Why toes go numb: causes of numbness,walking at night

Update: November 2018

That feeling, when some part of the body goes numb, was experienced by everyone
at least once in a lifetime. For example, states are known when
the person “served a leg” or “laid his arm”. If limb
squeezed, blood supply to the nerves is disturbed, and they stop
perceive and transmit impulses. After a while all
is being restored. But the feeling is unpleasant, agree.

Now imagine that this state does not pass. The discomfort,
decrease in sensitivity, feeling that your limb is not yours can
to some extent present for a long time or at all
constantly.

Most often this happens with the legs, and it begins with
fingers. Impaired doctors denote the term
�”Paresthesia.”

The reasons

Our body is pierced through with nerves. They are sensitive
and motor. The smallest branching sensory nerves
perceive signals from the environment and transmit them further to
spinal cord and brain. With their normal functioning, we
we feel touches, pain, heat, cold. We can on time
pull up a limb, if you touch something hot,
feel pain in trauma.

Changes in sensitivity occur when disturbed
one of the links in this chain:

  1. Peripheral lesion (peripheral
    poly- or mononeuropathy). Nerve fibers can suffer from
    impaired blood circulation, from metabolic disorders, from direct
    toxic effects.
  2. Conductive lesions (spinal cord level).
  3. Damage to the cerebral cortex (strokes, tumors,
    hemorrhage).

So the question: “Why are the toes numb?” Unequivocal
There can be no answer. A comprehensive examination, inspection is necessary.
a neurologist to determine the level of nervous damage
system. 

Peripheral neuropathy

This is the state when our peripheral sensitive fibers
can not fully perceive and transmit signals to the brain.
There are only about 100 causes of neuropathy. At the same time emit
polyneuropathy (damage to many nerves) and mononeuropathy (affected
one nerve). In addition to numbness, polyneuropathy is manifested by the following
symptoms:

  • Pains
  • The feeling of a tight sock and gloves
  • Tingling
  • Crawling sensation
  • Thinning skin.
  • Uncertainty, instability when walking.

Numbness can begin with one finger, then
spread to others. All fingers and feet may be numb.

The most common causes of neuropathy:

  • Diabetes. Symptoms of neuropathy occur early or
    late in most diabetics. Diabetes toes go numb
    60-70% of patients. The reason for this is metabolic disorders,
    which occur in tissues with high blood sugar levels.
    Small nerve fibers just die. And this complication begins
    from the lower limbs.
  • Renal failure – a lot of blood accumulates
    content of toxins.
  • Hypothyroidism – a decrease in thyroid function.
  • Lack of food in vitamins of group B, E, A. Vitamins B1, B6, B12,
    as well as some fat-soluble vitamins are involved in the structure
    nerve sheaths and conduction processes.
  • Alcohol. This is probably the second most common cause of diabetes after diabetes.
    neuropathy. Alcohol is toxic to nerve tissue, causing
    death of small nerve fibers.
  • Intoxication with various chemicals – solvents,
    insecticides, glue, mercury, lead and others.
  • Infections that cause damage to the nervous tissue: HIV, herpes,
    Epstein virus –Bar.
  • Autoimmune Diseases – Rheumatoid Arthritis, Systemic
    lupus, vasculitis.
  • Some medicines can damage nerves:
    anticonvulsants, antibiotics, tuberculosis
    drugs, cytostatics (frequent complication of chemotherapy –
    polyneuropathy).
  • The lack of trace elements in the body, such as potassium, magnesium,
    calcium, iron. They are required to participate in electrochemical
    reactions of nerve impulses.

Mononeuropathy

Mononeuropathy – это поражение (ущемление, травма, опухоль)
just one single nerve or nerve bundle. Wherein
symptoms are asymmetrical, as in polyneuropathy, and correspond to
damage to certain fibers. Fingers can only go numb
right or only on the left foot, or only one finger.

Examples of nerve damage on the leg

  • Sciatica. Quite common pathology. This is infringement or
    inflammation of the sciatic nerve – the largest nerve trunk
    our body. Manifested mainly by pain, but may also
    to be weakness and feeling of numbness in the foot.
  • Tarsal tunnel syndrome. Appears during infringement
    tibial nerve in the tarsal canal (it is located
    behind the inner ankle). Manifested by severe pain in the sole and
    numbness of the inner edge of the foot and heel.
  • Injuries. Injuries can result from injuries, sprains, or
    fractures. Localization of numbness depends on the specific damaged
    branches. For example, if one of the branches is damaged
    fibular nerve will be numb only the ring finger of the foot, with
    damage other branch – only the gap between the first and
    second fingers.
  • Neuroma Morton. This is a thickening of one of the nerves, which
    passes between the long bones of the foot. Symptoms – tingling, pain
    and numbness in the foot.
  • Neuritis of the peroneal nerve. At the same time, the back surface is numb.
    feet and side of the leg, but to the fore
    movement disorders: the foot “does not obey”, hangs down,
    tucks when walking.
  • Compression of nerve endings uncomfortable, cramped shoes also
    can be attributed to this group. First of all the little finger suffers
    leg. Feelings persist for some time and after removing the shoes.
    If this is a one-time occurrence, then the symptoms are reversible. If the leg
    subjected to constant “execution” of cramped shoes, nerve fibers
    may be permanently injured.

Spinal causes

Impaired sensitivity may occur if damaged
the main conductor of nerve impulses – the spinal cord. Main
The reasons for this are:

  • Intervertebral hernia, a consequence of lumbar osteochondrosis
    of the spine. It can lead to compression of the spinal cord.
    spine, spinal cord or horsetail.
  • Spinal cord tumor.
  • Congenital anomalies – spinal hernia, congenital
    stenosis.
  • Spinal stenosis.
  • Multiple sclerosis. It is an autoimmune disease,
    accompanied by the destruction of the myelin sheath of nerve trunks.
    The first sign may be a violation of sensitivity in
    limbs.

Spinal cord injury will not only be manifested by loss
sensitivity, but also muscle weakness, as well as impaired
the functions of the pelvic organs.

Brain damage

In the cerebral cortex are the centers that take
signals from the peripheral nervous system and convert them to
sensations. Therefore, if these centers are damaged, our
tactile, temperature and pain sensitivity.

The reasons for this may be:

  • Strokes
  • Transient ischemic attacks.
  • Brain injury.
  • Tumors.

Brain lesions that manifest only in violation
sensitivity, are not as common, but still possible.
Often there is a picture of a combination of hemihypesthesia and hemiplegia
(numbness and movement disorders in one half of the body).

Circulatory disorders

Another big reason why the toes go numb is
circulatory disorders. With many pathologies violated
microcirculation of blood, and especially this will manifest itself in
distal regions (that is, the most distant from the central
сосудов), а именно в limbs.

If there is not enough oxygen in the tissue, the nerves are powered
suffers, and sensitivity decreases.

We all have ever felt such a numbness in violation
blood circulation:

  • In the cold, when a small blood spasm occurs
    vessels.
  • Forced prolonged stay in an uncomfortable position (for example,
    when you need to stand still for a long time or sit in a plane for a long time or
    car).

But these conditions are reversible, it is enough to warm up, move or
change position.

Patients with circulatory system diseases may
experience symptoms of numbness and “leaking” of the limbs constantly.
The most frequent of them are:

  • Raynaud’s disease. Manifested by spasms of blood vessels, while numb and
    my fingers are cold.
  • Atherosclerosis and endarteritis of the vessels of the lower extremities. Special
    often manifested in smokers with experience. The main symptom of
    this is pain when walking, but numbness is also often manifested.
  • Heart failure.
  • Varicose veins of the legs, venous edema.
  • Thrombosis of the arteries of the lower extremities.

Why numbness at night

All of the above reasons lead to paresthesias, which
appear at any time of the day. However, it so happens that the toes
numb only at night, or worse at night and evening.
This can be explained by the fact that during the day we get many different
environmental signals that suppress these
pain in the legs. In addition, when moving, they also
expressed less.

At night, the person does not move, does not receive “distracting”
signals, and this feeling of leaking, crawling goosebumps,
discomfort comes to the fore, to the point that much
disturbed sleep.

Paresthesias in the legs at night can be when:

  • The initial manifestations of any neuropathy.
  • Osteochondrosis of the lumbar spine.
  • Debut multiple sclerosis.
  • Inconvenient posture during sleep.
  • Restless legs syndrome. It is manifested by paresthesias in
    shins, sometimes in the feet, sometimes with inexplicable sensations,
    the need to constantly make movements. The reason is not completely
    is clear.

What doctor to contact and how urgently it needs to be done

What if my toes are numb? You can go immediately to
to the neuropathologist. But it’s easier to turn to a therapist who will
initial inspection, assign the minimum required volume
research and refer you to the right specialist. Need to be ready
answer the questions:

  • When did numbness first appear?
  • Does it happen permanent or pass?
  • Under what circumstances increases (when walking, in the cold,
    or fingers get numb only at night).
  • What other symptoms occurred with numbness?
  • Are you abusing alcohol?

The therapist will evaluate the condition of the heart, check the pulsation of the blood vessels,
outline a survey plan. A neurologist will check reflexes,
sensitivity.

In what cases should doctors be consulted immediately?

  • If the sensory impairment appears suddenly and
    accompanied by muscle weakness in one leg or in the arm and leg
    (stroke is possible).
  • If it began with fingers, quickly spread to the foot,
    the shin, the leg at the same time freezes and turns pale (suspicion
    thrombosis).
  • If the symptom appeared after injury.
  • If urinary or fecal incontinence appears simultaneously (possibly
    compression of the spinal cord).

What tests prescribed for numbness of the toes

Main обследования:

  • General blood and urine tests. In the blood test may decrease
    hemoglobin, which may indicate a lack of iron in the body.
    It is also possible to increase leukocyte counts, ESR, which
    indicative of an inflammatory process.
  • Biochemical blood test will show the level of glucose,
    inflammatory proteins, creatinine (an indicator of kidney function),
    major blood electrolytes (potassium, calcium, sodium).
  • X-ray or MRI of the lumbar spine
    allows you to identify signs of osteochondrosis and intervertebral
    hernia.
  • Ultrasound examination of the vessels of the legs (determines the state
    both arteries and veins).
  • Electroneuromyography. This is a conduction research method.
    peripheral nerves. Allows you to determine their level
    lesions.

Additional studies:

  • Determining the level of thyroid hormones.
  • Iron serum.
  • Determination of basic vitamins in the blood (B1, B6, B12,
    E).
  • A study on markers of infectious diseases (HIV, herpes,
    Epstein-Bar virus).
  • Nerve biopsy.

Why is this condition dangerous?

It would seem that paresthesias in the toes only cause
discomfort, and if you get used to it, you can continue to live without
problems.

In fact, reducing pain sensitivity is dangerous.
Why? If a person does not feel pain, he will not be able to on time
notice any skin lesions, sores, wounds,
to be treated. Without treatment, they can progress,
become inflamed.

Special опасно это для больных диабетом. There is such a thing as
�”Diabetic foot”. Diabetes causes not only neuropathy, but also
circulatory disorders in small vessels, as well as reduction
resistance to various infections. As a result, the legs
diabetics are very often formed sores. If their time is not
notice and not treat, they can lead to gangrene and
amputation.

In addition, numbness can be the first symptom of severe
systemic disease, the outcome of which will be the better, the earlier
treatment started. Therefore, delay the visit to the doctor with this symptom
not worth it.

Treatment

If the toes are numb, treatment will depend on the diagnosis.

  • Factors contributing to neuropathy are eliminated first.
    – blood sugar is normalized, the refusal of alcohol is recommended and
    smoking, contact with harmful substances is excluded.
  • Treatment основного заболевания (оперативное лечение при грыжах
    treatment of heart failure, insulin therapy for
    diabetes mellitus, hemodialysis for renal failure, treatment
    infections).
  • In the treatment of neuropathy used drugs such as
    thioctic acid, group B vitamins (complex Milgamma,
    Neuromultivitis, Kombilipen, or separately Thiamin, Benfotiamin,
    Cyancobalamin, Pyridoxine), Neuromidine, Proserin, Vascular and
    metabolic agents. In some cases, hormones are prescribed,
    plasma exchange.
  • Moderately intensive massage with long courses.
  • Physiotherapy methods – percutaneous
    electroneurostimulation, UHF, darsonvalization, magnetic field,
    paraffin or ozocerite applications, radon or
    hydrosulphuric baths.

What you can do at home

So, the diagnosis is set. Perhaps a stationary stage
treatment and the patient was discharged. Main рекомендации, которые пациенту
with neuropathy will have to abide at home:

  1. Complete refusal of alcohol and smoking.
  2. If the patient is diabetic, then it is necessary to maintain normal
    sugar level. Measuring glucose in the blood is necessary not only on an empty stomach,
    but after eating, several times a day, keep a diary, independently
    регулировать дозу инсулина по количеству хлебных единиц (ХE).
  3. Shoes to fit the size, comfortable, low-heeled
    natural materials.
  4. Inspect fingers and feet daily for scuffs,
    abrasions. To inspect the soles you can use a mirror.
  5. Foot bath with warm water for 10-15 minutes in the evening.
  6. Self-massage of feet.
  7. Contrast douches of feet (alternately hot and cold
    water).
  8. Walking. For almost all causes of paresthesias in the limbs
    shown walking at a moderate pace for at least 30-40 minutes every day.
    It improves blood circulation in the legs.
  9. Taking medications prescribed by a doctor.
  10. Reception of vitamin and mineral supplements.

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