Hand and Foot Pain, Numbness, and Dizziness Symptoms

Regarding the issues of pain and numbness in the fingers and toes, as well as dizziness?

The tips of my fingers (the area with fingerprints) hurt and feel numb when I apply pressure or exert force.
I also have difficulty sensing objects with my fingers, and when I hold a cup, it tends to tilt outward.
My toes experience similar symptoms, although they are somewhat better than my fingers.
Occasionally, I experience dizziness, especially when standing or walking, to the point where I need support to avoid falling.
Sometimes, when I lean on something, my body appears to sway from side to side.
These symptoms started this year; I didn't have them before.
Recently, with the colder weather, I've been enjoying some sunlight, which seems to improve my condition a bit.
I have been taking medication for angina for the past 4-5 years.
I would like to know what might be causing these issues, as I am concerned about my father's condition.

A Lun, 70~79 year old female. Ask Date: 2008/02/02

Dr. Gao Chunde reply Neurology

Based on your description of symptoms, weakness and loss or abnormal sensation in the fingertips, as well as pain with exertion or pressure, it is important to consider neuropathy, particularly in elderly patients.
This could be related to peripheral nerve issues or problems with the lower cervical spine nerves.
However, peripheral nerve issues typically affect the feet more severely than the hands, which does not align well with your father's symptoms.
If there is cervical nerve involvement with spinal cord pathology, it could lead to balance and sensory disturbances in the lower limbs, as well as dizziness.
Additionally, consider orthostatic hypotension as a cause of dizziness and instability; measuring blood pressure in lying, sitting, and standing positions can be helpful.
If the systolic blood pressure difference is greater than 20 mmHg, it indicates a problem.
I hope this basic information is helpful to you.

Reply Date: 2008/02/02

More Info

Based on the symptoms you've described, it seems that you are experiencing a combination of hand and foot pain, numbness, and dizziness, which can be indicative of several underlying medical conditions. Let's break down these symptoms and explore potential causes and solutions.

Symptoms Analysis
1. Hand and Foot Pain/Numbness: The pain and numbness in your fingers and toes, especially when pressure is applied, could be related to nerve compression or peripheral neuropathy. Conditions such as carpal tunnel syndrome, which affects the median nerve in the wrist, can lead to pain, tingling, and numbness in the fingers. Similarly, tarsal tunnel syndrome can affect the tibial nerve in the foot, leading to similar symptoms.

2. Dizziness: The dizziness you experience when standing or walking could be due to several factors, including orthostatic hypotension (a drop in blood pressure upon standing), vestibular disorders, or even anxiety-related issues. Given your history of angina and medication use, it’s crucial to consider cardiovascular factors that could contribute to dizziness.

3. Balance Issues: The sensation of your body swaying or needing support while standing could indicate issues with your vestibular system, which helps control balance. This could be exacerbated by the dizziness you experience.

Possible Causes
- Peripheral Neuropathy: This condition can result from diabetes, vitamin deficiencies (especially B vitamins), or exposure to toxins. It can cause numbness, tingling, and pain in the extremities.

- Circulatory Issues: Given your history of angina, it’s essential to evaluate your cardiovascular health. Poor circulation can lead to numbness and pain in the extremities.

- Nerve Compression Syndromes: Conditions like carpal tunnel syndrome or tarsal tunnel syndrome can cause localized pain and numbness in the hands and feet.

- Vestibular Disorders: These can lead to balance issues and dizziness. Conditions like benign paroxysmal positional vertigo (BPPV) or vestibular neuritis could be contributing factors.

Recommendations
1. Medical Evaluation: It’s crucial to consult a healthcare professional for a thorough evaluation. This may include blood tests to check for diabetes, vitamin deficiencies, and thyroid function, as well as imaging studies (like MRI or ultrasound) to assess for nerve compression or circulatory issues.

2. Neurological Assessment: A neurologist can help determine if there are any underlying neurological conditions contributing to your symptoms. They may perform nerve conduction studies or electromyography (EMG) to assess nerve function.

3. Cardiovascular Check-Up: Given your history of angina, a cardiologist should evaluate your heart health. They may recommend tests like an echocardiogram or stress test to assess your cardiovascular function.

4. Physical Therapy: Engaging in physical therapy can help improve strength and balance, especially if your symptoms are related to nerve compression or vestibular issues.

5. Lifestyle Modifications: Maintaining a healthy diet, staying hydrated, and managing stress can positively impact your overall health. If you are taking medications for angina, ensure that your doctor is aware of all your symptoms, as some medications can have side effects that contribute to dizziness and balance issues.

6. Sun Exposure: You mentioned feeling better when exposed to sunlight. This could be related to vitamin D synthesis, which is essential for overall health. Ensure you are getting adequate sunlight or consider discussing vitamin D supplementation with your doctor.

Conclusion
Your symptoms of hand and foot pain, numbness, and dizziness warrant a comprehensive medical evaluation to determine the underlying causes. It’s essential to address these symptoms promptly, especially considering your history of angina. By working closely with healthcare professionals, you can develop a tailored treatment plan that addresses your specific needs and improves your quality of life.

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