The normal function of peripheral tissue depends on normal blood supply to provide nourishment and oxygen to the tissue and organs. Similarly, normal part depends on exchange of sensory, motor and autonomic signals from and to spinal string from peripheral receptors. Receptors lies over the surface of peripheral tissue and organs. The normal function of upper and lower extremities involves muscle contraction, joint movements and feeling of harmful sensation by peel. The lack of adequate blood supply or malfunction of peripheral nerve to the human foot or big toe can cause numbness of the big toe.

Consult Medico- Big toe numbness is instant or slow in occurrence. Anytime if yous experience numbness in large toe then you should see master care physician or specialist every bit soon equally possible.

Blood Supply To Big Toe-

The arterial blood carries the nourishment and oxygen to the peripheral tissue like big toe. The branches of kickoff metatarsal avenue supplies fourscore% of the arterial blood and first plantar metatarsal artery supplies xx% of the blood.i

Nervus Supply To Big Toe-

The spinal nerve carries sensory and motor nerves to the peripheral tissue. The sensory nerve carries signals of impact, temperature and pain from skin, muscles, tendon, ligaments, joints, cartilages and bones to the spinal cord. Spinal nervus likewise carries signals from brain and spinal cord to the muscles so the muscle contracts and assist joint movement. In addition to sensory and motor nerves there are autonomic nerves known as sympathetic and parasympathetic fretfulness. These nerves originate in spinal string as well every bit sympathetic ganglion. Autonomic fretfulness follow the arteries to the large toe. Sympathetic nerve causes narrowing and parasympathetic nerve causes dilatation of arteries and its branches. The branch of spinal nerve known every bit superficial peroneal nerve carries sensory and motor nerve to the foot and big toe. The branch of superficial peroneal nerve that supplies sensory and motor nervus to big toes is known equally dorso-medial cutaneous nervus.2

Numbness in big toe is the condition that usually occurs when there are abnormalities in the circulatory system or peripheral nervous system. It is important to know the causes of numbness in big toe, so proper handling is provided to treat the cause of pain.

Causes of Numbness in Big Toe

Causes of Numbness in Big Toe

The numbness is caused by abnormal function of peripheral sensory nerve. The temporary numbness is reversed when cause of numbness is removed. The abnormal part of sensory nervus causes hurting, tingling, numbness and inability to understand the position of extremity too as joint. Such abnormal function of branches of sensory nerve to big toe is caused by nerve injury or lack of blood supply to nerve and sensory receptors. Sensory receptors lie on surface of tissue like skin, musculus, tendon, ligament, cartilage, joint capsule and bone. The lack of claret supply or injuries to these tissue causes amercement to sensory receptors that results in numbness and hurting.

    1. Restricted Peripheral Claret Apportionment– The condition is too known equally peripheral vascular affliction (PVD). In virtually of the cases, the menstruum of claret to the feet gets restricted. Sitting or continuing in awkward position, keeping the anxiety in wrong management etc. can restrict the blood flow and is one of the causes of numbness in big toe. Although it subsides on its own, simply if it persists, the condition needs to be elevated.

Causes of Restricted Peripheral Claret Supply and PVD-

Peripheral vascular disease (PVD) causes narrowing of the peripheral blood vessels. Peripheral vascular affliction is frequently observed in individual suffering with post-obit risk factors:

Age-

Peripheral claret supply is reduced in elderly.3

Smoking-

Chronic smoking causes peripheral vasoconstriction and too peripheral hypoxia. Peripheral hypoxia is acquired since hemoglobin carries less oxygen molecules. Smoking also causes abnormal endothelial part and platelet role.4

Obesity-

Obese patient often suffer with peripheral vascular disease. The possible crusade of Peripheral vascular illness (PVD) in obese patient is hypertension, dyslipidemia and hyperglycemia (increase claret sugar)5

Diabetes-

Diabetes causes peripheral vascular diseases. The cause of PVD observed in individual suffering with diabetes are endothelial dysfunction, vascular smoothen muscle cell dysfunction, mucosal inflammation and hypercoagulability.6

Deep Vein Thrombosis and Peripheral Embolism-

Deep vein thrombosis of veins in lower leg restricts the blood menstruation through the peripheral veins. The condition causes ulcers and tissue trauma that frequently damages peripheral nerve fibers and receptors. Such furnishings causes numbness of big toe.

    1. Vitamin B12 Deficiency – Vitamin B12 takes care of polish functioning of the nervous system. One of the main causes of numbness in big toe can be a deficiency of vitamin B12, which can also lead to a tingling sensation.7

    2. Lumbar Radiculopathy – Lumbar radiculopathy is caused by pinch of spinal nerve in lower spinal segment. Compression of fourth and 5th lumbar nerve causes numbness of big toe.8 The symptoms of such condition (lumbar radiculopathy) is hurting, numbness and weakness in muscles. The nerve is pinched by disc burl, herniation, spinal stenosis and foraminal stenosis.

    3. Peripheral Nerve Injury- Peripheral nervus injury is caused by penetrating injury and edgeless trauma. Such injury is observed in auto accident equally well as piece of work and sport injury. Nerve injury may exist associated with dislocation of joints of large toe or fracture of metatarsal and phalangeal os. A bad pair of shoes can be responsible for causing numbness in toes.9 Bad pair of shoes can put unnecessary pressure on the peripheral nerve that lies over the surface of toe. Such pressure can cause irritation or compression of peripheral nervus. Such injury may result in numbness and hurting. Similarly, Bunion is basically the bump that occurs at the base of the big toe. These bumps cause extreme pain in toe and former it can atomic number 82 to numbness in the big toe.

Causes of Peripheral Nerve Injury:-

    1. Sport injury
    2. Automobile injury
    3. Work injury
    4. Domestic fall
    5. Shoes
    6. Bunion

  1. Diabetic Neuropathy – Diabetes causes peripheral neuropathy and autonomic neuropathy.10 This is the condition that affects sensory nerve and causes peripheral sensory nerve impairment. The condition causes numbness of foot and large toe.

  2. Gout – In many cases gout is overlooked, but it can be one of the crusade of numbness in big toe. When the level of uric acid increases in torso, then uric acid crystals deposits in the pocket-size joints. Such effect causes swelling of articulation and ulceration. Ulceration causes side by side sensory nerve harm resulting in numbness.11

  3. Raynaud's Disease – This is a medical condition that hampers the supply of claret to toes and fingers. The symptoms of this condition include pain, tingling sensation and numbness in big toe. Raynaud's disease causes peripheral vasoconstriction, narrowing of peripheral arteries and tissue harm such as peripheral tissue gangrene. The peripheral tissue damage and lack of adequate claret supply causes peripheral sensory nerve impairment.12

Handling for Numbness in Big Toe

The best treatment options for numbness in big toe depends on the underlying causes. Seeking timely medical opinion and following medical advice is essential.

Some of the treatment options include:

    1. Diabetes– Diabetes should exist treated with oral antidiabetic pills or insulin depending on level of blood sugar. The fasting and after nutrient (mail service-prandial) blood saccharide must be maintained within normal level to prevent and reversed complexity like peripheral neuropathy.
    2. Handling to Opposite B12 Deficiency– B12 neuropathy is treated with diet and pills. Daily intake of B12 pills help to decrease or reverse the symptoms of big toe numbness.
    3. Peripheral Vascular Illness– Treatment involves surgery and medications. Medications prescribed are vasodilator to improve blood circulation.
    4. Gout– Gout is treated with medications like Colchicine, NSAIDs and Prednisone.
    5. Raynaud'south Disease–

      1. Medications- Raynaud's illness is treated with medication, surgery and nerve block.

        1. Calcium Channel Blocker- Pills or oral medications prescribed for dilatation of arteries are Calcium channel blocker (Nifedipine, Felodipine and Amilodipine)

        2. Peripheral Vasodilator- The vasodilator (Cozaar, Revatio, Prozac and Sarafem) is prescribed to care for constriction of peripheral arteries that is frequently observed in Raynaud'due south disease.

      2. The Sympathetic Ganglion Block- Sympathetic nerve impulses or signals causes constriction of peripheral claret vessels that supplies claret to great toe. Sympathetic ganglion block stops or reduces such signals and causes vasodilatation that improves blood supply to big toe.

      3. Surgery- Surgery performed to ameliorate blood menstruum the big toe is sympathectomy. Surgery involves excision of sympathetic ganglion and nervus.

    6. Lumbar Radiculopathy- Following treatment is recommended for big toe numbness when the numbness is caused by lumbar radiculopathy.

      1. Medication- Severe hurting not responding to NSAIDs and tylenol is treated with opioids. Opioid handling is carefully observed to forestall addiction and dependence. Muscle spasm is treated with muscle relaxants. Post-obit medications are recommended for numbness associated with hurting.

        1. NSAIDs- Motrin, Naproxen and Celebrex
        2. Tylenol
        3. Opioids- Hydrocodone, Oxycodone, Morphine and Methadone.
        4. Muscle relaxants– Baclofen, Soma and Flexeril.

      2. Concrete Therapy– Concrete therapy is brash if big toe pain is associated with muscle cloudburst or muscle paralysis.

Interventional Therapy- Pain and numbness acquired by pinch or irritation of spinal nerve is treated with epidural steroid injection.

    1. Surgery- Numbness of big toe when acquired past disc bulge, disc herniation, foraminal stenosis and spinal stenosis is treated with following surgical treatment.

    1. Discectomy
    2. Laminectomy
    3. Foraminectomy
    4. Spinal fusion surgery

  1. Smoking– Big toe numbness caused past smoking is treated with discontinuation of smoking. Quit smoking works in 9 to 12% of chronic smoker. Other treatment recommended to end smoking are Zyban, Chantix and counseling.

  2. Obesity– Obesity is treated with weight reduction therapy.

  3. Treatment of Bunion- If bunion is the underlying cause of numbness, the doctors volition recommend wearing square-shaped shoes and socks that don't accept seam equally information technology tin alleviate the numbness and tingling in big toe. Corrective surgery is a treatment pick for numbness in big toe only when the condition worsens.

References:

  1. Arteries to the great and second toes based on three-dimensional analysis of 100 cadaveric anxiety. Hamada N1, Ikuta Y, Ikeda A., Surg Radiol Anat. 1993;xv(3):187-92.
  2. Origin and grade of the dorsomedial cutaneous nerve to the great toe. Miller RA1, Hartman Chiliad., Foot Ankle Int. 1996 October;17(10):620-ii.
  3. Peripheral arterial disease in the elderly Wilbert S Aronow, Clin Interv Aging. 2007 December; 2(4): 645–654.
  4. The human relationship of cigarette smoking to peripheral arterial illness. Lu JT1, Creager MA., Rev Cardiovasc Med. 2004 Fall;v(4):189-93.
  5. Obesity and peripheral arterial disease: A Mendelian Randomization analysis. Huang Y1, Xu Mone, Xie Ltwo, Wang T1, Huang Xane, Lv Xone, Chen Y1, Ding 50i, Lin L1, Wang West1, Bi Y1, Dominicus Y3, Zhang Y4, Ning Mone., Atherosclerosis. 2022 Apr;247:218-24.
  6. Diabetes and peripheral vascular disease. Huysman E1, Mathieu C., Acta Chir Belg. 2009 Oct;109(five):587-94.
  7. Nutritional Neuropathies Nancy Hammond, MD, Yunxia Wang, MD, Mazen Dimachkie, MD, and Richard Barohn, Doctor, Neurol Clin. 2013 May; 31(2): 477–489.
  8. Peroneal neuropathy misdiagnosed as L5 radiculopathy: a instance report Michael D Reife1,2 and Christopher 1000 Coulis3,iv,5, Chiropr Man Therap. 2013; 21: 12.
  9. Bunions: Overview Created: June 28, 2018; Next update: 2021 https://www.ncbi.nlm.nih.gov/books/NBK513134/
  10. Diabetic neuropathy V Bansal, J Kalita, and U Chiliad Misra, Postgrad Med J. 2006 February; 82(964): 95–100.
  11. Ulcerated tophaceous gout Michelle Gita Filanovsky,i Kumar Sukhdeo,2 and Megan Cunnane McNamara3, BMJ Case Rep. 2015; 2015: bcr2015210707.
  12. Raynaud Disease (Raynaud Miracle, Raynaud Syndrome) Rina Musa; Ahmad Qurie., Creighton Academy School of Medicine

Also Read:

  • Bunions or Hallux Valgus Deformity: Symptoms, Causes, Treatment- Bunion Splint
  • Simple Approaches for Treating Bunions Without Surgery
  • Claw Toe: Causes, Symptoms, Diagnosis, Treatment, Prevention, Complications
  • Overlapping Toes: Handling, Shoes, Products to Ready Overlapped Toes
  • What Causes Toe Spasm? Dwelling Remedies and Exercises to Save It
  • Diseases of the Pes: Apartment Pes, High Curvation Human foot, Hammer & Claw Toes, Hallux Valgus & Hallux Limitus

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