Sensory Differences Between Left and Right Feet

There is a difference in sensation between the left and right foot?

Several months ago, I started to occasionally feel a difference in sensation between my right and left foot.
When I touch both feet, the left foot has a clear sensation, while the right foot feels somewhat numb or foggy.
This sensation includes the right foot's dorsum, toes, sole, and ankle.
Some days it is more pronounced, while other times it is less noticeable.
I recall only one instance of trauma, where I hit my coccyx on the ground, which was very painful at the time.
Occasionally, if I sit in a poor posture, I feel pain in that area, but otherwise, it does not hurt and does not affect my walking.
I have a habit of crossing my legs and sitting in a lotus position, and when I walk, my legs rub against each other on the inner side.

1.
My mother has diabetes, but my last fasting blood sugar test was normal.
Should diabetes be ruled out first?
2.
If it is not diabetes, what other conditions should be considered? Which specialty should I consult, or what tests should I undergo? Thank you.

Miss Wang, 30~39 year old female. Ask Date: 2023/09/11

Dr. Jiang Junyi reply Neurology

Dear Ms.
Wang,
You mentioned that you have a habit of crossing your legs and that your mother has diabetes, but your last fasting blood glucose level was normal.
Should diabetes be ruled out first? If it is not diabetes, what other conditions should be considered? Which specialty should I consult or what tests should be performed?
Your symptoms may suggest compression of the right common peroneal nerve, which can cause numbness, tingling, and pain from the knee to the outer side of the ankle.
Evaluation of peripheral nerve issues typically involves electrophysiological studies to assist in diagnosis.
Nerve conduction studies assess the conduction velocity and waveform of large fiber nerves, while electromyography evaluates the muscle response in the areas supplied by the nerves.
I recommend that you visit a neurology clinic for further evaluation.
It would be beneficial to consult a physician specializing in peripheral nerves, as they have more experience with electromyography.
Thank you for your inquiry, and I welcome further discussion.
Wishing you good health and happiness.
Sincerely,
Dr.
Jiang Junyi
Department of Neurology, Taoyuan Hospital

Reply Date: 2023/09/11

More Info

Experiencing sensory differences between the left and right feet, such as a distinct "foggy" sensation in the right foot compared to the clear sensation in the left, can be concerning and warrants further investigation. Here’s a comprehensive overview of potential causes, considerations, and recommendations based on your symptoms.

Understanding Sensory Differences
1. Neuropathy: One of the most common causes of altered sensation in the feet is peripheral neuropathy. This condition can result from various factors, including diabetes, vitamin deficiencies, alcohol use, and certain medications. Given your family history of diabetes, it is prudent to rule out diabetic neuropathy, even if your recent fasting blood sugar levels were normal. Diabetes can sometimes cause nerve damage even before blood sugar levels become elevated.

2. Nerve Compression or Injury: Your history of tailbone injury could potentially lead to nerve compression or irritation, especially if you have habits like crossing your legs or sitting in positions that may put pressure on certain nerves. Conditions such as sciatica or piriformis syndrome can also lead to altered sensations in the lower extremities.

3. Circulatory Issues: Poor circulation can lead to sensory changes in the feet. Conditions such as peripheral artery disease (PAD) can cause reduced blood flow, resulting in numbness or altered sensations.
4. Multiple Sclerosis (MS): Although less common, MS can cause sensory disturbances in various parts of the body, including the feet. This is due to demyelination of nerves, which can lead to altered sensations.

5. Vitamin Deficiencies: Deficiencies in vitamins such as B12, B1, and B6 can lead to neuropathy and altered sensations. It may be worthwhile to check your vitamin levels, especially if your diet lacks these essential nutrients.

Recommendations
1. Consult a Healthcare Provider: Given your symptoms, it is advisable to consult a healthcare provider, preferably a neurologist or a primary care physician. They can conduct a thorough examination and take a detailed medical history, which is crucial for diagnosis.

2. Diagnostic Tests: Your doctor may recommend several tests, including:
- Blood Tests: To check for diabetes, vitamin deficiencies, thyroid function, and other metabolic conditions.

- Nerve Conduction Studies: To assess the function of the nerves in your legs and feet.

- Imaging Studies: Such as MRI or CT scans, to evaluate for any structural issues in the spine or pelvis that may be compressing nerves.

3. Lifestyle Modifications: In the meantime, consider modifying your sitting habits to avoid prolonged pressure on your legs and feet. Regular exercise can also improve circulation and nerve health.

4. Monitoring Symptoms: Keep a log of your symptoms, noting when they occur, their intensity, and any associated activities. This information can be valuable for your healthcare provider in determining the underlying cause.

Conclusion
While sensory differences between the left and right feet can stem from various causes, it is essential to approach this symptom with a comprehensive evaluation. Given your family history of diabetes and your recent symptoms, ruling out diabetes and other potential causes is crucial. Early diagnosis and intervention can significantly improve outcomes, so seeking medical advice promptly is recommended.

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