Tingling and numbness on soles of feet after prolonged walking
June 20, 2016 8:37 PM   Subscribe

What are the odds that is peripheral neuropathy, and if it's that, what can be done about it?

Did not wear orthotics during and hour-long walk that led to burning and tingling in feet (along soles and up to calf). Was like that for a few days. Mostly calmed down, except the burning & tingling still occurs on soles of feet after walking and for some time after that.

Non-diabetic, normal BMI, heavy smoker (this is what I fear is contributing). Orthotics are there for various orthopedic reasons.

Which tests do I need, which doctor to see (GP, sports med?)? Canada
posted by cotton dress sock to Health & Fitness (18 answers total) 1 user marked this as a favorite
Response by poster: *s/b "an hours-long walk" - 4 or so - this happened a month ago and the pain still occurs with walking

(on phone)
posted by cotton dress sock at 8:38 PM on June 20, 2016

Best answer: Does it only happen after walking? Do you ever notice it at rest? Is it on both sides equally? I wouldn't limit the possibilities to peripheral neuropathy, especially since you aren't diabetic (even if you were, it'd take a while for it to affect the nerves). It could be vascular, and your smoking history puts you at risk for inflammation of your blood vessels (thromboangiitis obliterans). Definitely see your doctor.
posted by gemutlichkeit at 8:52 PM on June 20, 2016 [1 favorite]

Best answer: I was also coming to say blood flow is a potential additional factor. Nerve compression and blood vessel compression can have some similar symptoms based on my own experience. Being on both sides is a bit strange though unless it's something specifically with muscle tension (I get tingling on both hands due to a repetitive stress injury, when I let my shoulders get compressed, *if* they aren't stretched/relaxed earlier in the day).

The course of action if it is that is a lot like the course of action if not: go see a doctor (and, in my case get a referral for physical therapy).
posted by Lady Li at 9:02 PM on June 20, 2016 [1 favorite]

Response by poster: Yes, it's only after walking for longer than brief periods, never at rest. It is on both sides equally. It lasts for several hours, sometimes for a day or so. Elevation helps a bit.

I am very confident it isn't muscles or ligaments (too much experience with that :/). It's like pins and needles x 10 (+ burning).

Should I see my GP, though? (I'm still with this one - nutshell, not confident the appointment will lead to more than a rec for Advil.) I could also see a sports med I feel comfortable with. Walk in clinic would be a crapshoot.
posted by cotton dress sock at 9:09 PM on June 20, 2016

You say you didn't wear orthotics, which suggests to me that you usually do wear orthotics, which suggests to me that at some point you were given some kind of diagnosis by some kind of professional that led to you purchasing orthotics, so what was that for, originally?
posted by turbid dahlia at 9:16 PM on June 20, 2016

Best answer: I don't think sports med would cover this. This is more cardiology's turf, though it's a fairly common issue and I'm not sure a specialist is needed at this point. I'm not familiar with how self-referral works in Canada, but I'd find a GP that you trust first, and then go from there.
posted by gemutlichkeit at 9:19 PM on June 20, 2016 [1 favorite]

Response by poster: A cardiologist... yikes. Ok. Thank you very much, gemutlichkeit.

turbid dahlia - I had plantar fasciitis, peroneal tendonitis (with neuropathy, but in a very local area on one side - this pain feels similar, but more diffuse [and across the soles of both feet]), and arthritis (big toe) when the orthotics were made. A couple of other things have happened since then (torn peroneal retinaculum on the other foot; various knee issues, all diagnosed by PT & sports med). Have (congenitally) lax joints, also.
posted by cotton dress sock at 9:26 PM on June 20, 2016

I mean, don't discount your prior experience-- if it feels similar to neuropathic pain you've had before, it very well could be neuropathic. I wouldn't go straight to cardiology. The thing that makes me think possibly vascular is just that it occurs after walking, but if the discomfort lasts that long, it might not be.

IANAD and I do think that GP should do the traffic direction in this case. That's their job!
posted by gemutlichkeit at 9:38 PM on June 20, 2016 [1 favorite]

Response by poster: I don't know what it is, exactly :/ It feels more like the neuropathy than anything else I've experienced. Keeping my feet up does help, a little, so it's possible there's some kind of vascular thing happening. I agree that GPs, ideally, should guide things. I'll talk to mine, and if I get told to take Advil again, I'll try to find someone else. Thank you!
posted by cotton dress sock at 9:53 PM on June 20, 2016

In my experience with bad feet, finding a good podiatrist to visit periodically, or at least whenever you start having problems like this, can be very, very helpful.

I don't know much about foot problems but I know enough to realize that the problem you describe could be one of several different things. Someone knowledgeable about feet can do a few tests to narrow down the cause rather easily.

FWIW with different shoe inserts than you usually wear, it could be as simple as the bottoms of your feet were rubbed a bit raw due to different shoes than you are used to. Or it could be any number of other conditions. It could be the first inkling of plantar fasciitis coming back . . . or whatever.

Point is--don't guess. Get to someone who knows about foot problems and can accurately diagnose and treat.
posted by flug at 10:01 PM on June 20, 2016 [1 favorite]

Response by poster: Podiatrists do full-on diagnostics (in Canada)? Mine just looked at my feet and fit my orthotics, after I informed him of my existing diagnoses. (This is 100% not just skin being rubbed raw or a blister, btw :/ and it's definitely not muscles or ligaments. No way. It's pins and needles and burning, inside the skin. Yup will def see a doctor, though.)
posted by cotton dress sock at 10:11 PM on June 20, 2016

Best answer: Just nthing that it's not a good idea to try to leapfrog to a specialist when you're not sure which organ system is causing the symptoms. Your GP is best.

Podiatrists DO do full-on diagnostics as long as the diagnostics are foot-related, but still I would say GP is best for this because if it is neurologic or vascular, your GP will be better equipped to manage it.
posted by treehorn+bunny at 10:21 PM on June 20, 2016 [6 favorites]

Not making a diagnosis here, but given your description of the symptoms, and the way it started, it could also be tarsal tunnel syndrome. I agree with seeing your GP and moving on to podiatry or whichever specialist seems to be most appropriate.
posted by The Elusive Architeuthis at 10:41 PM on June 20, 2016 [1 favorite]

Plantar faciitis or tarsal tunnel, it sounds like. Plantar faciitis is also more common in overweight people, and you can get micro-tears in the connective tissue that don't heal properly(or at all) if you have a compromised immune system or poor healing. Plantar faciitis can be treated with cortisone injections and alignment therapies. Tarsal tunnel can also be a secondary effect of untreated plantar faciitis, as the arch collapses and the heel rolls towards the outside, the nerve gets compressed.

You should also get some xrays, to rule out micro fractures/stress fractures just in case.
posted by InkDrinker at 11:21 PM on June 20, 2016 [1 favorite]

Just a possible note of comfort, remembering that IANAD and this is not medical advice:
Back when dinosaurs roamed the earth, I spent a few months in the Australian Army Reserve. I have always had particularly high arches and the Army MD looked very hard at my feet before deciding I was medically fit. Anyway, as an infantryman I did a lot of marching and a lot of walking in the bush in heavy boots. After the longest bush marches, my toes and possibly other bits of my feet used to go numb. Discussions among the diggers indicated that it happened to some of them too. I did nothing about it, just passed it off as one of those things, and it went away. 35-plus years later my feet still function pretty well.

So: it may be nothing. But absolutely see your GP/PCP if you're concerned, or it doesn't go away pretty smartly. AS others have said, start with your GP.
posted by Logophiliac at 4:15 AM on June 21, 2016

Does it happen only when you're wearing one particular pair of shoes? I had something similar and switching out my shoes solved it, though it wasn't immediate (I assume the old shoes had damaged something or restricted blood flow in some way and it was getting re-aggravated every time I wore them, so it both needed to not be re-aggravated and some time to heal.) This page on Metatarsalgia has some more info, including suggestions for when to see a doctor (and suggests a GP or podiatrist).
posted by lazuli at 5:45 AM on June 21, 2016

Response by poster: Does it happen only when you're wearing one particular pair of shoes?

Nope, it's any of my shoes, including runners with orthotics :/ None of my shoes are tight. (My last update was deleted so will limit my response to that + thanks to all :) )

posted by cotton dress sock at 7:51 AM on June 21, 2016

Response by poster: Update: I went to a walk in and got bloodwork a few days after this question; haven't heard back yet, followup booked.

Also, for Ontarians reading - I was wrong, it was a chiropodist who fit my orthotics. Turns out we don't actually have a lot of podiatrists; none have been registered for ages. Foot care here is currently mostly split between orthopedic surgeons (about which, see link or talk to anyone, good luck seeing one within a year) and chiropodists. And GPs. But I guess things may change.
posted by cotton dress sock at 8:50 PM on July 6, 2016

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