Discussions By Condition: I cannot get a diagnosis.

Numbness in legs and right knee, help please

Posted In: I cannot get a diagnosis. 42 Replies
  • Posted By: Grubby
  • November 26, 2008
  • 00:26 AM

Hello, I am sorry if this has already been discussed, but I could not find anything and I am quite worried, so I really want to ask for some advice..

I have had a minor numbness in the big toe of my right foot for quite some time, but recently (possibly due to excessive pressure on back from working with used cars and working out in the gym) it escalated and numbness spread to a larger area of the right foot (like 3cm upwards from the big toe) and the right knee (like 5cm downwards starting from the knee). Today I did some physical work involving cleaning the car lot from snow, and again maybe a little too much back pressure was involved and today I also have some light numbness in left big toe. Also, when I sit for long periods of time, I often feel "pins and needles" on my back.
The numbness in all those areas basically feels like the feeling you get in the mouth when you go to the dentist and he puts your gums to sleep, and then after you go home they gradually regain sense, and in my right big toe I have maybe about 40% of the sensations I used to have, in the knee and left toe maybe 75%. I am a 20 year old male, tall and relatively skinny.

I have already visited many doctors, and the magnetic resonance didnt find any problems in the nerves. Has anyone ever had to deal with something like that? How worried should I be?


If anyone has anything, anything to share, I would be extremely thankful.

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42 Replies:

  • Sciatica is a good fit for what you're describing. although, the left foot involvement makes this less likely. Piriformis syndrome, which is a subclass of sciatica is possible or you could have a herniated disk causing the syndrome.If your unusually tired and you need to urinate alot, it could be Diabetes.. Diabetes can lead to peripheral neuropathy. but this would be a little high for that.There are some more serious conditions such as guillain-barre, and Transverse Myelitis... but those are disorders with motor nerve function, so I wouldn't start worrying about those yet. and they most likely would be bilateral in every instance.You shouldn't be to worried unless it progresses to muscular weakness that doesn't return shortly after adjusting posture, body position. Then maybe you should contact a doctor about the possibility of paralysis. But, because your symptoms come and go it would be very unlikely to progress to that.
    nckmorris 53 Replies
    • November 26, 2008
    • 00:50 AM
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  • Thanks nckmorris.Visited another neurologist today, she said that the lower back nerves were ok, so she couldn't yet say what was the problem. She also said that the nerves responsible for movement are not directly involved with the ones that are responsible for sensations, so this couldn't directly progress into a form of paralysis, is that so?My symptoms so far have persisted, the small numbness in the big toe for more than a year, the knee numbness for a month and small numbness in the other foot for a day or so.What did you mean with musular weakness? My right arm does kind of feel a little weird, like 1% weaker, but the changes are barely noticable and I didnt feel them yesterday.
    Grubby 14 Replies
    • November 26, 2008
    • 09:58 AM
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  • Have you had an MRI of your neck? If not, I would. I am not suffering from your symptoms and do not have a diagnosis for myself yet, but I know something has to be wrong with my neck (though the radiologist said the MRI was normal), but I get strange fleeting pains and sensations in my legs occasionally. So if you have not had a neck MRI yet, I would ask your neurologist about the possibility of that causing your problems.
    halal37 96 Replies
    • November 26, 2008
    • 02:03 PM
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  • The Sensory and Motor nerves come from different parts of the spinal cord. Sensory=back, Motor=front. However, they travel together. so pressure, or compression, on the nerve as its traveling to the muscle could cause problems in both. Also, certain Autoimmune diseases can attack the spinal cord it self causing paralysis, These are very rare however, so you shouldn't worry about them.Try to see if you can stress the nerve into going numb by flexing different parts of your leg, or sitting on the edge of a chair so that pressure is on different locations. Peoples, nerves sometimes have habits of traveling different roots to get to the muscle (abberant nerve paths) and this can allow them to be more susceptible to different kinds stress. if the nerve travels through the Piriformis muscle (10 Percent of the population) certain motions of leg can compress the nerve and cause numbness. It's the most likely cause.
    nckmorris 53 Replies
    • November 26, 2008
    • 06:05 PM
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  • Thanks for the advice halal37, I dont think the MRI I did to check the back also checked the neck, I'm going to call and ask them if it did.Thanks nckmorris, Your answer was very helpful and makes a lot of sense, especially because the tingling is very dependant on my posture.If that is the case, should I probably just do some stretching, medical massaging and that kind of things or think about a more "serious" solution?Is it common for people to recover and regain sensations in the affected areas if it is caused by this kind of nerve compression?
    Grubby 14 Replies
    • November 26, 2008
    • 06:53 PM
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  • According to the most recent Article on Piriformis syndrome:"osteopathic manipulative treatment, can be used alone or in conjunction with pharmacotherapeutic options in the management of piriformis syndrome."Diagnosis and management of piriformis syndrome: an osteopathic approach.Boyajian-O'Neill LA, McClain RL, Coleman MK, Thomas PP.J Am Osteopath Assoc. 2008 Nov;108(11):657-64.]Basically its a DO doctor stretching your muscle by hand, as well as using some drugs to decrease symptoms. There is also injection of steriods used by MDs. I forgot to ask if Marfan's syndrome runs in your family, i just ask this because you mentioned that you were tall and thin.. There are neurological complications with the disease, and it can be subclinical. http://www.allaboutarthritis.com/image/stock_image/marfan_syndrome02.jpg
    nckmorris 53 Replies
    • November 26, 2008
    • 08:58 PM
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  • As far as I know, nobody in my family has Marfan's syndrome, but I have had posture problems since childhood (kind of like in the picture You linked just not nearly as severe). For the last few years there had been occasional increased and possibly at times improper pressure on my back and legs (which wasn't in a good shape to being with), so maybe that could have been a factor for nerve compression?But with regard to limbs, lungs and eyes- everyone in my family has nearsightedness, but that's about it, no other signs of Marfan's syndrom.Can Piriformis syndrome be present if there is no pain involved? Because I don't have any at either the numb feet areas or tingling upper legs.
    Grubby 14 Replies
    • November 26, 2008
    • 10:38 PM
    • 0
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  • I wouldn't really worry about the Marfan's thing. But, you might want to ask a doctor about it during a physical or next time you go in. Without testing, It would be impossible to know. Think of nerve compression like falling asleep on your arm.. It can be pretty much the same as that. I'm not sure of the mechanism but depending on the location of the compression and type, you can get extreme pain or numbness. Baseball players often get numbness in their arms because of shoulder muscles compressing their brachial plexus; it's called thoracic outlet syndrome.
    nckmorris 53 Replies
    • November 27, 2008
    • 00:58 AM
    • 0
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  • I agree that compression seems a likely culprit. I would add to get your B12 levels tested to rule out B12 deficiency, which can cause neurological damage and numbness symptoms. Ask for a uMMA test or serum Blood test for B12 at your next doctors visit. Best wishesDOM
    acuann 3080 Replies
    • November 27, 2008
    • 04:52 AM
    • 0
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  • Okay I will discuss this at my next doctor's visit and see what the best treatment options could be. Maybe there's also some discussion about the treatment of this symptom somewhere in these forums too, now that I seem to have a probable diagnosis it should be a lot easier to find what I should actually do.Nckmorris and everyone else, you have all been really helpful, thanks!Best Regards, Oscar
    Grubby 14 Replies
    • November 27, 2008
    • 11:27 AM
    • 0
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  • Hello, I am sorry if this has already been discussed, but I could not find anything and I am quite worried, so I really want to ask for some advice..I have had a minor numbness in the big toe of my right foot for quite some time, but recently (possibly due to excessive pressure on back from working with used cars and working out in the gym) it escalated and numbness spread to a larger area of the right foot (like 3cm upwards from the big toe) and the right knee (like 5cm downwards starting from the knee). Today I did some physical work involving cleaning the car lot from snow, and again maybe a little too much back pressure was involved and today I also have some light numbness in left big toe. Also, when I sit for long periods of time, I often feel "pins and needles" on my back.The numbness in all those areas basically feels like the feeling you get in the mouth when you go to the dentist and he puts your gums to sleep, and then after you go home they gradually regain sense, and in my right big toe I have maybe about 40% of the sensations I used to have, in the knee and left toe maybe 75%. I am a 20 year old male, tall and relatively skinny.I have already visited many doctors, and the magnetic resonance didnt find any problems in the nerves. Has anyone ever had to deal with something like that? How worried should I be?If anyone has anything, anything to share, I would be extremely thankful.I would second the notion for getting your B12 levels checked ask for a uMMA and HCY tests as well...also CBC and iron studies.......do you have any other symptoms like brain fog,fatigue,stomach issues,bowel trouble,dizziness,gait problems,sore jionts,vision problems?if you do happen to have B12 deficiency then please visit us at B12 misdiagnoses on this board.....good luck to you
    Rainbows End 227 Replies
    • November 27, 2008
    • 11:35 AM
    • 0
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  • Thanks for suggestions Rainbows End.. I did do some general blood/urine testing, it was ok, but I am not sure if they checked all or even any of the things you mentioned. The doctors I visited also suggested I take some B vitamins (which I have started to do).I haven't noticed any other symptoms than the numbness and tingling. There used to be an electric-like feeling when I touched on a particular spot on my right foot (a few cm upwards from the numbness area). The feeling was not painful, just weird, like when you accidentally hit your elbow on the edge of the table and it hits just the spot where a nerve is.. like that just not as strong. I also used to have a similar feeling when I flexed the 2nd toe. I haven't felt it for a couple of months now though.
    Grubby 14 Replies
    • November 27, 2008
    • 07:56 PM
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  • Thanks for suggestions Rainbows End.. I did do some general blood/urine testing, it was ok, but I am not sure if they checked all or even any of the things you mentioned. The doctors I visited also suggested I take some B vitamins (which I have started to do).I haven't noticed any other symptoms than the numbness and tingling. There used to be an electric-like feeling when I touched on a particular spot on my right foot (a few cm upwards from the numbness area). The feeling was not painful, just weird, like when you accidentally hit your elbow on the edge of the table and it hits just the spot where a nerve is.. like that just not as strong. I also used to have a similar feeling when I flexed the 2nd toe. I haven't felt it for a couple of months now though.Hi There GrubbyIf you can get hold of your test results this may seem like a pian to do but it is worth it and check for those tests doctors dont usually do them as a standard.....If you are taking a B supplement that is great but if you have deficiencies it will hardly be enough as deficiencies need to be fed large doses of B12......You have to be careful not to take to much B6 as it can actually cause neuropathies.........Folate & B12 do not have any know side effects......I can not express to you how important it is to get your tests results your self for instance I got all of mine from over a 5 year period and had low lwvels of B12 even though they were in the normal range I had to fall severely low before I got recognized as B12 deficiency I also had folate, vitD low ferritin and I just realized the other day my iron although normal was extremely low..........I am now aware about the damage that low levels of B12 can do even in the normal ranges so I would like to let others be aware to what tests to have and what to look for because believe it or not a lot of docs dont think you can be deficeint if you do not have anemia so they wont even look at it or they say well your levels are fine so it cant be that when in actual fact it is B12 is a rather complex issue and I would suggest looking at the other thread there is some very knowledge people on the subject over there.........Methylcobalamin is the active form of B12 and is very effect at reversing neuropathies it certainly made me functional again.....Remembering those levels are there to prevent pernacious anemia not neurological damage........If you are currently taking B vitamins and you pursue further testing this may skew the results.......As I said come over the the other thread and you can chat over there......This thread is located at:http://forums.wrongdiagnosis.com/showthread.php?t=9948&goto=newpostGood luck Grubby:)
    Rainbows End 227 Replies
    • November 27, 2008
    • 10:46 PM
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  • Hi There Grubby If you can get hold of your test results this may seem like a pian to do but it is worth it and check for those tests doctors dont usually do them as a standard.....If you are taking a B supplement that is great but if you have deficiencies it will hardly be enough as deficiencies need to be fed large doses of B12......You have to be careful not to take to much B6 as it can actually cause neuropathies.........Folate & B12 do not have any know side effects...... I can not express to you how important it is to get your tests results your self for instance I got all of mine from over a 5 year period and had low lwvels of B12 even though they were in the normal range I had to fall severely low before I got recognized as B12 deficiency I also had folate, vitD low ferritin and I just realized the other day my iron although normal was extremely low..........I am now aware about the damage that low levels of B12 can do even in the normal ranges so I would like to let others be aware to what tests to have and what to look for because believe it or not a lot of docs dont think you can be deficeint if you do not have anemia so they wont even look at it or they say well your levels are fine so it cant be that when in actual fact it is B12 is a rather complex issue and I would suggest looking at the other thread there is some very knowledge people on the subject over there.........Methylcobalamin is the active form of B12 and is very effect at reversing neuropathies it certainly made me functional again..... Remembering those levels are there to prevent pernacious anemia not neurological damage........If you are currently taking B vitamins and you pursue further testing this may skew the results.......As I said come over the the other thread and you can chat over there...... This thread is located at:http://forums.wrongdiagnosis.com/showthread.php?t=9948&goto=newpost Good luck Grubby:) Great advice Rainbow's end! I always ask my patients to get copies of their blood work and bring them to my acupuncture clinic. I can't tell you how many times they have NOT been tested for B12, or their levels were in the 200's and their docs did nothing! It is truly an underdiagnosed problem so easily treated and prevented, but if left unchecked can cause irreversible neurological problems. Vit D deficiency is becoming EPIDEMIC, and most docs are now testing for it. Vit D deficiency causes a host of problems as well, mimicking fibro. Best wishesDOM
    acuann 3080 Replies
    • November 28, 2008
    • 01:19 AM
    • 0
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  • Great advice Rainbow's end! I always ask my patients to get copies of their blood work and bring them to my acupuncture clinic. I can't tell you how many times they have NOT been tested for B12, or their levels were in the 200's and their docs did nothing! It is truly an underdiagnosed problem so easily treated and prevented, but if left unchecked can cause irreversible neurological problems. Vit D deficiency is becoming EPIDEMIC, and most docs are now testing for it. Vit D deficiency causes a host of problems as well, mimicking fibro. Best wishesDOMHi There DomThat is great telling your patients that...........Yes neurological symptoms can start at 550 my docs like to keep me at 1600 but that is rare for that knda thinking ....When you think that we are born with over 2000 in our tiny bodies at that stage why would it be ok to have 200 in adulthood......I had severe symptoms so much so that I would either be in a nursing home or dead at this point it had been going on for years...I had def of Folate vit D and low ferritin and iron all from celiac but my damage must have been mild because they didnt ppick it up at it first which is very common .......That is why I think vit D is on the rise and apart fromn the fact we dont go in the sun these days for fear of cancer we need that ole Mr sunshine.........the number of people with celiac has risenn perhaps in part because the symptoms vary not just thoses classical ones they used to diagnose with.......I think gluten is rather toxic for us anyway it is used in so many things......Have a fun day Domcheers
    Rainbows End 227 Replies
    • November 28, 2008
    • 01:34 AM
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  • Nerve compresion symptoms.I`m affraid that little could be done as long as no major damage to the discs or vertebras was observed during MRI
    Anonymous 42789 Replies
    • November 28, 2008
    • 04:47 PM
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  • Thanks for the information, I called the laboratory that did my blood testing, they said it wasn't checked with the basic testing but they can do it, so I could visit them, but I dont know when I can do it so that the results would not be influenced by the medications I already take (200mg B1, 50mg B6 and 1mg B12 a day for the last month or so).. is that a lot?Rainbows End you mentioned pernacious anemia so I looked it up and in the description it said something about gastritis, I used to have it (although not in a heavy form), also you mentioned gluten, I know my father is gluten intolerant and cant eat anything that has gluten in it, as far as I know I dont have it (yet?), but maybe its important...Also, thanks for the link I will print the thread and read it like a novel before going to sleep :pDOM.. could vitamin D deficiency also be causing the kind of problems that I have? Because I dont know if anyone in my town is offering tests for it but if it can be a part of the problem I would probably need to find a way to do them no matter what..
    Grubby 14 Replies
    • November 28, 2008
    • 05:13 PM
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  • I have you been checked for Diabetes? It is common for diabetics to have numbness in their fingers and toes.
    windy city girl 2 Replies
    • November 28, 2008
    • 05:48 PM
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  • Dear Grubbyare the b vits you are taking oral tablets...........If you have gastritis B12 will not be of much help orally as the stomach will not be able to utilize the ...So you would need injections oR sublinguals......Yes you are right the tests can be skewd from the supplements I can really give you advice in that dept it is up to you wether you stop them for a bit or not..........I would recommned having the following though because they will be elevated if you have aproblem & the results are with in rangeuMMA (urine test)HomocysteineAs well as the Serum B12 & Red cell Folate......If you have celiac disease you will more than likelybe deficient in Vit D,Folate,Iron,B12 as these Vits are dependenat on the stomach for utilizationGet the celiac testing and the Celiac gene done tell them about your dad it is strongly familial.........Do you know why you had/have gastritis and are you on any antacids at all?All the best GrubbyAlso a diabetes test is a good idea as it can cause neuropathies......In relationship to nerve compression as its always possible....But that was what I was sure I had in my shoulder but the B12 has slowly healed it so I wouldnt assume its nerve compression and do nothing get all those tests as you are a igh candidate for B12 deficiency its interesting the docs told you to take B vitamins in the first place.......You would also need folate as well as the B6 as they are both cofactors of B12 and are needed to work better.......The B12 amount you are taking is large but not that large by standards needed to repair B12 damage causing neuro symptoms........The type is also crucial I have methylcobalamin injection 3 a week at 10,000 mcg for 4 months and all my symptoms have gone I am now having injections of 2 a week..........staying away from gluten will help me and it is in your best interests to find out what the cause is.....Let us know how you go Grubby........Dont forget to visit the other board I mentioned as there is some spectacular info re B12 over there they helped me tremendously.....Cheersrainbow
    Rainbows End 227 Replies
    • November 28, 2008
    • 11:09 PM
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  • Again, thanks for the advice everyone !Would a home test for diabetes be a good way to check if I have it? I know my grandmother has it and she has that thing at home which checks blood sugar levels but I dont know if I would nessecarily have high blood sugar if the problem might be diabetes..?I dont know why I had gastritis, but I had it in a mild form like 2 years ago, took some meds and it kind of went away.Seems like from what has been mentioned so far, the things that I need to check for and are the most likely diagnosis should be one of these:Nerve compression (perhaps Piriformis syndrom)Vit B12 deficiencyDiabetesCeliac diseaseDoes that seem correct (just wanted to get them all on the table)?Tomorrow I will have my new blood test results (for B12, Iron, and D vit) and blood sugar level test results so hopefully that will help.
    Grubby 14 Replies
    • November 30, 2008
    • 10:51 AM
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