Numb Toes & Feet

Nerve problems in your feet can be caused by several metabolic issues, such as alcohol use, heavy metal exposure, hyperlipidemia and, most commonly, diabetes mellitus.

Numbness in feet and toes that is symmetrical is called poly-neuropathy. In previous years, diagnosis of poly-neuropathy was made by subjective, qualitative and indirectly quantitative techniques.

Today an indication of poly-neuropathy can be initially identified by subjective complaints as well as objective qualitative evaluation. These techniques include evaluating vibratory sensation, two-point tactile discrimination, warm-cold discrimination and protective sensorium. The most critical qualitative finding is that of protective sensorium. If protective sensorium is lost in your feet, then you will not know if an injury has occurred. Subsequent infection and tissue loss is a result, sometimes as severe as an amputation.

Today at Central Florida Foot and Ankle Specialists, PA, Dr. McNamara has gone beyond the standard of qualitative evaluation to diagnose poly-neuropathy. He provides his patients in Orlando with a directly quantitative measurement of epidermal nerve-fiber density and those nerves’ relative health quality.

Epidermal nerve fiber density (ENFD) evaluation is performed by Dr. McNamara, who acquires a 3 mm punch biopsy of skin from the outside of the ankle of the patient. This biopsy is then processed in a very specific manner and submitted to the scrutiny of a highly trained dermatopathologist. This process requires two weeks for results to be available. The end result is that a patient’s loss of small nerve fibers that are the cause of their numbness can be detected often well before a diagnosis of diabetes has been made. Furthermore, treatment for the regrowth of small nerve-fiber loss can be instituted, with prognostic indicators for success being given as well. If you have concerns about diabetes or numbness of feet and toes, you can contact Dr. McNamara at Central Florida Foot and Ankle Specialists, PA at 407-228-2838.

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