Numbness in Hands and Feet: Sciatica and Beyond

Q: Numbness in Hands and Feet: Sciatica and Beyond

Hello, Wang： <br>Your description of the problem is very clear, but there are a few points that need further clarification. <br>Generally, neurological issues tend to present with symptoms such as numbness, tingling, and pain that radiate, for example, from the neck and shoulders

Numbness in the hands and soles of the feet, along with sciatica?

Hello, Dr.
Chang.
A month ago, I started experiencing symptoms similar to sciatica, and it has persisted until now.
I have visited a few traditional Chinese medicine practitioners, but none of them could definitively confirm that it is sciatica.
Two days ago, I saw another practitioner who suspected it might be sciatica, but the pain is primarily in the middle of my foot, which is not typical.
I have undergone acupuncture and taken medication.
Initially, I felt a tightness in my buttocks when sitting, which later extended to my thighs, causing discomfort and pain.
Eventually, my calves began to hurt, and now the middle of my foot also experiences pain and numbness.
After acupuncture, there was no improvement in my foot condition.
My entire foot often feels numb (like it’s swelling and contracting), and sometimes only a specific area of my foot feels this way, while other times it’s the whole foot.
However, the pain is only in the middle of my foot.
Last night before bed, my calves felt sore, my foot was numb, and even my left little toe felt numb.
Today, I also felt discomfort in my thighs while sitting, and my right little toe felt slightly numb.
I feel a tingling sensation extending down the outer side of my entire arm.
Occasionally, my right back also experiences numbness.
Sometimes, I feel muscle spasms in my leg, particularly near the knee, and the tendon in my heel feels twitchy and painful when pressed.
Additionally, the tendon connecting my foot to my calf (which I can't quite describe) also hurts.
After walking, my muscles feel weak.
The entire sole of my foot, especially when standing still, is the most painful, and wearing cushioned shoes makes it worse.
I’m afraid to wear my cushioned shoes at home.
Since I’m still in school, I have to walk at least 30-40 minutes to catch the bus, and the same on the way back, making it impossible to avoid walking.
Could you please help me understand what these symptoms might indicate? Is it sciatica combined with plantar fasciitis, or could it be piriformis syndrome or a muscle strain? Or could there be issues with my nerves, knees, pelvis, or spine? I feel like I’ve almost forgotten what healthy feet feel like, and my visits to the doctor seem ineffective.
I’m really worried that if this continues, I might not be able to walk.
Please guide me in the right direction.
Thank you.

Wang Tongxue, 20~29 year old female. Ask Date: 2016/03/21

Dr. Zhang Weidong reply Traditional Chinese Medicine

Hello, Wang:
Your description of the problem is very clear, but there are a few points that need further clarification.
Generally, neurological issues tend to present with symptoms such as numbness, tingling, and pain that radiate, for example, from the neck and shoulders to the arms, or from the lower back and hips to the legs or feet.
However, your description does not seem very typical of these symptoms.
Therefore, it is advisable to first consult a neurologist or a rehabilitation specialist to determine the underlying issue before seeking traditional Chinese medicine.
One aspect that is often overlooked is the numbness in the back and the little finger, which can also be related to certain circulatory problems.
It would be prudent to have a cardiac evaluation as well.
Typically, these issues have been developing over a period of time; it is rare for them to become this severe within just a month unless there has been trauma, illness, poor posture, or unhealthy lifestyle habits.
Thus, it is important to consider what might have caused your symptoms, and this will require further consultation with other physicians to gather a detailed medical history.
I hope this information is helpful to you.

Zhang Weidong, Department of Traditional Chinese Medicine, Changhua Hospital

Reply Date: 2016/03/21

More Info

Dear Patient,
Thank you for sharing your detailed symptoms and concerns regarding your condition. Based on your description, it appears that you are experiencing a complex set of symptoms that could potentially involve multiple underlying issues, including sciatica, plantar fasciitis, and possibly other musculoskeletal or neurological conditions.

Understanding Your Symptoms
1. Sciatica: This condition typically arises from irritation or compression of the sciatic nerve, which runs from the lower back down through the hips and buttocks and into each leg. Symptoms often include pain that radiates from the lower back to the leg, numbness, tingling, or weakness in the affected leg. The fact that you initially felt discomfort in your buttocks and it has since radiated down to your thigh, calf, and foot suggests that sciatica could indeed be a contributing factor.

2. Plantar Fasciitis: This is an inflammation of the plantar fascia, a thick band of tissue that runs across the bottom of your foot. Symptoms typically include heel pain and discomfort in the arch of the foot, especially after prolonged periods of inactivity or after getting up in the morning. Your description of pain in the middle of your foot and the sensation of tightness could indicate this condition, especially if the pain worsens with certain activities or footwear.

3. Piriformis Syndrome: This condition occurs when the piriformis muscle, located in the buttock region, spasms and causes pain in the buttocks, which can also affect the sciatic nerve. This could explain some of the pain and numbness you are experiencing in your lower extremities.

4. Nerve Compression or Injury: The numbness and tingling in your toes and the outer side of your arm could suggest a possible nerve compression issue, either in the lumbar region (lower back) or potentially in the cervical region (neck). Conditions such as herniated discs or spinal stenosis could lead to these symptoms.

5. Muscle Strain or Overuse: Given your active lifestyle and the amount of walking you do, muscle strain or overuse injuries could also be contributing to your discomfort, particularly if you have altered your gait due to pain.

Recommendations
1. Consult a Specialist: It would be beneficial to see a neurologist or an orthopedic specialist who can perform a thorough examination, including imaging studies like MRI or CT scans, to assess for any structural issues in your spine or pelvis.

2. Physical Therapy: Engaging in physical therapy can help strengthen the muscles around your spine and pelvis, improve flexibility, and alleviate pressure on the sciatic nerve. A physical therapist can also provide exercises specifically tailored to your symptoms.

3. Pain Management: Over-the-counter anti-inflammatory medications may help reduce pain and swelling. However, consult your physician before starting any medication.

4. Footwear: Since you mentioned that certain shoes exacerbate your pain, consider investing in supportive footwear that provides adequate arch support and cushioning. Custom orthotics may also be beneficial.

5. Activity Modification: While it’s important to maintain mobility, consider modifying your activities to reduce strain on your lower back and feet. This may include taking breaks during long walks or alternating with low-impact activities like swimming or cycling.

6. Follow-Up: Keep a symptom diary to track when your pain worsens or improves, and share this information with your healthcare provider. This can help in diagnosing the underlying issue more accurately.

Conclusion
Your symptoms are complex and may involve multiple conditions. It is crucial to seek a comprehensive evaluation from a healthcare professional who can provide a tailored treatment plan. Remember, early intervention can often lead to better outcomes, so don’t hesitate to pursue further medical advice.

Wishing you a speedy recovery and improved health.

Best regards.

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