When is numbness in the toe a cause for worry?Sport Medicine Orthopaedic Surgery
Hi I'm 19 years old, male, doing national service. 4 weeks into BMT, I started noticing a numbness in my right big toe on the tip and the pad of that toe. Wearing all kinds of foot wear from boots to slippers, or going bare foot does not seem to help the numbness. When I was younger that toe would turn purple and numb if it got too cold in air con, but would recover back to normal after it warmed up. The toe is normal coloured now, and when I press and release the blood seems to flow back normally.
Thanks for the question and certainly something worth discussing.
There seems to be two issues here:
1. The numbness in the toe and foot pad
2. The history of colour change
From the first point, sensation is detected and transmitted through nerves. If you consider nerves to be a bit like wiring in a house, then you have the "peripheral" nerve that are situated around the foot (a bit like the wiring in your house) and then you have the "central" nerves that are around the spine and brain (a bit like the national grid).
If there is an issue with sensation or nerve conduction it can be from a peripheral or central issue. Often there are other symptoms that go along with this (such as tingling, weakness, changes in reflexes etc) depending on where the problem might be and certainly it sounds like you would benefit from getting this assessed.
From the history of colour change and blueness in the toe, there could be an issue with blood flow and once again might warrant further questioning or investigation; this might include blood tests for various conditions.
Overall, I think it would be a good idea to consult someone about these symptoms.
Perhaps start with medical team at your camp? They might refer you on for further investigation in one of the hospitals local to where you are based.
Thank you for the question. Rightfully as Dr Dinesh has mentioned, the numbness and/or colour change can be due to various causes, and commonly could be due either to a nervous (central or peripheral nerves) problem or even a vascular (bloodflow) problem.
It is important to identify the cause, and get that checked up, as these symptoms may be persistent, or even start affecting other toes/ part of the foot.
I think you should see the camp MO, and get a referral to see either a vascular surgeon, or an orthopaedic surgeon. They can then do the necessary investigations, to try and identify the cause of your symptoms, and start the proper management for you.
Dr Sean Ng