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Thursday, May 9, 2013

Neuropathy or Referred Pain from the Low Back: Email Advice

Hi Dr. Blake,

I have a few symptoms that I will be telling my doctor about at my annual physical in two months. In the meantime, I thought I would ask you about them.

For about a year or so, I have a hard time with walking around the house barefoot. It is especially difficult first thing out of bed. Recently I have been having numbness in the corner of my right big toe. I thought this was just and old ingrown toenail thing acting up again, but it seems to be more than that. I have pain in my arches-just below the ball of my foot. I bought some arch inserts from Germany, and now have to put them into almost any shoe I wear, except my dansko clogs.
Dr Blake's comment: I have linked this with my video on foot nerve pain and it's relationship to the back. You can see how the corner of the big toe is related the L4 Disc as well as the pain in the ball of the foot into the arches.


Sometimes I imagine I get relief after stretching my hamstrings. I have one of those green stretch nylon ropes with loop holes I got after rehabbing from my knee surgery(right knee)  I got a little freaked out tonight after standing in a rite aid store. There I was getting dental floss and the auto message over the loud speaker was warning customers of their possible undiagnosed diabetic neuropathy. They listed off some sensations that sounded like a few of my symptoms.  Of course, walking home, I kept thinking.."what if this is something I have?" I don't have diabetes, that I am aware of anyway?

My questions are:

Why would the upper left corner of my big toe feel numb and burning on and off? Not just at the toenail, but under it on a callous pad and at side of toe bone.
Why is it so painful to walk barefoot? As if I need the support of a shoe or else it feels like my bones crunch with each step. As though not enough muscle in my arche to hold myself up?
Dr Blake's comment: The video above should explain what nerve root in your back is probably effected. Pressure on a nerve can cause both abnormal sensations and abnormal muscle function (ie your muscles are not supported the bones and they complain mightily.) 
Should I be concerned about diabetic neuropathy?
Dr Blake's comment: This does not sound like neuropathy, but, in the early stages of development, the symptoms can be atypical. If you were in my office, I would send you to our back doc to check if this was coming off your back. 
How can you tell the diference between foot weakness symptoms  - foot neuropathy -- Morton's neuroma - plantar fascia pain ?

Also what type of doctor would I want to be seen by. Is this for a podiatrist or a neurologist?
Dr Blake's comment: Both a podiatrist to treat the local symptoms and a neurologist or physiatrist to evaluate and possibly treat the back. The MDs would definitely help in pinpointing the diagnosis better, but the lion's share of the treatment can be left with the podiatrist. Sure hope this helps. Rich

Thanks for your time.

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Thank you very much for leaving a comment. Due to my time restraints, some comments may not be answered.I will answer questions that I feel will help the community as a whole.. I can only answer medical questions in a general form. No specific answers can be given. Please consult a podiatrist, therapist, orthopedist, or sports medicine physician in your area for specific questions.

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