Doctors Lounge - Neurology Answers
provided on www.doctorslounge.com is designed to support, not
replace, the relationship that exists between a patient/site
visitor and his/her physician."
Back to Neurology Answers List
| scott in Wisconsin
- Sun Dec 21, 2003 6:32 pm
I'm concerned about tingling in my feet.
My right big toe has a kind of "shooting" tingle if I point my toes.
My left heal tingles, especially if I stretch the toes up toward my head, with my leg straightened.
This started 4-5 months ago with the right big toe, and the heal started recently. No pain, just uncomfortable tingle. Not constant, but often. Nothing similar in other extremities.
I'm 46, male, and I retired 3 years ago in fine health. I do spend much more time sitting now. No stress what-so-ever! :lol:
I have no other complaints. Never tired, no head aches, etc. I can run, play sports, long walks, etc., with no problem. Vision the same as it has been. I'm sleeping well, about 8 hrs a day.
I'm 5'11" 160 lbs.
Blood pressure 100 over 60.
I'm on no medication, never have been. I've had no colds, no flu, no problems of any kind for many years. Heterosexual, monogamous for 10+ years.
I take vitamins, but just the same ones I have for 20 years, including some herbs (like garlic, green tea extract, stinging nettles, Pygeum bark, saw palmetto). NO changes in my diet, which is pretty ordinary. I drink distilled water, mostly. No alcohol or tobacco.
No history in my family of any genetic maladies, as far back as we can see. Certainly no diabetes! My 78 year old father has had a high PSA for 20 years, but no symptoms.
I've been waiting for it to go away on it's own, but it has not. The right big toe does not seem any worse after 4+ months.
My insurance has a $5000 deductible, so I haven't been anxious to pursue costly test just to see . . .
I'm hoping all my sitting has pinched a nerve. Anything else I might want to consider? Is there a specific type of specialist I should see about this? Basically, what are the outside possibilities?
Thank you very much for your time!!
| Dr. Russell M
- Tue Dec 23, 2003 1:06 pm
I would broadly put you into the category of peripheral neuropathy (meaning disease of the peripheral nerves), preferably sensory neuropathy (meaning disease affecting sensory nerves, which are different from motor or autonomic nerves), which has many causes, the commonest being diabetes mellitus, which you don't have. Plenty of other diseases like hypertension, AIDS, sarcoidosis, lyme disease, paraproteinemias, etc., can also be behind a neuropathy, as can vitamin deficiency. If you weren't on multivitamins, I would have begun you on Vitamin B complex and dietary supplementation, and if that didn't work, I would have given you vitamin B12 injection intramuscular.
Extreme cold and even high dose vitamins of Pyridoxine variety can cause sensory neuropathy. Drugs, solvents, pesticides, and heavy metals are known to cause neuropathy. Do you drink alcoholic beverages? Alcohol is another important cause for neuropathy.
There is no substitute for direct clinical examination of your nerves. In certain diseases like leprosy, the particular nerve may be felt thickened by the examiner to the size of a clothesline, and in others specific signs can be elicited, which helps diagnosis.
Electrodiagnosis involves the measurement of nerve conduction velocity, and is a quite helpful investigation to differentiate different types of neuropathies, and help pin the diagnosis. Nerve biopsy would be an ultimate step, which I doubt would be required in your case.
Most patients help themselves by taking their minds off of their tingling, if the tingling doesn't freak their minds. A healthy lifestyle like yours should go a long way to help you from being nervous about nerves.
Hope this helps.