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The response to the question below was authored by Marc Mitnick DPM

intermittent numbness in various toes

by renee
(simsbury, ct)

This happens mostly in my right foot, and have noticed it since about a month ago. Has been cropping up along about once or twice a week until about a week or so ago during that time, but then had a resurgence in it tonight. First small toe on right foot goes numb and white on and off, and often when I get cold, but it doesn't absolutely have to be the case. Move it some, and maybe within ten minutes to about 3/4 of an hour, it will be fine again. Now tonight, with below freezing temperatures, I ran outside briefly, not wanting to stop to put on socks for a quick run to empty trash in garage. Upon my return a minute later to the house, that same toe was white and numb, and normally would only be on the bottom, but this time was also on the top, along with being stiff as well. Perhaps should have stopped to put on socks before even making a short trip out there in the cold. In any case, within about a half hour when I got in the shower, it was fine again. However, while drying off and pulling my toes apart on that foot to get in between them, the next little toe over to it got both white and stiff in terms of locking up while I was drying myself off. Then it stopped not more than a minute later. I am 45, female and have a bit of a high blood pressure issue, which I take 2.5 mg of amlodipine for. I happen to be allergic and/or sensitive to a lot of meds, so this is all I take right now. Have been told I'm perimenopausal also, and as far as blood pressure goes, it jumps around, if this has anything to do with this, depending on stress levels, whether I'm working or not, and other factors, I'm sure. I'm also coming down with a bit of a cold right now, so

my bp has been higher here and there, but overall has been better than it was in a while. Mentioned the part about two weeks ago to my doctor about the first little toe's on and off numbness like that, but he said to monitor it for now and see if, say, it kept cropping up all the time and/or stayed for a couple or more hours at a time. He also, when I asked, did say that high heels over time could sometimes cause toes to take a bit of a toll along the way, so in any event, I space out instances when I wear such shoes these days. But I feel as if I might be several steps away from rigor mortis when something like this happens. What do you think? Sorry I rambled some; I just wanted to cover most or all the bases best I could!

RESPONSE

Hi Renee,

Based on your "story" and not having the luxury of being able to examine you, it sounds like what is referred to as a vasospastic disorder. This means when your feet are exposed to cold or just being in a not so warm environment, the cold causes your blood vessels to clamp down in your toes and your toes turn white. They may also tingle somewhat.
Once warmed up, the small arteries in the toes open up, blood begins to flow back in and the color returns to normal.
This is what occurs in most people, but other conditions must be ruled out as well. As an example, sometimes people can have small blood clots in the arteries of the toes which will also cause similar symptoms.
You do not mention your age, but age related conditions such as arteriosclerosis may also cause similar symptoms as well.
My best piece of advice would be for you to schedule an appointment with a vascular specialist to confirm my suspicions of a vasospastic disorder and to rule out other possibilities.

Marc Mitnick DPM
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intermittent numbness in various toes

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