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Big toe goes numb and becomes white

by Peter
(Oakland, CA)

Every month or two one of my big toes (and sometimes the next ones) becomes numb and turns white. Most times it's the right side but it does also occur on the left. Never both at the same time. The rest of my toes are a nice pinkish red. I can resolve the problem by soaking my feet in warm/hot water for 5 to 10 minutes. The color comes back and the numbness goes away - back to normal. During the feet soaking I notice the affected toe goes from complete numbness to pins and needles to feeling completely normal. What is this? I'm 51, male, caucasian with high blood pressure and hyperlipidemia both of which are treated with medications (statins, lisinopril, Triamterene/HCTZ.)


RESPONSE

Hi Peter,

I would suggest to you that your problem is one that needs medical intervention simply to find out what is causing this.

I say this because your problem could range anywhere from a simple vasospastic condition where the arteries bringing blood into your big toe (and toe next to it) simply go into spasm, cutting down the circulation into your toe and causing them to turn pale. By soaking in warm water you relax the vasospasm and the circulation into the toes increases causing normal color to return. It would not be uncommon for the pins and needles effect to occur as the circulation increases. This would be similar to when your foot or hand "falls asleep" and as the circulation returns, there can be a feeling of pins and needles as well.

Here is what concerns me. Although, not limited to, most cases of vasospastic disorders occur in women and is exacerbated in cold weather. I am not a weather man but I assume Oakland does not experience the cold weather that we see elsewhere in the country.

On top of that I am concerned about your hypertension and hyperlipidemia, which as you may know is excess fat circulating in the blood. People with this condition can be prone to forming blood clots in the arterial tree (arterial system) which will cause, in your case, your two toes to turn pale. Yes, in the early stages, this problem can come and go such as what you are presently experiencing.

If there is a clot somewhere in your legs or all the way up to your abdominal aorta, it may eventually break off and get lodged in a smaller artery, totally cutting off the circulation into your foot and leg. This can have catastrophic results.

Sitting here on the other side of the internet I have no idea what is actually going on with your toes, but I do know this. If you walked into my office tomorrow, I would immediately send you to a vascular specialist to accurately determine the cause of your discoloration in your toes. If you are lucky it will be of the minor nature, but, if it turns out to be a more severe problem, you will be able to receive treatment before it becomes a crisis.

Do yourself a favor and make an appointment to see a vascular surgeon immediately.

Marc Mitnick DPM
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