itching in little toes when feet get warm at bedtime

by jim
(coventry u/k)

My feet are fine during the day but when i go to bed at night my little toes start to itch, the rest of my feet are fine. The itching feels like small electric shocks which after a while shoot down the side of my feet. The itching feels like it originates from the toenail.. It becomes so intense that my feet and sometimes legs, will jump involuntarily. Normally, getting out of bed and walking around for half an hour will ease the itching, but as soon as my feet get warm again, the itching starts. During the day my feet can be as warm as toast and i don't seem to suffer the same intensity of itchiness, tho i do feel a slight irritation.

RESPONSE

Hi Jim,
The fact that your symptoms are reproducible when you go to bed each night is suggestive of either a neurological or vascular problem as opposed to a skin condition. In a skin condition you would tend to be bothered by this problem all day long, regardless of whether you were in bed or not.
I wish I knew more about your medical history, primarily your age and any major medical conditions that you may suffer from.
Without this information, lets talk about the two possibilities.
1. neurological. In this situation when you go to bed at night there is a chance you are experiencing what is known as a radiculopathy, which is an irritation of the nerves as they come out of the spinal column. Depending on your position in bed, the spine may be bent in such a manner that certain nerves are being irritated. It then manifests itself along the nerves that in your case go down into the fifth toes. It is symmetrical because the same nerve on each side of the body is being irritated. When you get out of bed and walk around you are releasing the pressure on the nerve and over time the feeling in your toes return to normal.
2. vascular. In this instance because your feet are elevated you are naturally reducing the blood flow into your feet because of no other reason other than gravity is no longer a factor in bringing blood down to your feet. Once again you get out of bed and you walk around, gravity then comes into play and more blood begins to flow into your feet and your symptoms diminish. What we find with many patients with poor circulation is that they sleep in chairs so that they can keep their feet in a dependent position all night.
So which condition are you suffering from? Unfortunately, I cannot answer that because I do not have the luxury of examining you. What I have presented to you are the two main possibilities, but not the only possibility.
Because their is a possibility that this is a circulation issue, my best advice to you would be to seek the services of a local doctor who would be best suited to make an accurate diagnosis.

Marc Mitnick DPM
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