Numbness and Tingling in Feet and Calves: Causes and Solutions

Q: Numbness and Tingling in Feet and Calves: Causes and Solutions

Hello Mr. <br>Lele： Your main issue seems to be intermittent distal numbness and pain in both lower limbs. <br>According to your description, these symptoms occur with activity. <br>You mentioned having used Sichuan pepper, and you wonder if there is a correlation. <br>Based on y

Numbness and tingling in the soles of the feet and calves?

About a week before the Lunar New Year, I started experiencing a tingling sensation in the soles of my feet and calves.
It feels like a numbness, and I can sense my muscles twitching, but when I touch them, there is no actual movement.
I have previously undergone electrical stimulation therapy on other body parts, but the level of tingling I am experiencing now is more severe.

The first episode occurred about a week before the New Year and lasted until the fourth day of the New Year.
However, it flared up again on Saturday night (the sixth day of the New Year).
Before the symptoms reappeared, I had consumed a considerable amount of Sichuan peppercorn peanuts, including the peppercorns themselves.

The second episode lasted only about two days, again with the same tingling sensation in the same areas.
The third episode has persisted until today, February 23, 2016.
Each morning when I wake up, I do not have a noticeable tingling sensation, but after about an hour and a half (ninety minutes), the symptoms gradually emerge.

Could this indicate a deficiency in some nutrients? Are there certain foods I should avoid? Or is it serious enough that I should see a doctor promptly? If so, which specialty should I consult?

Lele, 20~29 year old female. Ask Date: 2016/02/23

Dr. Yang Shenggong reply Neurology

Hello Mr.
Lele: Your main issue seems to be intermittent distal numbness and pain in both lower limbs.
According to your description, these symptoms occur with activity.
You mentioned having used Sichuan pepper, and you wonder if there is a correlation.
Based on your description, common concerns include:
1.
Distal neuropathy in both lower limbs: Your numbness and pain have been increasing in duration and may extend upwards, even reaching the hands, along with weakness or gait abnormalities.
Please seek medical attention promptly, as acute multiple neuropathies can be quite serious.
2.
Bilateral lumbar radiculopathy: You may experience accompanying lower back pain and sensory loss in the lower limbs, as well as weakness in the lower limbs.
3.
Lumbar spinal cord lesions: Numbness in the lower limbs may occur, along with weakness, and there may often be difficulties with bowel and bladder control.
Sichuan pepper is rich in various proteins, fats, and vitamins, but it is not advisable to consume it in excess, especially since unripe Sichuan pepper contains hydroxy-alpha-sanshool, which can be toxic in large amounts.
It can be consumed in moderation for seasoning if there are no allergies.
I did not find any literature linking your mentioned symptoms to this.
Therefore, I recommend that you visit a neurology clinic for examination to clarify the issue.
Dr.
Yang Sheng-gong, Neurology Department, Changhua Hospital, Ministry of Health and Welfare.

Reply Date: 2016/02/23

More Info

Numbness and tingling in the feet and calves can be concerning symptoms that may arise from various underlying causes. Based on the description provided, it seems that the numbness and tingling sensations have been intermittent, occurring in episodes that last for a few days and then subside. This pattern can suggest several potential causes, which I will outline below, along with recommendations for further evaluation and management.

Possible Causes
1. Nerve Compression or Entrapment: Conditions such as sciatica, where the sciatic nerve is compressed, can lead to numbness and tingling in the legs. Similarly, conditions like tarsal tunnel syndrome, where the tibial nerve is compressed at the ankle, can also cause similar symptoms.

2. Peripheral Neuropathy: This condition is often associated with diabetes, alcohol use, or vitamin deficiencies (particularly B vitamins). It can lead to sensations of tingling, numbness, and weakness in the extremities.

3. Circulatory Issues: Poor circulation due to vascular conditions can lead to numbness and tingling. This can be exacerbated by prolonged sitting or standing, especially in cold environments.

4. Nutritional Deficiencies: As mentioned, deficiencies in certain vitamins, particularly B12, B1, B6, and folate, can lead to neuropathy. If you have recently changed your diet or have been consuming foods that may lead to deficiencies, this could be a contributing factor.

5. Anxiety and Stress: Sometimes, anxiety can manifest physically, leading to sensations of tingling or numbness, particularly in the extremities.

Recommendations
1. Dietary Assessment: Consider evaluating your diet for potential deficiencies. Foods rich in B vitamins (such as whole grains, meat, eggs, dairy, and leafy greens) should be included. If you suspect a deficiency, a blood test can help confirm this.

2. Hydration and Caffeine Intake: Ensure you are well-hydrated and monitor your caffeine intake, as excessive caffeine can lead to increased anxiety and exacerbate symptoms.

3. Physical Activity: Regular exercise can improve circulation and nerve health. Gentle stretching and strengthening exercises for the legs may help alleviate symptoms.

4. Posture and Ergonomics: Pay attention to your posture, especially if you sit for long periods. Ensure that your legs are not crossed for extended periods, as this can compress nerves.

5. Medical Evaluation: Given the recurrent nature of your symptoms, it is advisable to consult a healthcare professional. A neurologist would be the most appropriate specialist to evaluate your symptoms. They may conduct a physical examination, nerve conduction studies, or imaging studies to determine the underlying cause.

6. Monitoring Symptoms: Keep a diary of your symptoms, noting when they occur, their duration, and any associated activities or dietary changes. This information can be helpful for your healthcare provider.

Conclusion
While occasional numbness and tingling can be benign, the persistence and recurrence of your symptoms warrant further investigation. It is essential to rule out any serious underlying conditions, especially if the symptoms interfere with your daily life. A thorough evaluation by a neurologist will provide clarity and guide appropriate management strategies. In the meantime, focusing on a balanced diet, regular physical activity, and good posture can help mitigate symptoms.

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