Foot Numbness and Lower Back Pain: When to Seek Help - Neurology

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Hello! Thank you for sharing your concerns regarding your foot numbness and lower back pain. Based on your description, it seems that you have been experiencing a combination of symptoms that could be related to several underlying issues. Given your work as a long-standing operator, it is not uncommon to develop musculoskeletal problems due to prolonged standing and limited sitting time.

Your history of lower back pain, which improved with rehabilitation, suggests that you may have had some form of mechanical back pain or possibly a disc-related issue. The persistent pain near your hip and the numbness in your big toe could indicate nerve involvement, potentially due to compression or irritation of the nerves that supply sensation to your foot.


Possible Causes of Your Symptoms
1. Nerve Compression: The numbness in your big toe could be due to compression of the nerves in your lower back or at the level of the foot. Conditions such as a herniated disc or spinal stenosis can lead to nerve root compression, resulting in symptoms like numbness, tingling, or pain radiating down the leg.

2. Peripheral Neuropathy: This condition involves damage to the peripheral nerves and can result from various factors, including diabetes, vitamin deficiencies, or prolonged pressure on nerves. The fact that you experience numbness and a reduced response to pain and temperature suggests that there could be some form of neuropathy.

3. Circulatory Issues: Although less likely given your description, circulatory problems can also lead to numbness in the extremities. If blood flow is restricted, it can cause symptoms similar to what you are experiencing.

4. Musculoskeletal Issues: Given your occupation, repetitive strain or overuse injuries could lead to muscle imbalances or joint issues that might contribute to both your back pain and foot symptoms.


When to Seek Help
Given the duration and nature of your symptoms, it is advisable to seek medical attention. Here are some recommendations on which specialists to consult:
1. Orthopedic Specialist: An orthopedic doctor can evaluate your musculoskeletal system, including your spine and lower extremities. They can perform imaging studies, such as X-rays or MRIs, to assess for structural issues.

2. Neurologist: A neurologist specializes in nerve-related issues and can help determine if your symptoms are due to nerve compression or peripheral neuropathy. They may conduct nerve conduction studies or electromyography (EMG) to assess nerve function.

3. Physical Medicine and Rehabilitation (PM&R) Specialist: Also known as physiatrists, these specialists focus on rehabilitation and can provide a comprehensive approach to managing pain and improving function through physical therapy and other modalities.

4. Podiatrist: If your symptoms are primarily localized to your foot, a podiatrist can evaluate your foot mechanics and assess for any conditions affecting your toes or foot structure.


Additional Recommendations
- Physical Therapy: Engaging in physical therapy can help strengthen your back and core muscles, improve flexibility, and alleviate pressure on the nerves. A therapist can also provide exercises tailored to your specific needs.

- Ergonomic Adjustments: Since your job involves long hours of standing, consider discussing ergonomic adjustments with your employer. This could include anti-fatigue mats, supportive footwear, or even scheduled breaks to sit and relieve pressure.

- Lifestyle Modifications: Incorporating regular stretching and strengthening exercises into your routine can help maintain flexibility and strength in your back and legs.
In conclusion, it is essential to address these symptoms promptly to prevent further complications. Seeking the right specialist based on your symptoms will help you receive an accurate diagnosis and appropriate treatment. Wishing you the best in your recovery!