Burning pain in the toes & numbess in the hands

Since the birth of my child 4 years ago, I've had extreme burning in the top of my right foot and I now have a large dent on top between my 4th & 5th toe, almost like my foot is caving in.  I get severe cramping in my foot and leg as well.  It happens a little in my left but mostly the right.  I also have really bad numbness in my right hand when I go to sleep.  Doesn't matter how I lay in the bed, I get awakened by my hand falling asleep.  But, I'm now at my wits end because just in the past 2 weeks, my right foot, in my arch near my heel, feels like I've stepped on a bolt and it has embedded itself in my foot.  It get a knot in it and I have to sit down and prop my foot up for it to feel better.  It is very painful and I'm not sure who/what kind of doctor to go see about this.  Can anyone PLEASE help me?

[Neuro Forum]

Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with your doctor.

Without the ability to examine you and obtain a history, I can not tell you what the exact cause of your symptoms is. However I will try to provide you with some useful information.

Your hand and feet symptoms could either be related, or due to separate conditions.

If you were to divide them into separate conditions, one possibility is that your foot symptoms are due to musculoskeletal causes (such as tendonitis, plantar fascitis) etc., or due to a focal mononeuropathy, irritation of a specific nerve in the foot. Another potential cause of your foot symptoms is a herniated disc in the lumbar spine.

Your hand symptoms could be consistent with carpal tunnel, which is a problem that often starts in pregnancy. The carpal tunnel is the area in the wrist that the median nerve passes through. If the median nerve is compressed in the carpal tunnel, it can cause symptoms in the first three digits of the hand most often, but in some patients shooting pains can occur all the way up to the elbow. The symptoms are often worst at night, and characteristically wake people up at night with numbness/tingling in teh hand. Carpal tunnel syndrome can be caused by repetitive movements at the wrist like typing. Thyroid function and tests for diabetes should be done in people with carpal tunnel. Treatment includes wearing a wrist brace and in severe cases surgery. Another potential cause of arm/hand symptoms is a herniated disc in the neck.

If your symptoms are to some extent in both hands and both feet, the other possibility is a neuropathy. A neuropathy is a generic term for some sort of dysfunction of the peripheral nerves. Symptoms include burning, tingling, numbness, loss of sensation, and in some cases, muscle weakness. There are several causes, most commonly diabetes, but also certain vitamin deficiencies, hormone problems, protein abnormalities, and others.

All the above disorders are all diagnosable based on the history and examination, with ancillary testing as indicated, such as a test called EMG/NCS which assess how well the nerve conduct electricity and how well muscles respond. If there is concern for a herniated disc in the neck and/or lower back, MRI of the spine may be indicated.

Evaluation by a general practitioner (primary physician, family doctor, internist) is recommended, with referral to the appropriate specialist as necessary.

Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.