Numbness in on toe

by Cypres
(Cuenca, Ecuador, South America)

Last night while I was at work, I noticed that from about halfway down the nail to the tip of my left big toe was a really unpleasant combination of numb and painful. In the past I have occasionally had very sharp discomfort when I take a step, mostly with that same toe, and it feels like pain from an ingrown toenail. I'm wondering if that was not some sort of warning sign of nerve problems,as I have two herniated discs in my low back. I also have a history of Reynaud's Syndrome in my family. And I used to be a smoker, which contributes to circulatory problems. This numbness and discomfort is really annoying, and I was hoping it would go away in a couple hours, but it's been like this for a full day now. Please help! I'm from the United States but currently I'm residing in Ecuador for the next six weeks and so I don't have access to any terrific medical care, and I'm totally freaked out about my toe. It's really uncomfortable and it's really annoying.

Thanks,
Cypres

RESPONSE

Hi Cypres,

Obviously it is impossible to make a diagnosis from the other side of the internet without the luxury of examining your foot, but I will offer a few insights and suggestions.
The first thing I would like to know is if you ever had your ingrown nail treated? Sometimes something as simple as an ingrown nail will cause pain, perhaps even numbness in the toe if the area is inflamed. Does pressing on the side of the toe create pain in the area of the nail? If it does then once the ingrown nail is cut away, perhaps all your symptoms will disappear.
If cutting away a piece of nail does not do the trick then there are various potential causes that have to be explored.
I do not know how old you are, but you do mention you were once a smoker. (I will also assume you are not a diabetic) Nonetheless, circulatory embarrassment to the toe would have to be ruled out. Do you notice the big toe to be more pale or more red in color than the other toes? Does the particular toe seem to go thru different color changes? Does the toe bother you more when the temperature is colder rather than warm? With a family history of Raynauds, that might be hard to determine, but all these differences may be a sign of poor circulation in the toe, more so than just a Raynauds phenomenon.
You also mention you have a history of herniated disks in the lower back. That can create what is known as a radiculopathy or irritation of the nerve as it exits the lower back, which in turn may cause nerve like pain in the toe.
Along the lines of nerve irritation, in many instances there can be nerve irritation at the level of the bunion joint. The nerve passing through there is compressed between the bone and your shoe resulting in local nerve damage. This too could cause your symptoms, particularly if you notice the problem tends to be worse when you are walking.
As you can see, the obvious problem is you need to have a doctor look at your foot to determine the source of the problem.
Potentially, vascular compromise would be the most serious of the problems.
The problem as you mention has been present for a day. There is a possibility that by the time you read this, the pain may be gone.
If getting to a local doctor is an issue, then I would at least recommend you observe for color changes in the toe. If the toe is not changing color than more than likely it is not circulatory related and the issue can probably wait, as all the other potential causes are issues you can live with until you can seek proper medical care.

see related article....circulation

see related article....neuropathy

see related article....ingrown nail

Marc Mitnick DPM
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