Feb 06, 2012 - 7:23 pm (MST)
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Asked by shopfres (Female; 55; 78851; Hypertension; overweight; varicose veins; Relevant drugs:Benazepril ) on Tue 22, Jun 2010 11:53pm for $19.00:

Mostly while resting my right foot's big toe has a numbing feeling. This has been going on for about 6 weeks. When I walk, it seems to go away or get better. It is also better in the morning. Other issues in my right leg is my knee. I haven't broken a bone, but fell 6 years ago and had big soft tissue damage. Since then, there has always been some discoloration on the knee. Around May 20th my right knee began looking pink and slightly swelling. My doctor took xray's and the only result was to tell me I have arthritis in my knee. I get some sore feeling in my right upper leg, but the blood test came back, no clots (Yea!). I don't know if the other issues in my right leg has anything to do with the toe issue. My doctor also ordered a nerve test on the right foot and that also came back fine. Any ideas?
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Answer by Dr JS Anand (doctor) on Wed 23, Jun 2010 01:18am:

Hi, Welcome to the forum. I am really glad to help you out. In view of the numbness of the great toe, the following possibilities need to be looked into. Firstly & commonly, the shoes are an important culprit in this. Tightly fitting shoes can compress the nerve or the blood vessels supplying the great toe causing the numbness. Diabetes is one of the important causes of peripheral neuropathy which can present as numbness of the great toe. Hence, it makes sense to get the blood sugar and HbA1c tested to rule out diabetes. Gout, in which there’s a deposition of the uric acid crystals at the base of the great toe can present as numbness and pain in the great toe. Please get your uric acid levels checked. Compression of the nerve supplying the great toe can also cause this but fortunately, the nerve conduction velocity which you have already done is normal and thus nothing much to worry about the same. Please get an arterial Doppler also done of the foot to ensure your toe is getting adequate blood supply. I’ll suggest consulting an neurologist as it is not possible to make an online diagnosis. I sincerely hope that helps. Take care.
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Comments:

Comment by Dr Ajit Singh on Wed 23, Jun 2010 03:08am:
Hello shopfres, welcome to ask medical doctor .com. The most likely possible causes have been very well explained by Dr.J.S.Anand. I would like to add on some other possibilities which have to be ruled out in your case. Knee swelling, pinkish in colour, mostly should be associated with local rise in temperature {warm, when compared to other knee} suggest inflammation secondary to Rheumatoid Arthritis. The other characteristic feature associated in your case is big toe pain accompanied with numbness. The other possible causes are Kneecap Bursitis, Gout, Pseudo gout, Cysts, Tumors or may be over use. The important diagnostic test is Arthrocentesis. This procedure involves withdrawal of fluid from the knee and sending it for analysis like cell type, cell count, uric acid levels and cultures for bacteria. Other laboratory investigations include C reactive protein, ESR, complete blood picture and serum electrolytes. Treatment involves NSAIDS {non steroidal anti inflammatory drugs}, treat the underlying cause, rest and ice compression. Apart from this Diabetic Neuropathy has to be ruled out as suggested by Dr. Anand. Get a FBS, PLBS and HbA1c done. Hope this additional information helps you. Any further doubts kindly keep posting. Regards
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