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Suggest Remedy For Numbness In Sole Of Feet That Spreads To Ankles
Question:
I have suffered from numb feet for approximately 11 years - soles of feet spreading up to ankles. A tarsal tunnel operation on both feet about 3 years ago hasn't helped. Recently I have experieced persistant lameness in my left arm. Although I still have use of the arm, raising it above shoulder level or moving it in certain positions can be uncomfortable or painful , e.g., when driving my car or exercising. I am nearly 70 years old. What could be wrong with me and what should I do about it?
I have suffered from numb feet for approximately 11 years - soles of feet spreading up to ankles. A tarsal tunnel operation on both feet about 3 years ago hasn't helped. Recently I have experieced persistant lameness in my left arm. Although I still have use of the arm, raising it above shoulder level or moving it in certain positions can be uncomfortable or painful , e.g., when driving my car or exercising. I am nearly 70 years old. What could be wrong with me and what should I do about it?
Brief Answer:
It is possible but unlikely that condition of feet and left arm are related
Detailed Answer:
Good evening. My name is Dr. Saghafi and I am a neurologist from XXXXXXX OH.
Sorry, you're having discomfort.
If the tarsal tunnel procedures made no difference to your condition then, perhaps that was not the primary problem.
What needs to be done is an EMG with a nerve conduction study to determine where the problem may be....peripheral nerves (plantar nerves or related terminal branches in the feet, plexus of interconnected nerves just outside of the spinal cord in the lower back, or spinal cord and above. That is what these tests can show.
You then, should get a complete blood testing panel looking for reasons to have what could be termed a PERIPHERAL NEUROPATHY. If there is a metabolic or chemical reason then, there are a number of special tests that can be done to try and figure out what's causing the problem such as Vitamin B12 levels, Vitamin D levels, glucose levels, thyroid hormone levels, and other substances that we typically look for when testing.
I would also recommend getting an imaging study such as MRI of both the cervical and lumbar spines to see if the left arm could be related but somehow I think that's a separate problem. It could be that you've got degenerative disk disease compromising both the cervical as well as lumbar cords.
At any rate, these would be my recommendations for a good workup. A solid neurologist should be able to perform all of this for you. You're looking for one who also does electrical work and clearly understands the workup of a peripheral neuropathy in the face of a failed tarsal tunnel workup.
I'd appreciate the favor of a HIGH STAR RATING and some written feedback if your question has been satisfactorily answered.
Also CLOSING THE QUERY on your end will be most helpful and appreciated so that this transaction can be processed.
Don't forget that my webpage to keep me abreast as to how you are doing if you choose or if you ever have any other questions of a medical nature is:
bit.ly/drdariushsaghafi
All the Best
This query has required a total of 26 minutes of physician specific time to read, research, and compile the return envoy to the patient.
It is possible but unlikely that condition of feet and left arm are related
Detailed Answer:
Good evening. My name is Dr. Saghafi and I am a neurologist from XXXXXXX OH.
Sorry, you're having discomfort.
If the tarsal tunnel procedures made no difference to your condition then, perhaps that was not the primary problem.
What needs to be done is an EMG with a nerve conduction study to determine where the problem may be....peripheral nerves (plantar nerves or related terminal branches in the feet, plexus of interconnected nerves just outside of the spinal cord in the lower back, or spinal cord and above. That is what these tests can show.
You then, should get a complete blood testing panel looking for reasons to have what could be termed a PERIPHERAL NEUROPATHY. If there is a metabolic or chemical reason then, there are a number of special tests that can be done to try and figure out what's causing the problem such as Vitamin B12 levels, Vitamin D levels, glucose levels, thyroid hormone levels, and other substances that we typically look for when testing.
I would also recommend getting an imaging study such as MRI of both the cervical and lumbar spines to see if the left arm could be related but somehow I think that's a separate problem. It could be that you've got degenerative disk disease compromising both the cervical as well as lumbar cords.
At any rate, these would be my recommendations for a good workup. A solid neurologist should be able to perform all of this for you. You're looking for one who also does electrical work and clearly understands the workup of a peripheral neuropathy in the face of a failed tarsal tunnel workup.
I'd appreciate the favor of a HIGH STAR RATING and some written feedback if your question has been satisfactorily answered.
Also CLOSING THE QUERY on your end will be most helpful and appreciated so that this transaction can be processed.
Don't forget that my webpage to keep me abreast as to how you are doing if you choose or if you ever have any other questions of a medical nature is:
bit.ly/drdariushsaghafi
All the Best
This query has required a total of 26 minutes of physician specific time to read, research, and compile the return envoy to the patient.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I was hoping to avoid further neurological tests as I had 2 or 3 before the tarsal tunnel op and they showed nothing untoward. similarly a recent blood test as part of a normal check up showed vitamin levels normal.
I'll consult my GP and perhaps show him your recommendations.
Thank you.
I'll consult my GP and perhaps show him your recommendations.
Thank you.
Brief Answer:
Don't see how you can avoid further testing if you want answers?
Detailed Answer:
Good afternoon.
I'm not sure how to go about making a diagnosis in this case without further testing. You've not given much else to go on aside from the fact that the TTT surgery was unsuccessful. That means that anything from a purely peripheral type of neuropathy (caused by diabetes, hypothyroidism, alcohol induced neuropathy, amyloidosis, paraneoplastic disease, and at least another 50 metabolic and/or genetic problems) to a compression syndrome in the back or even more strange, demyelinating disease of the brain could be the cause. Without the proper battery of tests and diagnostic studies--- the best answer will be, "Progressive Bilateral Plantar paresthesias, cause unknown." My feeling on the shoulder is that you have either a calcific bursitis, rotator cuff tear, or degenerative arthritic joint disease. If it were purely degenerative arthritis I'd think that the other side would also be affected...but doesn't have to be the case.
Blood tests for peripheral neuropathy workup can be extensive and usually very few of those tests are automatically done in a routine blood draw for wellness checkup purposes.
And I will stand by my statement of an EMG/NCV study if that has not yet been done and to couple that with an MRI of the lumbar spine. Cervical spine is less likely to have the pathology in a case like this though not impossible. Thoracic spine probably doesn't need to be imaged as this is the segment least likely to be the cause of plantar neuropathy. Having said that something as silly as a scoliosis which could be in the thoracic spine and cause some symptoms....but again, if there are limitations or constraints due to equipment availability or cost I would get the lumbar spine first followed by cervical then, thoracic, and lastly, I'd get an MRI of the brain since one could hypothesize a bizarre (and highly unlikely) demyelinating type of picture.
I'd appreciate the favor of a HIGH STAR RATING and some written feedback if your question has been satisfactorily answered.
Also CLOSING THE QUERY on your end will be most helpful and appreciated so that this transaction can be processed.
Don't forget that my webpage to keep me abreast as to how you are doing if you choose or if you ever have any other questions of a medical nature is:
bit.ly/drdariushsaghafi
All the Best
This query has required a total of 43 minutes of physician specific time to read, research, and compile the return envoy to the patient.
Cheers!
Don't see how you can avoid further testing if you want answers?
Detailed Answer:
Good afternoon.
I'm not sure how to go about making a diagnosis in this case without further testing. You've not given much else to go on aside from the fact that the TTT surgery was unsuccessful. That means that anything from a purely peripheral type of neuropathy (caused by diabetes, hypothyroidism, alcohol induced neuropathy, amyloidosis, paraneoplastic disease, and at least another 50 metabolic and/or genetic problems) to a compression syndrome in the back or even more strange, demyelinating disease of the brain could be the cause. Without the proper battery of tests and diagnostic studies--- the best answer will be, "Progressive Bilateral Plantar paresthesias, cause unknown." My feeling on the shoulder is that you have either a calcific bursitis, rotator cuff tear, or degenerative arthritic joint disease. If it were purely degenerative arthritis I'd think that the other side would also be affected...but doesn't have to be the case.
Blood tests for peripheral neuropathy workup can be extensive and usually very few of those tests are automatically done in a routine blood draw for wellness checkup purposes.
And I will stand by my statement of an EMG/NCV study if that has not yet been done and to couple that with an MRI of the lumbar spine. Cervical spine is less likely to have the pathology in a case like this though not impossible. Thoracic spine probably doesn't need to be imaged as this is the segment least likely to be the cause of plantar neuropathy. Having said that something as silly as a scoliosis which could be in the thoracic spine and cause some symptoms....but again, if there are limitations or constraints due to equipment availability or cost I would get the lumbar spine first followed by cervical then, thoracic, and lastly, I'd get an MRI of the brain since one could hypothesize a bizarre (and highly unlikely) demyelinating type of picture.
I'd appreciate the favor of a HIGH STAR RATING and some written feedback if your question has been satisfactorily answered.
Also CLOSING THE QUERY on your end will be most helpful and appreciated so that this transaction can be processed.
Don't forget that my webpage to keep me abreast as to how you are doing if you choose or if you ever have any other questions of a medical nature is:
bit.ly/drdariushsaghafi
All the Best
This query has required a total of 43 minutes of physician specific time to read, research, and compile the return envoy to the patient.
Cheers!
Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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