Loss of Sensation in Right Big Toe: Causes and Recommended Tests

Numbness from the right big toe to the lateral side of the arch?

Recently, my mother discovered that there is no sensation when pressing on her right big toe.
Upon visual comparison of both big toes, the toe with no sensation appears darker in color.
Even after repeatedly soaking it in hot water and then pressing on it, the lack of sensation persists.
What could this condition be? What kind of examinations should be conducted to quickly determine the cause?

Ms. H, 60~69 year old female. Ask Date: 2018/05/08

Dr. Liao Yaopan reply Family Medicine

Hello, it is recommended to first visit the neurology outpatient clinic for an evaluation by a physician.
Please note that online consultations are not equivalent to in-person visits and cannot provide diagnoses or treatment recommendations.
Changhua Hospital cares about you.

Reply Date: 2018/05/08

More Info

Loss of sensation in the right big toe, especially when accompanied by a change in color, can be indicative of several underlying conditions. The symptoms you describe—loss of sensation, discoloration, and the lack of response to pressure—suggest that there may be an issue with blood flow or nerve function in that area. Here are some potential causes and recommended tests to help identify the underlying issue.

Possible Causes
1. Peripheral Neuropathy: This condition occurs when there is damage to the peripheral nerves, which can lead to loss of sensation. Common causes include diabetes, vitamin deficiencies (especially B12), and exposure to toxins.

2. Circulatory Issues: Conditions such as peripheral artery disease (PAD) can lead to reduced blood flow to the extremities, causing discoloration and numbness. This is often due to atherosclerosis, where arteries become narrowed due to plaque buildup.

3. Nerve Compression or Injury: A herniated disc in the spine or compression of the nerves in the leg (such as from a tight bandage or prolonged pressure) can lead to loss of sensation in the toes.

4. Raynaud's Phenomenon: This condition causes blood vessels to constrict excessively in response to cold or stress, leading to color changes and numbness in the fingers and toes.

5. Infections or Inflammatory Conditions: Conditions such as gout or infections can also lead to localized symptoms in the toes.

Recommended Tests
To determine the exact cause of the loss of sensation in your mother's right big toe, the following tests may be recommended:
1. Physical Examination: A thorough physical examination by a healthcare provider will help assess the sensation, blood flow, and any visible signs of injury or disease.

2. Blood Tests: These can check for diabetes, vitamin deficiencies, and other metabolic conditions that could contribute to neuropathy or circulatory issues.

3. Doppler Ultrasound: This test can evaluate blood flow in the arteries and veins of the legs and feet, helping to identify any blockages or circulatory problems.

4. Nerve Conduction Studies (NCS) and Electromyography (EMG): These tests measure the electrical activity of nerves and muscles, helping to identify any nerve damage or dysfunction.

5. MRI or CT Scan: If a nerve compression or injury is suspected, imaging studies may be necessary to visualize the spine or surrounding structures.

6. Ankle-Brachial Index (ABI): This simple test compares blood pressure in the ankle with blood pressure in the arm to assess for peripheral artery disease.

Conclusion
Given the symptoms of loss of sensation and discoloration in the right big toe, it is essential to seek medical attention promptly. A healthcare provider can perform the necessary evaluations and tests to determine the underlying cause and recommend appropriate treatment. Early diagnosis and intervention can help prevent further complications and improve outcomes. Encourage your mother to consult with a healthcare professional as soon as possible to address these concerning symptoms.

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