Sudden Left Foot Pain and Heart Discomfort: A Neurology Perspective

Foot pain and palpitations?

In the past year, I have been experiencing sudden pain in my left foot.
It started with my big toe, and now the pain has progressed upwards, reaching below my knee.
This issue only affects my left foot; my right foot is completely fine.
The pain comes on very suddenly; sometimes pressing on it doesn't cause any pain, but at other times, it hurts without any apparent reason.
What could this problem be? Additionally, this week, I felt sudden sharp pain below my heart that lasted for about four hours.

Xiang, 20~29 year old female. Ask Date: 2021/10/30

Dr. Jiang Junyi reply Neurology

Dear Mr.
Hsiang,
You mentioned that "only the thumb...
suddenly hurts a lot." I wonder if this pain is located at the joint? It may be necessary to first consider joint-related diseases, such as gout, among others.
However, if you experience symptoms including pain, numbness, or weakness, these symptoms can easily be confused with other conditions originating from the muscles, bones, or spine.
A physician's experience and familiarity with nerve distribution are often key in identifying the underlying cause early on.
If the pain is accompanied by the following phenomena, there is a high probability that it is related to peripheral nerve compression:
1.
The pain has a burning or electric shock-like quality.
2.
Symptoms have a specific dermatomal distribution, and touching or pressing can provoke the symptoms.
3.
Accompanied by muscle soreness or weakness.
I recommend that you visit a neurology clinic for further examination and follow-up.
Thank you for your inquiry, and feel free to discuss any related questions!
Wishing you good health and peace.
Dr.
Jiang Junyi
Department of Neurology, Taoyuan Hospital

Reply Date: 2021/10/30

More Info

The symptoms you are experiencing, particularly the sudden and localized pain in your left foot, along with the heart discomfort, warrant a thorough evaluation from a neurological perspective. Given the complexity of your symptoms, it is essential to consider various potential neurological and cardiovascular conditions that could be contributing to your discomfort.

Sudden Left Foot Pain
The sudden onset of pain in your left foot, which has progressively moved from the toe to the area below the knee, could be indicative of several underlying issues. One possibility is peripheral neuropathy, which can result from nerve damage due to various causes, including diabetes, vitamin deficiencies, or even trauma. The fact that the pain is localized to one side and can occur without any apparent trigger suggests that it may be related to nerve compression or irritation.

Another consideration is nerve entrapment syndromes, such as tarsal tunnel syndrome, where the tibial nerve is compressed as it passes through the tarsal tunnel near the ankle. This condition can lead to symptoms of pain, tingling, or numbness in the foot. Additionally, conditions affecting the lumbar spine, such as a herniated disc, could also lead to referred pain in the lower extremities, particularly if a nerve root is being compressed.

Heart Discomfort
The heart discomfort you described, characterized by sudden pain lasting for about four hours, raises concerns that should not be overlooked. While it may be tempting to attribute this to anxiety or stress, it is crucial to rule out any cardiac issues. Conditions such as angina or even a myocardial infarction (heart attack) can present with atypical symptoms, including pain that radiates to other areas of the body, including the left arm or jaw.

Given that you have experienced both foot pain and heart discomfort, it is essential to consider the possibility of a vascular issue. Conditions like peripheral artery disease (PAD) can lead to reduced blood flow to the extremities, causing pain, especially during activities. Additionally, a deep vein thrombosis (DVT) could also present with pain in one leg and may be associated with cardiovascular symptoms.

Recommendations
1. Neurological Evaluation: It is advisable to consult a neurologist for a comprehensive evaluation. This may include nerve conduction studies and electromyography (EMG) to assess the function of the nerves and muscles in your leg. Imaging studies, such as MRI or CT scans, may also be warranted to evaluate for any structural abnormalities in the spine or pelvis that could be contributing to your symptoms.

2. Cardiac Assessment: Given the heart-related symptoms, it is crucial to undergo a cardiac evaluation. This may include an electrocardiogram (ECG), echocardiogram, and possibly a stress test to assess the heart's function and rule out any significant cardiovascular issues.

3. Lifestyle Modifications: While awaiting further evaluation, consider lifestyle modifications that may help alleviate symptoms. This includes maintaining a healthy diet, engaging in regular physical activity, and managing stress through relaxation techniques or counseling.

4. Monitoring Symptoms: Keep a detailed log of your symptoms, including the frequency, duration, and intensity of the pain in your foot and any heart discomfort. This information can be invaluable for your healthcare providers in determining the underlying cause.

In conclusion, the combination of sudden left foot pain and heart discomfort is concerning and should be thoroughly investigated. A multidisciplinary approach involving both neurological and cardiovascular assessments will be crucial in identifying the underlying causes and developing an appropriate treatment plan. Please prioritize seeking medical attention to address these symptoms effectively.

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