since conservative methods at this stage become ineffective.
Numbness of individual areas of the foot is observed with radicular syndrome involving 1 and 2 sacral roots. In the first case, hypoesthesia spreads along the outer edge of the foot. In the second, numbness of the plantar surface, 1 toe is determined. In addition, a violation of sensitivity in the foot area is detected in people with paresis of the central genesis due to strokes, tumors, inflammatory diseases of the brain and spinal cord.
Numbness of the feet is a typical manifestation of diseases accompanied by obliteration of the vessels of the lower extremities. The symptom is combined with a feeling of fatigue, chilliness of the limbs, weakness in the legs. Paresthesias are possible. There are muscle cramps, intermittent claudication. The listed signs are detected in the following diseases of the arteries:
Similar symptoms are found in patients with Menckeberg's arteriosclerosis, a pathology in which calcium salts are deposited in the walls of the arteries. Calcification often affects the arteries of the legs. With the simultaneous involvement of the upper limbs, not only the feet, but also the hands freeze.
Acute occlusion of the vessels of the extremities can occur against the background of the above diseases, ischemic heart disease, myocardial infarction, hypertension, arrhythmias, endocarditis, tumors of the lungs and heart, periarteritis nodosa. Numbness, paresthesia, cold extremities are rapidly growing, complemented by pain. In the absence of timely assistance, paresis appears, then necrosis zones form, and gangrene of the limb develops.
Many diabetic patients complain of foot numbness. The symptom is detected in all forms of the disease, including steroid diabetes mellitus and MODY diabetes. The likelihood of numbness correlates with the severity, duration of the course of the disease. The disorder is especially pronounced in the development of a diabetic foot, which in most cases proceeds along a neuropathic variant.
Foot numbness in diabetic neuropathy is combined with tingling, burning, pain in the toes, short-term cramps, muscle weakness. Possible loss of temperature sensitivity, hypersensitivity to touch. In patients with an ischemic form of diabetic foot, pain, persistent edema, weakening or absence of pulsation in the arteries of the foot prevail.
The symptom can also be observed in diabetic macroangiopathy. In this case, both small arteries and large-caliber vessels are affected. Along with numbness, chilliness of the feet, intermittent claudication, intense pain in the muscles of the thighs and legs are revealed. Patients are diagnosed with coronary artery disease, atherosclerosis of the cerebral arteries.
Diabetic foot and macroangiopathy can be complicated by tissue necrosis, development of gangrene of fingers and foot. With dry gangrene, numbness of the distal parts of the foot is combined with severe pain, pallor or bluish-marble color of the skin, itching, burning, tingling. Wet gangrene is manifested by cold snap, edema, vesicle formation, severe general intoxication. After tissue necrosis, numbness in both types of gangrene is replaced by a complete loss of sensitivity.
Foot numbness can be detected in the following cases:
Neurologists are engaged in determining the cause of foot numbness. Patients with vascular disease are referred to a vascular surgeon. An endocrinologist takes part in the examination of patients with diabetes mellitus. The doctor finds out when and under what circumstances a violation of sensitivity occurred, how the symptom changed over time, what manifestations it accompanied. To clarify the diagnosis, the following procedures are carried out:
Foot sensation test
If a spinal cord injury is suspected, spinal immobilization is required, immediate delivery to a neurosurgical hospital. First aid tactics for nerve damage is determined by the nature of the injury. Victims with wounds need to apply an aseptic bandage. With all leg injuries, especially those accompanied by severe edema, it is necessary to provide the limbs with an elevated position. If numbness, increased edema occur after fixation with a plaster cast, you should immediately go to the emergency room to dissect the plaster.
With neuropathies, if possible, the etiofactor is eliminated. Means are prescribed to improve blood circulation, NSAIDs, vitamins from group B. For pain, therapeutic blockades of trigger points are performed. The list of non-drug methods includes UVI, diadynamic therapy, UHF. A significant role is played by massage, manual therapy, physiotherapy exercises.
In vascular diseases, antithrombotic agents, antispasmodics, vitamins, and medications are recommended to reduce erythrocyte aggregation. Intense pain is an indication for the use of painkillers, paravertebral and pararenal blockades. Patients with acute occlusion are given thrombolytics, anticoagulants.
Non-drug treatments for vascular pathologies include hyperbaric oxygen therapy, ILBI, ozone therapy, mud applications, magnetic therapy, UHF, drug electrophoresis, pearl, radon, hydrogen sulfide baths. Patients with trophic ulcers undergo dressings, perform laser treatment.
With numbness of the feet on the background of diabetes mellitus, an insulin dose adjustment or transfer of the patient to insulin therapy is required. Drug treatment is represented by antispasmodics, preparations of a-lipoic acid, infusions of solutions. With ulcerative defects, dressings, antibiotic therapy are indicated.
Taking into account the etiology of foot numbness, the following operations are performed: