Hand and Foot Numbness: When to Seek Neurology Help

Q: Hand and Foot Numbness: When to Seek Neurology Help

Hello： The first issue you raised concerns "trigger finger." It is generally believed that repetitive and forceful use of the fingers over a long period can lead to tendon and tendon sheath injuries, swelling, and poor blood circulation. <br>If there is frequent exposure to cold

The ring finger of the right hand cannot be straightened upon waking up in the morning?

Hello Dr.
Jiang, I have two questions I would like to ask:
1.
My right ring finger is in a clenched position when I wake up in the morning and I cannot straighten it.
I use my left hand to help straighten it, but throughout the day it feels stiff and I cannot bend it like my other fingers.
Bending it causes a little pain.
This situation has been ongoing for a week.
What should I do or which specialty should I consult?
2.
Both of my toes have been numb since the second half of last year (I underwent rehabilitation last year and stopped before the Lunar New Year this year, with no improvement).
For about the past two months, when I stand barefoot on the ground, I constantly feel like I'm stepping on something small, but there is nothing on the floor.
How should I address this or which specialty should I see?
Medical history: Meningioma (located near the brainstem), underwent surgery in 2001 and received stereotactic radiosurgery in 2017.
Degeneration of cervical vertebrae C4, C5, and C6.
Hyperlipidemia.
Thank you.

Sandy, 60~69 year old female. Ask Date: 2020/10/16

Dr. Jiang Junyi reply Neurology

Hello: The first issue you raised concerns "trigger finger." It is generally believed that repetitive and forceful use of the fingers over a long period can lead to tendon and tendon sheath injuries, swelling, and poor blood circulation.
If there is frequent exposure to cold water, it can cause vasoconstriction, further exacerbating the blood flow issues in the fingers, leading to trigger finger.

Regarding your second concern, your symptoms may suggest peripheral neuropathy.
It is important to consider metabolic diseases such as diabetes.
Treatment should be targeted towards the underlying causes.
It is recommended to supplement with B vitamins and to engage in stretching exercises to avoid nerve compression and muscle tightness, which can worsen symptoms.
I suggest consulting a neurologist for further evaluation and treatment.
Wishing you good health and happiness.

Dr.
Jiang, Department of Neurology, Taoyuan Medical Center, cares for you.

Reply Date: 2020/10/16

More Info

When it comes to numbness and discomfort in the hands and feet, it is essential to understand the underlying causes and when to seek medical help. Based on your description, you have two primary concerns: the inability to fully extend your right ring finger and the persistent numbness in your toes. Given your medical history, including a previous meningioma and cervical spine degeneration, it is crucial to approach these symptoms with caution.

1. Right Ring Finger Issue
The inability to extend your right ring finger in the morning, along with the sensation of stiffness and slight pain when bending, could indicate a few potential issues. One possibility is a condition known as "trigger finger," where the tendons that bend the fingers become inflamed, causing the finger to lock in a bent position. This condition can be exacerbated by repetitive motions or pressure on the tendons. Another possibility is a nerve compression issue, such as ulnar nerve entrapment, which can lead to symptoms in the ring and little fingers.

Given that this issue has persisted for a week, it would be advisable to consult with a specialist. A hand surgeon or a neurologist would be appropriate choices, as they can evaluate both the mechanical and neurological aspects of your symptoms. They may recommend imaging studies, such as an MRI or ultrasound, to assess the tendons and nerves in your hand.

2. Numbness in Toes
The numbness in your toes, along with the sensation of "stepping on something" when there is nothing there, suggests a possible peripheral neuropathy. This condition can arise from various causes, including diabetes, vitamin deficiencies, or nerve compression. Given your history of cervical spine degeneration, it is also possible that nerve roots in the lumbar region could be affected, leading to symptoms in your feet.

Since you have already undergone rehabilitation without improvement, it may be time to seek further evaluation. A neurologist would be the most suitable specialist for this issue, as they can perform nerve conduction studies and electromyography (EMG) to assess the function of the nerves in your legs and feet. They may also consider other diagnostic tests, such as blood tests to check for vitamin deficiencies or other metabolic issues.

General Recommendations
In the meantime, here are some general recommendations to help manage your symptoms:
- Avoid aggravating activities: If certain movements or positions worsen your symptoms, try to avoid them.

- Ergonomic adjustments: Ensure that your workspace and daily activities are ergonomically friendly to minimize strain on your hands and feet.

- Physical therapy: If you haven't already, consider consulting a physical therapist who can provide exercises to improve flexibility and strength in your hands and feet.

- Medication: Over-the-counter anti-inflammatory medications may help alleviate pain and inflammation, but consult your doctor before starting any new medication.

Conclusion
In summary, your symptoms warrant further evaluation by a specialist. Given your medical history, it is essential to address these issues promptly to prevent potential complications. A neurologist or hand surgeon can provide the necessary assessments and treatment options tailored to your specific needs. Remember, early intervention can often lead to better outcomes, so don’t hesitate to seek help.

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