What Causes Severe Lower Back Pain And Intermittent Numbness In Small Toe?

Posted on Fri, 27 May 2016

Question: In XXXXXXX of 2015, I fractured my pelvis, sternum and three ribs on my left side as a result of a car wreck. By September I recovered and was feeling great.

Around the middle of October 2015 I began experiencing pain/discomfort in my middle and lower back. It feels like muscle pain on both sides and the spine itself. It comes and goes in severity and is always worse in the early morning. It seems to get better with physical activity throughout the day.

I am able to work and otherwise function normally without exacerbating it at all, but this is an everyday symptom since the middle of October. I also have intermittent numbness in my small toe, both left and right foot.

I have had my kidneys checked and they came back normal according to the blood tests.

What could this possibly be?

Sorry, that should read, "It feels like muscle pain on both sides, and NOT the spine itself."

Answered by Dr. Ajay Panwar (53 minutes later)

Brief Answer:
Please tell me a few details:

Detailed Answer:
Hi XXXXX,
Thanks for being on healthcaremagic.com.
I am Dr.Ajay Panwar,a neurologist,here to answer your query.

I have gone through your detailed history and I would like to answer this query at my best.However,I need to know a few details for the same-
1)Does your low back pain radiate to your lower extremities also?
2)Are there any specific factors which aggravate the pain and those which improve the pain?If yes,what are they?
3)Do you have tingling/paresthesias in lower limbs?
4)Any difficulty in gripping slippers in feet?

I shall be glad to have you in follow-up with details so that I can answer this well.

Regards
Dr.Ajay Panwar,
MD,DM(Neurology)

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Ajay Panwar (18 minutes later)

1)Does your low back pain radiate to your lower extremities also?

- No sir. No pain in lower extremities. However, on occasion/intermittently both of my small toes have a numbness to them.

2)Are there any specific factors which aggravate the pain and those which improve the pain?If yes,what are they?

- In the early morning it is the worst. It does improve as the day goes on. Then, the next morning it is right back to dull pain/stiffness.

3)Do you have tingling/paresthesias in lower limbs?

- Sporadic (perhaps once every couple of weeks), bi-lateral small toe numbness.

4)Any difficulty in gripping slippers in feet?

- None

This discomfort/pain feels muscular to me. Middle and lower (far lateral) sides of my back.

There is no pain/discomfort when I exercise or work. It stays constant.

Answered by Dr. Ajay Panwar (1 hour later)

Brief Answer:
It's probably musculoskeletal in origin.

Detailed Answer:
Hi XXXXX,
Thanks for being in follow-up and providing further details.

In view of the clinical details you have mentioned,this pain indeed appears to be of musculoskeletal(non-neurological) in origin. Pain is worse in the morning and improves with work,goes well with the inflammation.This should be examined by a Rheumatologist. I suggest that you should visit a rheumatologist and get yourself physically examined.

However,numbness in bilateral small toe,appears to be of neurological origin(possibly spondylosis with lumbosacral radiculopathy).This can be evaluated with a MRI of lumbosacral(L-S) spine.Physiotherapy(spinal exercises) are likely to help significantly to improve this numbness.

Hope that helps.If you have any further questions,I shall be glad to have you in follow-up.

Regards
Dr.Ajay Panwar,
MD,DM(Neurology)

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar