Disc Herniation and Its Impact on Finger Sensation

Herniated disc finger issues

Hello Doctor, since around mid to late October, I've been experiencing a peculiar sensation on the outer side of my left little toe, as if it's soft when it touches the floor.
I consulted a doctor and had an X-ray taken, which revealed that I have scoliosis.
The doctor also suspected a herniated disc and sciatica.
I was prescribed painkillers and muscle relaxants, and until November, I didn't have any other significant symptoms.
Recently (mid-December), I've suddenly felt a lot of soreness in my lower back, and there's a tingling sensation like a pinprick on the right side of my left big toe.
I also feel very fatigued and often experience dizziness.
Additionally, there's a similar pinprick sensation on the first phalanx of my right middle finger.
I would like to know what symptoms these might indicate and what would be the best course of treatment.
Thank you.

Shi, 20~29 year old female. Ask Date: 2020/12/12

Dr. Wang Shouji reply Orthopedics

Hello, the symptoms in your hands and feet are likely not caused by the same issue.
First, we need to assess the degree of scoliosis.
Given your age, if the curvature is not significant, it is unlikely to affect the nerves, and treatment with medication and rehabilitation should suffice.
The tingling in your fingers should raise concerns about the median nerve and carpal tunnel syndrome.
Changhua Hospital cares about your health.
Dr.
Wang Shou-ji.

Reply Date: 2020/12/12

More Info

Disc herniation, commonly referred to as a slipped or bulging disc, occurs when the soft inner material of a spinal disc protrudes through a tear in the tougher exterior. This condition can lead to various symptoms, particularly when the herniated disc compresses nearby nerves. In your case, the symptoms you are experiencing, such as the peculiar sensation in your left little toe, the tingling in your left big toe, and the pinprick sensation in your right middle finger, may indeed be related to nerve compression caused by a herniated disc.

When a disc herniates, it can impinge on the spinal nerves or the cauda equina, which can lead to neurological symptoms. The sensations you describe, such as tingling or a "pins and needles" feeling, are often indicative of nerve irritation or compression. The fact that you have also experienced lower back pain and fatigue suggests that the herniation may be affecting the lumbar region of your spine, which is responsible for innervating the lower extremities.

The connection between your symptoms and the herniated disc is further supported by the fact that you have been diagnosed with scoliosis. Scoliosis can alter the biomechanics of the spine, potentially increasing the risk of disc herniation and nerve compression. The pain and tingling sensations you are experiencing in your toes and fingers may be due to the affected nerves being unable to transmit signals properly due to the pressure from the herniated disc.

In terms of treatment, the initial approach often includes conservative management. This may involve:
1. Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) can help alleviate pain and reduce inflammation. Muscle relaxants may also be prescribed to relieve muscle spasms.

2. Physical Therapy: A physical therapist can design a program tailored to your needs, focusing on strengthening the muscles around your spine, improving flexibility, and teaching proper body mechanics to reduce strain on your back.

3. Activity Modification: Avoiding activities that exacerbate your symptoms is crucial. This may include heavy lifting, prolonged sitting, or any movements that put additional stress on your spine.

4. Epidural Steroid Injections: If conservative measures do not provide relief, your doctor may recommend steroid injections to reduce inflammation around the affected nerve roots.

5. Surgery: In cases where conservative treatments fail and symptoms persist or worsen, surgical options may be considered. This could involve a discectomy, where the herniated portion of the disc is removed to relieve pressure on the nerve.

It is also important to monitor your symptoms closely. If you experience any new or worsening symptoms, such as significant weakness in your legs, loss of bowel or bladder control, or severe pain that does not respond to medication, you should seek immediate medical attention. These could be signs of more serious complications that require urgent intervention.

In summary, your symptoms of tingling and pain in your toes and fingers may be related to a herniated disc affecting the nerves in your lumbar spine. A combination of conservative treatments, including medication, physical therapy, and lifestyle modifications, is typically the first line of management. However, ongoing evaluation by a healthcare professional is essential to ensure that your condition is monitored and managed appropriately.

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