Nerve Damage: Causes and Treatment for Hand and Foot Numbness

Numbness in the hands and feet?

Hello, Doctor: I have a few questions to ask.
My left hand, including the palm and the back, has been experiencing persistent numbness for a long time.
A month ago, I visited a neurologist and underwent an electromyography (EMG) test.
When I returned for a follow-up a week later, the doctor informed me that there is a nerve injury in my wrist, which is causing the numbness, especially when riding a motorcycle.
The doctor only mentioned the nerve injury without providing further details.
I was prescribed Methylcobalamin, but I am confused and didn't know what to ask during the limited consultation time.
Could you please help clarify this for me? Can the injured nerve that is causing the numbness in my palm heal, or is it only manageable with medication? Will Methylcobalamin help eliminate my numbness? I have been taking it for almost a month, but the numbness seems to be about the same.
Additionally, a year ago, I twisted my ankle and experienced significant pain while walking.
I received several sessions of acupuncture, and the pain subsided after a week.
However, since then, whenever I touch the top of my foot, I experience an electric shock-like numbness and tingling.
Lightly touching the top of my foot results in a tingling sensation accompanied by sharp pain.
Could it be that the initial ankle injury also affected the nerve? Do I need to undergo another EMG? Does the EMG performed on my hand also reflect the nerve condition in my foot, or does the foot require a separate EMG? In your professional opinion, will the numbness and tingling in my foot recover on its own? I have many questions and would greatly appreciate your answers.
Thank you very much!

Mr. Wang, 40~49 year old female. Ask Date: 2016/05/31

Dr. Gao Chunde reply Neurology

The most common condition is carpal tunnel syndrome.
You can look up the causes and treatments online.
Your primary physician has only prescribed Methylcobalamin, which is a supplement that aids in the repair of nerve tissue and is classified as a medical treatment, typically used for mild cases.
If the condition is severe, accompanied by weakness or atrophy of the thumb muscles, you will be referred to a surgeon for surgical intervention.
Regardless of the severity, rehabilitation therapy can be added, which involves visiting a rehabilitation clinic where a rehabilitation physician will arrange the appropriate therapy.
If there is no improvement, you should return for a follow-up appointment to inform the physician, allowing them to assess and adjust the treatment plan as necessary.
The issues with your foot indeed seem to indicate sensory nerve abnormalities, suggesting some nerve damage.
Electromyography and nerve conduction studies will need to be performed separately, as the hand's condition cannot be evaluated through the foot.
Recovery will depend on the underlying cause of the nerve damage, which specific nerve is affected, and the extent of the injury.

Reply Date: 2016/05/31

More Info

Nerve damage can be a complex issue, particularly when it manifests as numbness or tingling in the hands and feet. Based on your description, it seems you are experiencing symptoms related to nerve injury in both your hand and foot, which can be caused by various factors, including trauma, repetitive strain, or prolonged pressure on nerves.

Understanding Nerve Damage
1. Causes of Nerve Damage:
- Trauma: Injuries from falls or accidents can lead to nerve compression or damage. For instance, twisting an ankle can affect the nerves in the foot, while repetitive motions or pressure on the wrist can lead to conditions like carpal tunnel syndrome.

- Repetitive Strain: Activities that involve repetitive motions, such as typing or using a motorcycle, can lead to nerve irritation or compression.

- Poor Posture: Sitting or standing in a way that puts pressure on nerves can also cause numbness or tingling.

2. Symptoms:
- Numbness, tingling, or a "pins and needles" sensation are common symptoms of nerve damage. In your case, the persistent numbness in your left hand and the electric-like sensations in your foot suggest that the nerves in these areas may be compromised.

Diagnosis and Treatment
1. Diagnosis:
- Electromyography (EMG) and nerve conduction studies are essential for diagnosing nerve damage. These tests can help determine the extent of the injury and whether the nerve is regenerating properly. If you have already undergone an EMG for your hand, it may not provide information about the foot unless a separate test is conducted.

2. Treatment Options:
- Medication: Medications like methylcobalamin (the drug you mentioned) are often prescribed to support nerve health and repair. However, the effectiveness can vary from person to person. If you have been taking it for a month without noticeable improvement, it may be worth discussing with your doctor whether to continue or explore other options.

- Physical Therapy: Engaging in physical therapy can help strengthen the muscles around the affected nerves and improve function. A therapist can also provide exercises to alleviate pressure on the nerves.

- Lifestyle Modifications: Avoiding positions that exacerbate your symptoms, such as prolonged wrist flexion while riding a motorcycle, can help prevent further nerve damage. Ergonomic adjustments in your workspace may also be beneficial.

3. Prognosis:
- The potential for recovery depends on the severity of the nerve damage. In many cases, nerves can heal over time, especially if the underlying cause is addressed. However, chronic compression or injury may lead to permanent changes. Regular follow-ups with your healthcare provider are essential to monitor your condition and adjust treatment as necessary.

Conclusion
In summary, nerve damage can lead to persistent symptoms such as numbness and tingling in the hands and feet. It is crucial to identify the underlying cause and address it through appropriate medical intervention, lifestyle changes, and possibly physical therapy. If you continue to experience symptoms or if they worsen, seeking further evaluation, including additional nerve studies for your foot, may be warranted. Always consult with your healthcare provider for personalized advice and treatment options tailored to your specific situation.

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