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I am getting a cold, wet tingling feeling in my toes quite…

Customer Question
I am getting a...

I am getting a cold, wet tingling feeling in my toes quite often. It started about 4 or 5 months ago

Doctor's Assistant: Do you have a fever? Do you have any other existing medical conditions?

No Fever. I have a torn left rotator cuff and biceps tendon being repaired in a couple days. I have some cervical spine issues. Have had later spine surgery to c-3 through c-7 about 6 years ago. I have a tooth ace for about the past 2 months that I am having checked tomorrow.

Doctor's Assistant: Anything else in your medical history you think the doctor should know?

I had double bunion surgery 2 years ago. I am on benezepril for blood pressure and a statin for cholesterol and sertroline 100 mg for mood. My left ankle swells up and gets sore a lot when walking, not sure why, but had been broken and sprained years ago.

Submitted: 4 months ago.Category: Neurology
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Answered in 2 hours by:
12/5/2017
Neurologist: Dr Subbanna MD, Neurologist (MD) replied 4 months ago
Dr Subbanna MD
Dr Subbanna MD, Neurologist (MD)
Category: Neurology
Satisfied Customers: 6,127
Experience: American Board Certified Neurologist, Internal Medicine
Verified

Hi, I am an American Board Certified Neurologist with vast experience in diagnosing & treating all neurological as well as all other health/medical conditions, and I am very glad to help you with your health concerns.

I see you have been having cold wet tingling feeling of the toes. As a neurologist I frequently diagnose & treat this type of health situation and I can certainly help you in this regard.

Please see the following are the various conditions that can cause this type of tingling sensation in the toes;

Nerve injuries/Peripheral neuropathy

Compression neuropathy or entrapment neuropathy

Pinched spinal nerves or radiculopathy

Vitamin deficiencies

Thyroid conditions

Diabetes

Prediabetes

Medication side effects

Certain inflammatory conditions/Autoimmune connective tissue disorders

Heavy metal poisoning

Exposure to other toxins

Certain chronic infections

Rarely circulation problems too can present with the above mentioned symptoms

Please see I am not telling all these above health conditions are applicable in your case, I am mainly trying to provide you with a list of various possibilities based on what we see in our clinical practice to explain these types of new symptoms you are having, these are just the various possibilities to consider to explain these types of symptoms you have been having, however not all of the above possibilities may be applicable in your case.

As you see above there are several possibilities and this needs to be further evaluated and investigated to find out the precise cause for the tingling symptom. In this regard please try to see a Dr in the clinic, preferably a neurologist, so that you can receive a thorough neurological examination in the clinic followed by certain relevant neurological investigations too such as the following;

MRI Scan of the spine – especially the lower spine (lumbar spine), and if the cervical spine scan has not been done recently then the mri should include the cervical spine too

EMG/Nerve conduction test of the legs (a nerve & muscle test)

Circulation tests such as Doppler Ultrasound

Blood tests such as the following ones;

Comprehensive metabolic panel (general medical & metabolic tests)

Blood sugar (diabetes test), GTT (Glucose Tolerance Test), HbA1c (Glycosylated hemoglobin)

Serum total protein & globulin

SPEP (Serum Protein Electrophoresis)

IPEP (Immuno Protein Electrophoresis)

Urine for BJP (Bence Jones Protein)

Vitamin B12, Folic acid, Vitamin B6, Vitamin B1, Vitamin D (Vitamin deficiency tests)

TSH, T3, T4 (thyroid tests)

ESR, CRP, ANA, dsDNA, Rheumatoid factor, SSA, SSB, serum complement assay etc (autoimmune disorders tests)

Lyme antibodies, RPR etc (tests for infections)

Heavy metal screening etc

Depending upon the results of the above tests sometimes additional tests such as the following too may be required;

A skin punch biopsy to check the density of small diameter nerve fibers in the skin

Sural nerve biopsy etc

The above mentioned are the various investigations that are usually required and then treated appropriately depending upon the test results. Please see I am not telling all the above mentioned investigations are required or are applicable in your case. After a thorough examination in the clinic the Neurologist will be in a position to decide which of the above investigations are required in your case. And also if any of the above mentioned investigations have already been done then there is no need to repeat them again, rather the focus needs to be on those investigations that have not already been done.

In the meantime please consider trying some of the following treatments that can help you with getting relief from the symptoms you have been experiencing;

A) Certain general measures, or home remedies such as the following;

Adequate rest

Sufficient sleep

Adequate fluid/ware intake

Nutritious diet

Daily exercises

Epsom salt compress

Hot compress

Capsaicin skin ointment etc

B) Certain specific treatments such as the following;

A course of physical therapy

One of the nerve-pain pills such as Gabapentin or Pregabalin that can help with tingling sensation too

Ultrasound therapy

Laser therapy

TENS (Transcutaneous Electric Nerve Stimulation) etc

The above are the various treatment options to consider, but please see I am not telling all these above mentioned treatments are required or are applicable in your case; I am trying to provide a list of the various treatment options like this so that you are familiar with various treatment options that are available for helping with your symptoms, and you may try to use them as necessary. If you see any of the above treatments you have already tried please disregard them and you may explore the treatment options which you may have not yet tried.

In addition to the above, you may also consider trying certain nutritional supplements such as the following ones;

Methyl Guard Plus (which is a combination of active forms of vitamin b12, vitamin b9/folate, vitamin b6, vitamin b2)

Vitamin B1 (Benfotiamine)

Vitamin D

ALA (Alpha lipoic acid)

Acetyl L Carnitine

Coenzyme Q10 etc

These above mentioned nutritional supplements too can help in getting relief from the symptoms, and also assist with faster recovery too.

To summarize once again;

1) Please see there are many possibilities that can cause the type of new symptoms you have been having - as mentioned earlier above

2) A thorough examination in the clinic by a Neurologist, followed by undergoing certain relevant investigations as mentioned above (MRI scan, EMG/Nerve conduction nerve & muscle test, certain special blood tests, circulation test etc) can help us in finding out the precise cause for these new symptoms and then treated appropriately

3) In the meantime you may try one of the symptomatic treatments & nutritional supplements mentioned above and these can help in providing relief from the annoying symptoms you have been experiencing, as well as help with faster recovery too

4) And also very importantly, please see this type of health condition can be diagnosed & successfully treated, so please not to be scared, an early diagnosis and treatment gives the best chance for quick & complete cure so please try to see a Neurologist asap and try to undergo a thorough neurological examination & neurological investigations as discussed above - for the best results.

Wishing you a quick & complete recovery! And also Wishing you the best health!

All the very best!

Please let me know if you have any additional questions or if you want to discuss this further.

Assuring you the best services!

Best Regards!

Dr Subbanna MD

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Neurologist: Dr Subbanna MD, Neurologist (MD) replied 4 months ago

Hi, have you received the answer I have posted above, and have you had a chance to go through the above answer?

Do you have any additional health questions? Do you want to discuss this health situation further? Please let me know and I am available here.

Assuring you the best services!

Best Regards!

Dr Subbanna MD

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Dr Subbanna MD
Dr Subbanna MD
Dr Subbanna MD, Neurologist (MD)
Category: Neurology
Satisfied Customers: 6,127
6,127 Satisfied Customers
Experience: American Board Certified Neurologist, Internal Medicine

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