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I Woke Up In The Middle Of The Night 5

Posted on Fri, 2 Aug 2019

Question: I woke up in the middle of the night 5 days ago and my pinky toe on my left foot was numb. it has been numb ever since. what could be causing it and can it stay like that permanently?

Follow up: Dr. Bhagyesh V. Patel (0 minute later)

I woke up in the middle of the night 5 days ago and my pinky toe on my left foot was numb. it has been numb ever since. what could be causing it and can it stay like that permanently?

Answered by Dr. Bhagyesh V. Patel (56 minutes later)

Brief Answer:
possible nerve compression most likely. need details please.

Detailed Answer:
Hello and welcome to Ask A Doctor services.
I have read your query and here is my advise.

* As per my clinical experience, sudden numbness in toe can be from different issues as
nerve compression, manifestation of underlying pathology process or else.

Kindly provide me further details so that I can answer your query completely.

1. Does the numbness remain persistent or you feel it intermittently ?
Is there any upward extension of the same to other areas of the foot ?
2. Associated changes of overlying skin in terms of temperature or else ?
3. Any numbness over rest of the toes or other foot, upper limb ?
4. History of any medical condition as diabetes or else ?
Any previous injury to same foot if any ?

Awaiting for your response.
Regards.

Dr Bhagyesh ( MS consultant surgeon )

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Answered by Dr. Bhagyesh V. Patel (0 minute later)

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Bhagyesh V. Patel (11 hours later)

Hi Doctor,

Here are the answers to your questions below:

1. The numbness remains persistent. It is 24 hours a day. There is no upward extensions to other areas of the foot. The only area that it goes beyond the toe is ever so slightly down the side of my foot. It's worth mentioning too that the entire pinky toe is not numb. Mainly the outside edge, and the bottom. The top and the tip and the inner side seem to have good feeling.

2. No changes to the skin in terms of temperature or anything else.

3. No numbness on other toes or other foot/limb.

4. No history of diabetes but I am hypoglycemic. No previous injury or occurrence of this.

I don't know if this matters but I've just begun taking Metoprolol 2 months ago and I've heard it can cause complications in circulation. I don't know if this is true but I'm mentioning it as another possible lead.

I'm also having shooting, stabbing pains in my big toe on the same foot in the same spot about once a day. It feels like an electric shock. I just thought to mention this.

Thank you very much.

Follow up: Dr. Bhagyesh V. Patel (0 minute later)

Answered by Dr. Bhagyesh V. Patel (1 hour later)

Brief Answer:
nerve conduction velocity with or without MRI is needed.

Detailed Answer:
Hi
Thanks for the details.

* As the numbness is persistent and there is associated involvement of great toe with
this, it is strongly suggestive of proximal nerve compression at higher levels ranging
from lower lumbar spine to lower part of same leg.
Electric shock feeling is almost always diagnostic for nerve involvement.

* The root cause may range from minor inflammation to compromised blood supply to
the coverings of the nerve as happens in diabetes or else.

In my clinic, I do recommend nerve conduction velocity with or without MRI for particular case after thorough physical examination to decide further management guidelines.

Wish you best health and recovery.
Regards.

Above answer was peer-reviewed by : Dr. Prasad

Answered by Dr. Bhagyesh V. Patel (0 minute later)

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Bhagyesh V. Patel (37 minutes later)

Now that you mention it, I do have a herniated disc in my L5 S1. Could this be causing it all?

Follow up: Dr. Bhagyesh V. Patel (0 minute later)

Now that you mention it, I do have a herniated disc in my L5 S1. Could this be causing it all?

Answered by Dr. Bhagyesh V. Patel (15 minutes later)

Brief Answer:
follow up .

Detailed Answer:
Welcome.

Herniated disc can be partly contributing to peripheral nerve compression presentations in many of the clinical contexts.

Above answer was peer-reviewed by : Dr. Prasad

Answered by Dr. Bhagyesh V. Patel (0 minute later)

Brief Answer:
follow up .

Detailed Answer:
Welcome.

Herniated disc can be partly contributing to peripheral nerve compression presentations in many of the clinical contexts.

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Bhagyesh V. Patel (41 minutes later)

Thank you. So in summary, what do you think is the most likely culprit for my problem and how should I treat it? Thanks so much.

Follow up: Dr. Bhagyesh V. Patel (0 minute later)

Thank you. So in summary, what do you think is the most likely culprit for my problem and how should I treat it? Thanks so much.

Answered by Dr. Bhagyesh V. Patel (49 minutes later)

Brief Answer:
follow up .

Detailed Answer:
Hi

* In summary, the current condition is neuropathy of segmental origin.

* Current management with

- Prescription medications as pregabalin, B12, anti oxidant, multi vitamins and analgesic
anti inflammatory drugs as supportive care.
- avoid exposure to excess cold
- control of blood sugar, body weight
- avoid smoking if involved

Definite management guidelines require precise diagnosis with the help of MRI and nerve conduction study as discussed earlier.

Hope this information will help you for sure.
Take care.

Above answer was peer-reviewed by : Dr. Prasad

Answered by Dr. Bhagyesh V. Patel (0 minute later)