Numbness and tingling in the toes

Patient

Q: I started a new job about 3month ago and have had some back pain especially when i first started but also just developed a bunion on my left foot which i have been taking care of but for the past 3 wks my toes on my right foot have been numb, tingly, and my big toenail is blueish..it feels this way pretty much all of the time and the other day it went up my foot a little but back down to the toes now. My back pain is better but just a little in the lower back..i have no insurance so was just needing an idea on what it could be so if i do have to go to a doctor i wanted to make sure to choose the correct type of doctor. Thank you! Rontasha

Doctor

A:   Based on your description, your symptoms might be due to a nerve compression that may produce an inflammatory process that affects the nerve roots (neuritis) in the lumbar region (stenosis, degenerative hypertrophy of facets and disc herniations and bulging) In the younger patients, as yourself, lumbar radiculopathy may be a result of a disc herniation or an acute injury causing impingement of an exiting nerve. In the older patient, lumbar radiculopathy is often a result of spinal canal narrowing from bone (osteophyte) formation, decreased disc height and degenerative changes due to aging process. It can be associated or not to other symptoms as back pain, numbness of the toes or hypoactive reflexes. I strongly recommend you to get an appointment with your doctor to rule out first of all  a possible lumbar nerve compression. If this gets ruled out there are other causes of numbness and tingling of the toes as: Peripheral Neuropathy,  Vitamin deficiencies (Vitamin B12,B6, B1, folate or E),alcohol abuse,  lead poisoning and metabolic causes as problems with the Thyroid gland and Diabetes.

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