Introduction
Everyone has experienced numbness and tingling sensations in the toes after the limb has “fallen asleep”, almost always due to a particular position perhaps maintained for a long time. In these cases there is nothing to worry about: after a few moments, the situation returns to normal.
If, on the other hand, it happens regularly that you have the numb toes and to lose sensitivity in the area it is better to investigate because the problem could depend on causes that require specific treatments.
What is paresthesia
The tingling and numbness, which in medical terms are called paresthesias, are the result of aalteration of the sensory afferent nerve fibers at any point on their journey from the periphery of the body to the cerebral cortex. Sensory nerve fibers are the structures contained within the nerves that allow us to feel pain, heat, cold and vibrations and supersede the sense of touch.
When the paresthesia of the feet is temporary it is usually related to forced positions held for a long time, for example during sleep, which cause a momentary crushing of the peripheral nerve that passes through the feet. When you return to a correct position, the tingling persists for a few seconds or minutes, but then passes.
Even when wearing one shoe too tight toes may go numb, because blood flow to the extremities can be blocked and cause a pins and needles sensation.
If the tingling does not resolve by changing the position then there may be other causes behind it.
The causes of numb toes
Peripheral neuropathy
Peripheral neuropathy, as the name implies, is one disease affecting the nerves of the peripheral nervous system, which are damaged. It is one of the most likely causes of frequent toe numbness.
In turn, this condition can be linked to diseases such as diabetes, autoimmune diseases such as rheumatoid arthritis and lupus, hypothyroidism, kidney disease, liver disease, excessive alcohol consumption, vitamin B12 deficiency, infections, chemotherapy treatments. In addition to numbness in the toes can also appear weakness, pain and/or burning. Symptoms often start out mild and tend to get worse over time.
How to act: the doctor could prescribe treatments based on drugs pain relievers, antiepileptic drugs and/or antidepressant drugs. They can also be indicated exercises which help to strengthen the feet. Pain-relieving ointments and creams such as lidocaine can also ease the discomfort. Of course, you also need to treat the underlying causes of the problem with the help of your doctor.
Nerve compression
Numb toes can be the result of pinched or compressed nervesespecially if they are accompanied by difficulty moving the fingers themselves and / or by a constant dull or sharp pain.
The most exposed subjects are those who suffer from bone spursrheumatoid arthritis, thyroid disease, neuroma of Morton (in which the tissue around the ball of the foot becomes thicker and compresses the nerve in the toe), metatarsalgia (inflammation affecting the sole of the foot), tarsal tunnel syndrome or pinched nerve in the ankle.
How to act: if you think you are suffering from compression of the nerves around your toes, you should contact your doctor, who will set up different treatments depending on the situation. In some cases, you may benefit from using more comfortable shoes, resorting to orthotics or from injections of steroidthe. More serious cases may require surgery.
Peripheral arterial disease of the lower limbs
Also called PAD, peripheral arterial disease of the lower extremities is a disease that occurs when i vessels that carry blood from the heart to the legs narrow or block, usually due to plaque. The most common symptoms are pain or cramps in the feet, calves, hips, or thighs that get worse with activity and ease with rest. Some people may also experience numbness in their toes.
PAD is more common in those with high blood pressure or cholesterol, diabetes, and smokers.
How to act: PAD can increase your risk of heart attack or stroke, so it’s important to talk to your doctor about your symptoms. In some cases, just incorporating heart-healthy habits such as diet, physical exercise, weight loss and smoking cessation. If that weren’t enough, your doctor might also prescribe drug treatments or other interventions.
Diabetes
Among the causes of numb toes there may also be systemic diseases characterized by widespread damage to the nerves, such as diabetes, a condition in which there is an increase in the concentration of glucose in the blood. In fact, diabetes can damage, among other structures, also the sensitive nerve fibers.
As a result you have a reduced sensitivity (tactile, painful and thermal) and paresthesias in the feet and hands, but also cramping pains in the calves. These symptoms manifest themselves above all at night, significantly disturbing rest and negatively affecting the quality of life.
How to act: to resolve the symptoms, it is essential to treat diabetes with the lifestyle correctioninsulin and/or other specific drugs in relation to the specific case.
Multiple sclerosis
Although more rarely, numbness can be indicative of diseases affecting the peripheral or central nervous system. The most frequent is multiple sclerosis, one chronic disease of the central nervous system linked to an anomaly of the immune system, which in this case is activated against myelin, the coating substance of the nerve fibers which, in addition to protecting them, helps to conduct nerve impulses.
The result of this process is the appearance of plaques or scars in nerve tissue, which prevent it from functioning properly, causing problems in the transmission of nerve impulses. The disease can affect one or more areas of the nervous system, triggering different consequences (based on the affected part). In addition to tingling, the most common symptoms are: marked tiredness, visual disturbances, pain, spasticity, intestinal and bladder disorders, alterations.
How to act: again, you need to follow through specific treatments for the underlying disease. The specialist team will recommend the most appropriate treatment to control multiple sclerosis.
freezing
If the numbness in your toes starts after spending time in a cold environment, you may have frostbite. Other possible symptoms are burning or swelling, skin that appears very red, blue, purple or even black. The most vulnerable subjects are children and the elderly.
How to act: mild frostbite can be treated removing shoes and socks and soaking the affected area in warm (not boiling) water for 30 minutes. Afterward, wrap your feet in a blanket to keep them warm. In the most serious cases they are needed emergency care.