Numbness

[vbabjee]

My right leg thumb bottom half part is in numb stage since last 12months.
What could be the reason?
Please suggest me some medication.
Age: 45 Male
Occupation: Shop Keeper

[vbabjee]

My right leg thumb bottom half part is in numb stage since last 12months.
What could be the reason?
Please suggest me some medication.
Age: 45 Male
Occupation: Shop Keeper

[Christopher R Newey, DO]

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 a doctor.

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

I am having difficulty interpreting what you are asking. There are many reasons to have numbness in the leg. One cause is from a radiculopathy.

The spinal cord is encased by bones called vertebra. Nerves start to form as they come off the spinal cord and exit through holes formed between the vertebra. If a nerve is compressed on as it exits through these holes, particularly in an area called the nerve root, a radiculopathy results. The compression could be due to arthritis of the spine or due to a herniated disc or other lesions. The symptoms include pain at the level of the problem (i.e. neck or back etc) and pain that may radiate down the arm or leg (depending on where the problem is). In more advanced cases, muscle weakness or sensory symptoms such as tingling or numbness may occur. A radiculopathy is often diagnosed based on history, physical examination, and MRI of the spine.

Another possibility is local trauma. For example, there is a nerve that is found below the knee on the outside aspect of the leg that can be injured, classically in those who cross their legs. This is called a peroneal neuropathy. This condition may cause a foot drop and sensory changes in the foot.  

Depending on the cause of your numbness, non-surgical treatment is the first option. For example, if it is from inflammation, treatment may include medications (non-steroidals such as advil), sometimes steroids if there is swelling (edema), temperature therapy (hot or cold packs), stretching and controlled physical therapy, muscle relaxants, and so on, these are best prescribed by an experienced physician, each has its own indications.

If the pain is neuropathic (damage to the nerve from either trauma, herniated disc, etc), specific medications are typically used to treat.

As with other conditions, medications that were originally invented for other purposes are useful for pain. This is true of gabapentin and pregabalin which were originally invented for seizures. Pregabalin is similar to gabapentin but has less side effects and often people who can not tolerate gabapentin benefit from pregabalin. However it is more expensive.

The same is true for medications such as amitryptiline, which was originally used for depression but is now a mainstay of treatment for neuropathic pain. However, it has several side effects and may not be used in patients with heart problems.

One means of assessing whether or not you have nerve compression/damage and then to localize the damage is a test called an EMG/NCS which assesses how fast the nerve conducts electricity and how the muscle responds. This type of test is done by neurologists in most centers. It would be best for you to discuss this with your physician.

I would recommend that you discuss your condition with your primary care physician. You may then need referral to a neurologist for diagnosis and medical treatment.

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