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Ask Dr. D. Love Your Own Question
Dr. D. Love
Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 18440
Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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The key problems are with a loss of sensation in the right

Customer Question

The key problems are with a loss of sensation in the right foot and an increase in crunching and cracking of joints in the right foot / ankle - I think there is a problem with the general physiology of the area. This is beginning to affect my gait and is causing hip and knee pain.
I have been dealing with this for more than two years without diagnosis. I was hoping that the problem would improve ver time but it seems to be worsening and, alarmingly, I am starting to see the early stages of the same symptoms in my right hand.
Submitted: 10 months ago.
Category: Medical
Expert:  Dr. D. Love replied 10 months ago.

Hello from JustAnswer.

Have you had any evaluation for these symptoms?

Have you tried taking any medicines for relief of these symptoms?

Customer: replied 10 months ago.
I'm trying to find out which type of specialist I should be talking to to find a diagnosis.
Expert:  Dr. D. Love replied 10 months ago.

The primary specialist would be an Orthopedic Surgeon, although a Neurologist may be necessary.

Numbness is related to dysfunction of a nerve. But in a 38 year old, dysfunction of a nerve is most likely due to pressure on a nerve or nerves related to a musculoskeletal problem. For numbness in the foot, it can arise form pressure anywhere along the nerve that serves the foot, but the most common locations are in the spine or lower back, or where the nerves passes the ankle.

There are some primary nerve problems that can present as numbness, but these are less likely in a 38 year old.

I asked about any evaluation done to this point, because that may help to more clearly indicate whether this is a musculoskeletal or neurologic problem.

Another option to seeking a specialist would be to first be seen by a primary care physician, who can perform an initial evaluation, if not already done. A primary care physician cannot perform the detail of evaluation of a specialist, but they can do enough of an evaluation that there is greater certainty about whether it is a musculoskeletal problem or a neurologic problem.

A third option would be a trial of home interventions to see if the symptoms can be eased. Many people have already tried some home interventions, which is why I asked whether you have tried any medicines. However, if you have not yet tried any medicines, it would be reasonable to first try an anti-inflammatory medicine, such as ibuprofen or naproxen, to see if the symptoms will improve. These mediicnes can relieve inflammation in various locations throughout the musculoskeletal system, and relief of the inflammation and the associated swelling can ease the pressure on a nerve from that swelling.

If I can provide any additional information, please let me know.

Customer: replied 10 months ago.
Thanks very much.Do you have any idea why I might be experiencing the start of similar symptoms in my right hand?I have had a nerve conduction test in the past but this showed no abnormalities.Thanks again
Jonathan
Expert:  Dr. D. Love replied 10 months ago.

People that develop musculoskeletal problems tend to develop them in multiple areas. And then, similar symptoms in the foot and hands is due to similar development of musculoskeletal problems affecting the nerves to each extremity. The most common reason that I see this is from degenerative disease of the spine that is affecting both the neck and the lower spine, and then pressing on the respective nerves to the foot and hand.

A normal nerve conduction study excludes many of the more common neurologic conditions that can present as numbness, which makes a musculoskeletal condition more likely.

Expert:  Dr. D. Love replied 10 months ago.

Please let me know if I can provide any further assistance.

Customer: replied 10 months ago.
Thanks very much - what sort of specialist do you think I should see and which tests should I be looking for?Thanks again
Jonathan
Expert:  Dr. D. Love replied 10 months ago.

I think that the Orthopedic Surgeon would be the appropriate specialist. The tests that should be done would depend upon the findings on exam, but an MRI of the spine may be appropriate.