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Sports Medicine

Paresthesia in toes

07/23/2009

Question:

I am a 40yo female in good physical condition. I`m 5`5", 135 lbs, active on a daily basis. I do have chronic insertional achilles tendonitis in my right foot, an old right ankle sprain and Raynaud`s.

In the last few weeks, I`ve had an occasional feeling of warmth/heat in the last two toes on my right foot. There is no difference in the actual skin temperature of those toes. I`m guessing it`s nerve related, but which one and how high up?

Answer:

Without actually seeing your foot it is impossible to determine the exact cause however there are a few possibilities. It is possible that the etiology is related to your Raynaud's type vasospastic disease. As you may know, when a Raynaud's event occurs it starts off with a reduction of local blood flow which causes the white and or blue appearance. When the event subsides the vessels dilate and the blood returns and the area becomes red and may even have the feeling you describe of warmth/heat. If it is nerve related it would most likely be a local nerve (in the foot) rather than from a remote site higher up and most likely due to local trauma to the nerve secondary to activity and/or shoe gear. It is of course possible for a nerve condition higher up to be the cause. In any event an examination by your foot care specialist would be suggested.

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Response by:

Jeffrey M Robbins, DPM Jeffrey M Robbins, DPM
Clinical Assistant Professor of Surgery
School of Medicine
Case Western Reserve University