Foot & Ankle

Numb Toes May be Indicative of an Underlying Condition

By Last updated on February 19th, 2020 No Comments

Everyone has experienced the sensation of numbness when an appendage “falls asleep”. There is numbness, tingling, and sometimes pain. But what happens when hands or feet never wake up? Chronic numbness can significantly impact quality of life and mobility. Numbness of the foot can lead to problems with walking or standing. Read on to learn what is going on inside the body as it experiences a lack of sensation and how it is treated.

Anatomy of the Foot

The foot is comprised of many structures, including bones, muscles, tendons, cartilage, and nerves, to name a few. Each structure plays an important role in the foot’s day-to-day ability to function and support the rest of the body.

One of the main nerves that runs into the foot is called the peroneal nerve, which runs from the bottom of the spine into the toes. Nerves located outside of the spinal cord and brain are called peripheral nerves. When damage occurs to these nerves, it is called peripheral neuropathy – neuropathy refers to damage in the nerves.

Numbness of the foot is commonly attributed to nerve damage or poor circulation, but there are many reasons why nerves and blood veins do not act as they should. Nerves and veins can become compressed on their way to the foot. Some potential causes of numbness or tingling in the foot include:

  • Swelling:
  • Footwear:
  • Peripheral Neuropathy:
  • Injury to the Foot:
  • Diabetes:
  • Vascular Disease:

If numbness and tingling begin to interfere with daily life, or impede one’s ability to complete normal tasks, the next step is to consult a doctor. Diagnosing numbness can lead to proper treatment of the issue, and ideally, relief of symptoms.

Diagnosing Numbness of the Foot

Doctors will begin an examination by asking questions in an attempt to locate the cause. It is important to be completely honest with them during this phase, as certain symptoms that may not seem relevant could be crucial information. These questions may seek information about diet, fitness level, type of employment, previous injury, smoking status, and so on.

Symptoms may vary, so it is important to describe each symptom in as much detail as possible. Some symptoms that may occur with numbness are:

  • Inability to feel hot or cold
  • “Pins and Needles” sensation
  • Sharp, shooting pain
  • Tingling
  • Inability to move the foot or toes

These symptoms may occur constantly or only in certain positions. Some symptoms may occur at random. Though some conditions can heal on their own, when symptoms begin to interfere with daily life it is time to consult a medical professional.

Once a doctor has received as much information as possible from speaking with the patient, they may perform a physical examination of the foot or feet. Physical examination may include watching the patient walk, touching certain areas and asking how it feels, and many more. The purpose of these tests is to determine the sensation that the patient is feeling, if the numbness has spread, and how severe the symptoms are.

Once the physical examination has occurred, doctors may order further testing to occur so that they can be certain of the cause. These may include:

  • Electromyography: this imaging technique measures the electrical activity in muscles while they are active and while they are at rest. The results of an EMG can indicate if there is an issue with muscles or nerves, and it can also indicate if there is an issue with the signaling between muscles and nerves.
  • Nerve Conduction Studies: an electrical impulse is sent through the nerves and measured to determine how long a nerve takes to transmit the electricity. If a signal takes a long time, it may be indicative of neuropathy.
  • Magnetic Resonance Imaging (MRI): this popular imaging technique is able to produce an image of soft tissues. In the case of numb toes, it could indicate that a nerve is being compressed, and sometimes it can reveal what is causing the compression. Issues relating to circulation (rather than issues with the nerves) may use an MRI to observe the blood vessels.
  • Biopsy: doctors may take a sample of nerve fibers to examine. A skin biopsy is a minimally invasive procedure that takes a piece of skin for observation. A nerve biopsy is an invasive procedure that takes a sample directly from the nerve inside the body.

Some doctors may also order blood tests or other scans to determine the underlying cause. Once a proper diagnosis has been made, doctors can begin to formulate a treatment plan. Treatment options can vary based on the diagnosis and the patient’s individual needs.

Treating Numbness

Each condition associated with numbness has a different treatment plan, but there are some steps that most individuals can take to alleviate symptoms. Many individuals can alleviate symptoms by keeping feet warm or changing footwear. Some may need to change their exercise routine to prevent stress on the legs and feet.

Treatment of numb toes and feet seeks to reduce symptoms and restore mobility. Some common methods are:

  • Physical Therapy: certain exercises can help muscles gain mobility. Some conditions can cause muscles to atrophy, a condition caused when lack of use causes muscles to begin wasting away. Exercising the muscles regularly can relieve symptoms of atrophy and prevent it in the future.
  • Pain Relief: some over-the-counter pain relief can be useful for individuals attempting to rehabilitate the area. If pain is severe, doctors may prescribe medication. Prescription pain relievers can be dangerous, so it is important to review all of the side effects and risks before taking them.
  • Orthopedic Equipment: certain corrective gear such as braces, shoes, socks, and splints can help relieve pressure on the nerve.
  • Corticosteroid Injections: this form of injection can reduce swelling, so it may help relieve symptoms if a nerve is compressed for that reason. Repeated use of corticosteroid injections can damage soft tissue over time, however, so they should be closely monitored by a medical professional.
  • Surgery: surgical procedures may vary depending on the patient’s condition. If other treatments fail to relieve symptoms, surgery may become an option. Some procedures seek to relieve pressure on the nerves by removing or easing pressure on the cause. If numbness is being caused by an abnormality of the bone either in the spine or legs, surgeons may be able to change the shape of the bone. Doctors and surgeons will determine which procedure is the most effective for each patient.

Treating numbness in the toes and foot can take a long time, as nerves take longer to heal than other structures such as muscle. For example, muscles can begin to heal in a matter of weeks but nerves can take several months.

It is important to note that some nerve damage may be permanent, depending on the cause of the numbness. Some conditions such as diabetic neuropathy and frostbite can damage nerves beyond the point of repair. If nerves have been damaged completely, treatment begins to focus heavily on managing symptoms and making lifestyle adjustments if mobility is impacted.

Though conventional treatments may be successful in some individuals, it is important to consider what else is out there that could help. Alternative treatments like regenerative therapy could alleviate symptoms and prevent further damage from occurring.

How Regenerative Medicine Can Reduce Symptoms of Numbness – and More

Treatments such as stem cell or platelet-rich plasma therapy have recently gained traction as a new way to treat many conditions. The range of these treatments include back pain, joint pain, neuropathy, and more.

These therapies use the patient’s own healing cells to repair damage that has occurred, relieve pain and swelling, and prevent future injury. CELLAXYS offers two treatments:

  • Stem Cell Therapy: stem cells are located throughout the body, and contain the ability to help cells regenerate once they have been damaged. Cells are procured using a blood sample, fat tissue, or bone marrow. The cells are then processed and injected into the area where symptoms occur. Increasing the amount of healing cells can help damaged cells recover while simultaneously reducing pain. Inflammation may also be reduced.
  • Platelet-Rich Plasma (PRP) Therapy: blood cells contain many important components, one of which is called platelets. These cells contain proteins and healing factors that can reduce inflammation and call to other healing cells such as stem cells. The procedure of receiving PRP therapy is similar to that of stem cell therapy. Once blood is drawn from the patient it is placed in a centrifuge that helps to concentrate the platelets. The solution is then injected into the area that is causing symptoms.

These outpatient procedures typically take less than two hours. The most common side effect is pain at the injection site, which often goes away within days. The operations are low-risk as they use the patient’s own cells, but the risks should be discussed beforehand.

Doctors use imaging technology such as an ultrasound or MRI to determine the exact location that will provide the most benefits to each patient. If an individual is participating in other treatments such as physical therapy or wearing a brace, they should continue to follow their doctor’s guidelines.

By reducing swelling and helping damage heal, these treatments allow patients to return to their normal lives more rapidly. In some cases, surgery is no longer necessary as the injury begins to heal.

Conclusion

Numbness in any body part can be alarming, but the first step to treating it is to identify the cause. Many individuals who experience numbness can simply address potential causes such as temperature or footwear. Making certain lifestyle adjustments could be enough to alleviate symptoms. When symptoms persist, however, seek medical advice as there may be an undiagnosed condition or hidden cause. Treatment varies depending on the cause and the patient’s needs. Conventional treatment can alleviate symptoms for some, but considering other options for treatment may lead to some sought-after relief.

Dr. Matthew HC Otten

Dr. Matthew HC Otten

Director of Orthopedic & Orthobiologics
Fellowship-trained & Board Certified in Sports medicine
Director Angiography at Harvard Clinical Research Institute
Michigan Stage University Alumni