Numbing and Electricity in Toes: Solutions for Neuroma in the Foot

Numbing and electricity in toes when running ruins the “high” of runnning for many patients. DeLoor Podiatry sees people who come in after trying different shoes, and different foot supports. When these don’t work, it means the issue is related to nerve compression, called neuromas.

Also called nerve entrapment, nerves in your feet are compressed, cutting off blood supply. This causes the numbing and electricity. Changing your footwear and gait sometimes helps, but when the damage is severe, you might also experience pain, swelling and tenderness, especially in the space between your toes, where the nerves are located. In this case, you should see your podiatrist for treatment.

Why do my toes go numb when running? Pins and needles/electricity in toes

Numbing is caused by your forefoot pounding the pavement. Dr. Albana Thomaraj says, “Your feet swell during every landing– you need shoes with plenty of space in the toe box to accommodate that. I’ve seen some running that are much too narrow.”

Walking–much more running– in ill-fitting shoes crowds your toes and inhibits proper blood flow. A cut off blood supply cuts off oxygen and other necessary factors needed by your nerves, tendons and muscles to function. When the nerve is freed, like when you stop running and take off your shoes, the release of blood flow results in pins and needles.

The following pointers can resolve numbing and tingling. But take note that if these adjustments don’t solve the problem and your numbing persists, especially with a ‘shooting’ kind of electricity that’s painful, consult DeLoor Podiatry.

• Get shoes with a wide toe box– get yours professionally fitted. It has to have plenty of room for your socks and the expansion of your toes and feet as you run.
• Examine your shoes. Wear it without socks and see if there’s a seam pressing on your foot or toes anywhere.
• Experiment with different ways to tie your shoelaces to see which one doesn’t press a nerve. Get advice from other runners. Never tie laces too tight.
• If you have high arches, see your podiatrist for special inserts you can use.
• If you’re a beginning runner, make sure you get plenty of conditioning. Try intervals of walking and see if this gives you more distance before the discomfort starts. Also try strengthening/stretching exercises for your feet.

Foot and ankle issues come up when you neglect precautions recommended for every form of exercise. “Serious runners invest in good shoes for a reason,” says Dr. Omar Gabriel. “If the brand you found tends to change or update their shoe models, buy several pairs of the shoe you found for backup. Ask for it as a Christmas gift from everyone. Shoe shopping can be difficult. But it’s worth it. Takes away a lot of headache and potential of pain and damage to your feet and joints.”

Symptoms of neuroma in the foot

“It’s easy enough to suspect that you may have neuropathy,” says Dr. Albana Thomaraj. “When adjusting your footwear and your exercise regimen doesn’t improve your symptoms, and if it persists and worsens, it’s time to take a look at that with X-ray or MRI.”

Neuropathy is the blanket term for nerves dysfunctioning because of damage. Neuropathy occurs in the hands, arms, feet, legs, mouth, face, and internal organs.

There are several types on neuroma in the foot. The following are signs the nerves in your foot may need foot and ankle surgery:

• Numbing and tingling in the heel, arch and/or toes. Either your toes or your heel experiences numbing, or both.
• Numbing and/or pain that occurs even when you’re at rest, and gets worse during weight-bearing and running
• Pain or tenderness between your third toe and fourth toe
• Pain on the balls of your feet
• Sharp stabbing pains
• A ‘walking on stones’ feeling on the balls of your foot
• Feeling like you’re wearing a tight sock
• A buzz, or a shock: electricity

Note: If you experience the following other symptoms along with numbing in your foot, consult a physician without delay:

• Bladder or bowel dysfunction: lack of control
• Saddle anaesthesia: numbness in your groin
• Difficulty walking: particularly tripping over your feet due to not being able to lift your forefoot up
• Shortness of breath
• Dizziness
• Paralysis
• Altered vision
• Confusion
• Loss of consciousness: for any period
• Problems with your speech or with swallowing
• Sudden, severe pain or numbness: that doesn’t settle in a few minutes

What causes neuroma in the foot?

If your family has a history of neuropathy, you are more likely to develop neuropathy as well.

The following conditions lead to or increase your risk of neuroma.

• Middle age (40 and up)
• Diabetes
• Obesity
• Hypertension
• Kidney disorders (toxin build-up damages nerve tissue)
• Hypothyroidism leads to fluid retention and compression of nerve tissues
• Chronic inflammatory diseases
• Vitamin deficienceis for E, B1, B6, B12, essential for nerve function
• Injury and physical trauma (other foot and ankle conditions like tarsal tunnel syndrome)
• Alcohol and other toxin exposure (insecticides, glue, solvents, chemical abuse)
• Exposure to heavy metals (lead, mercury)
• Infections, viruses (herpes simplex, chickenpox, shingles, Epstein-Barr virus) and auto-immune disorders (multiple sclerosis, lupus, rheumatoid arthritis, etc)
• Previous neuroma, in which case the present neuroma is “stump neuroma,” a previously surgically-removed neuroma that has regrown
• Medications
  • Anticonvulsants
  • antibacterial drugs
  • blood pressure medications
  • cancer treatments
  • statins for lowering cholesterol

What it means to ignore nerve damage

DeLoor Podiatry wishes to emphasize the importance of prompt treatment for neuroma to prevent long-term, permanent damage to your foot and ankle. If left unattended and untreated, neuroma leads to foot/ankle instability, permanent numbing, disability and prolonged pain.

Worst-case scenarios come to paralysis and amputation.

Diagnosing your foot neuroma

“We do a physical and look through your medical history,” says Dr. Jose Loor. “If you have any of the conditions that cause neuroma, it can be conclusive, on top of your symptoms.”

DeLoor Podiatry performs imaging and lab tests to pinpoint your neuroma. “We can order a CT or MRI. It’s good and quick,” says Dr. Loor. “It immediately shows us trapped and inflamed nerves in your foot. We also need to do an X-ray just to rule out fractures and other possible problems. But ultrasound is the best for soft tissues, and in showing neuromas.

“Sometimes we may also order a blood test. Your thyroid has to function well for nerve health. Blood tests reveal your vitamin and sugar levels. If something isn’t good, you have to treat that underlying condition causing the neuroma. If it’s diabetes, for example, you need to treat diabetes.”

Your treatment options for neuroma in the foot

“If an underlying foot condition causes it, we treat that condition,” says Dr. Junior Omar Gabriel. “We would fit you with orthotics, for example, to relieve pressure on the nerve. But this is often a short-term solution.”

DeLoor Podiatry offers PRP and tenex ultrasound debridement for neuroma. Both are minimally invasive procedures, and both have great results in effectively managing neuromas. 90% of DeLoor Podiatry patients treated for neuroma go to complete recovery and remission from neuromas, eliminating pain. 10% do go on to other foot and ankle surgery to return to their previous level of activity.

New York Tenex ultrasound debridement for foot neuroma

“The Tenex procedure uses ultrasound imaging for a precise location of your inflamed nerve,” says Dr. Albana Thomaraj. “It’s minimally invasive and virtually painless.”

Quick points about the tenex ultrasound debridement

• Also called percutaneous debridement
• Done under light sedative/local anesthesia
• A tiny incision is made on the area for the entry point of the Tenex microtip
• Uses ultrasound energy to break down and remove debris (damaged tissue) around the nerve without damaging healthy tissue
• More ultrasound imaging confirms the complete flush–debridement means cleaning– of debris around the nerve
• Works best when you’ve only started having the symptoms of neuroma

 

“You go home with a stitch and that’s it,” says Dr. Jose Loor. “Pain relief is immediate, if not instant.”

Platelet-rich plasma/PRP injection for neuroma

We’ve written about PRP before. See our article on Traumatic Arthritis. Platelet-rich plasma injection is a powerful solution for inflammation (such as in the many forms of arthritis), and ligament, tendon and cartilage damage.

The strong concentration of platelets provides natural growth factors that stimulate tissue regeneration for nerve damage. It restores and increases blood flow to the abnormal/damaged nerve tissue AND limits the formation of scar tissue.

Again using ultrasound, or arthroscopy, to guide the needle, small volumes of PRP is injected around the nerve. One session is usually enough, but multiple injections may be needed depending on your response and recovery.

DeLoor Podiatry also does PRP injections in support of Tenex ultrasound debridement. Most cases of neuroma respond to debridement, but when symptoms persist in the cases of severe damage, PRP is an effective final step before resorting to more invasive surgery.

DeLoor Podiatry provides all-around podiatry services ranging from ankle and foot trauma, ingrown toenails, bunions and hammertoes, to advanced treatments like stem cell injections, arthroscopic reconstruction, bone stimulators and spider veins and varicose reduction. We serve patients across New York and New Jersey, including Gramercy, Flatiron, Murray Hill, Herald Square, Chinatown, Bay Ridge, Wall Street and Bensonhurst, Fair Lawn NJ. The specialists, led by Dr. Jose Loor.