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Dysesthesia in 3rd and 4th toe and beneath them

by Ron
(Pacific Grove, CA)

About a year ago, I wrote you explaining that a local podiatrist had injected my foot with Lidocaine and a steroid to curtail a small area (one-half inch)of numbness on the under pad of my fourth toe. I have been told that the doctor likely damaged a nerve or the joint itself with the needle, as the following day my foot problem had increased by at least 30 times. Both toes and an area of about three inches in diameter are now "numb," though that word does not really express the sensation. Those toes now feel as if they are filled with a gel, liquid or clay-like substance. MRI's and multiple X-rays show nothing. The toes are normal to touch and temperature, so the problem is clearly internal.

For about 17 months now I have had no improvement. Two doctors at different research hospitals believe I now have synovitis. What do you recommend for this? I have tried everything imaginable. And in fact, have seen 14 various doctors about the problem. Most of them ruled out a neuroma. This problem has overturned my life is so many ways. Any help would be greatly appreciated.
And may I add, as I did before, that your website is uncommonly well designed and you are most helpful and kind to provide this help. Ron

Hi Ron,
If 14 doctors have examined you and come up with basically nothing, then I do not know how much help I can be without ever examining you.

In my mind, synovitis should have showed up on an MRI if nothing else, as a soft tissue inflammation.

I believe that numbness in this type of situation has to be nerve damage, not necessarily a neuroma, but damage to a nerve.

Has anyone suggested exploratory surgery? Both the nerve and area where the suspected "synovitis" lie could be physically examined and perhaps repaired/removed.

Have you tried medications like Neurotin? If it worked I would suspect nerve damage. If it did not work then it could still be nerve damage or a "synovitis"

I wish I could be more helpful but that is all I can come up with and for all I know, those options may have been already offered to you.

Marc Mitnick DPM

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