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Suggest Treatment For Lower Back Pain And Numbness On Toes
Question: I am a 54 year old female, I have a weight problem so it is understandable to me why I have suffered with lower back pain for many years. For about the last two years I have also suffered with numbness on the toes of both my feet, when I place my feet on the ground it feels like I have cotton wool under my toes. At times my toes feel like they're freezing and other times they feel like they're on fire or they burn. I also suffer with tremendous amount of pain running down both buttocks, upper leg and calves. If a do a little walking I have lots of pain from my toes all the way up to my lower back (or visa versa). Laying on my sides is ok for a little while, then the ache deep in my buttock starts until it becomes unbearable forcing me to turn over, but soon the process starts again & contunes through the night. I have had my sugar checked and thankfully am not diabetic. I don't know whether I should go and see a nerve or vein specialist. Please help me.
Brief Answer:
Looks more related to nerve root compression from spinal stenosis.
Detailed Answer:
I read your question carefully and I understand your concern.
You make a good question as pain along the extremities with the abnormal sensations you describe can be caused both from nerve related issues as well as blood vessels issues.
When it is related to the nerves it is due to spinal stenosis causing compression of nerve roots bilaterally and leading to bilateral sciatica as that type of pain is commonly named.
When related to arteries it is due to atherosclerotic plaques in the arteries,when bilateral as in your case the aorto-iliac arteries. In most cases it happens in people with vascular risk factors for a long time such as diabetes, smoking, high blood pressure, high cholesterol. Diabetes is present in the overwhelming majority so because of you mentioning no such factors while on the other hand back issues are already known I would say neurogenic origin is much more likely and you should see a neurologist first. Probably a back MRI will be necessary.
Other telling signs are for example then when pain starts while walking (this type of pain is called claudication), in vascular claudication it is relieved soon by standing while in neurogenic claudication it is not. Neurogenic claudication can be relieved on the other hand by bending forward or when walking uphill, while walking downhill is worse.
Also in vascular issues the pulses in your feet are low and absent, I am not sure you can evaluate this yourself but your general physician can before sending you to a specialist.
I remain at your disposal for other questions.
Looks more related to nerve root compression from spinal stenosis.
Detailed Answer:
I read your question carefully and I understand your concern.
You make a good question as pain along the extremities with the abnormal sensations you describe can be caused both from nerve related issues as well as blood vessels issues.
When it is related to the nerves it is due to spinal stenosis causing compression of nerve roots bilaterally and leading to bilateral sciatica as that type of pain is commonly named.
When related to arteries it is due to atherosclerotic plaques in the arteries,when bilateral as in your case the aorto-iliac arteries. In most cases it happens in people with vascular risk factors for a long time such as diabetes, smoking, high blood pressure, high cholesterol. Diabetes is present in the overwhelming majority so because of you mentioning no such factors while on the other hand back issues are already known I would say neurogenic origin is much more likely and you should see a neurologist first. Probably a back MRI will be necessary.
Other telling signs are for example then when pain starts while walking (this type of pain is called claudication), in vascular claudication it is relieved soon by standing while in neurogenic claudication it is not. Neurogenic claudication can be relieved on the other hand by bending forward or when walking uphill, while walking downhill is worse.
Also in vascular issues the pulses in your feet are low and absent, I am not sure you can evaluate this yourself but your general physician can before sending you to a specialist.
I remain at your disposal for other questions.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you so much for the prompt reply. To my knowledge I do not have Cholesterol but have taken blood pressure medication for at least 6 years. I have also has a laparoscopic gastric bypass two weeks ago so that I can loose the weight in order to help alleviate the pain. I hope it's not a case of too little too late.
Kind regards
Kind regards
Brief Answer:
Read below
Detailed Answer:
Thank you for your additional information.
As I said at such an early age usually multiple vascular risk factors are present to develop that degree of atherosclerosis, so I still think a neurogenic cause more possible.
Hopefully you will get better with physical therapy.
Read below
Detailed Answer:
Thank you for your additional information.
As I said at such an early age usually multiple vascular risk factors are present to develop that degree of atherosclerosis, so I still think a neurogenic cause more possible.
Hopefully you will get better with physical therapy.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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