Here’s a question I get pretty often: why feet? And I answer, because I love feet. And usually I’ll add a comment about how it’s a good thing I’m not a gastroenterologist or a urologist or something along those lines.
Sensitive little things, those nerves are. Always firing off signals, transmitting messages, and giving orders. For the most part, they are very efficient lines of transmission, communicating signals between our brains and just about every other part of the body, both detectable and undetectable, save for the toenails, which makes my job just a bit easier. However, as has been thoroughly documented in the annals of this world famous blog, at times something can go just a a bit wrong with our little friends, and recovery can lag just a bit.
We have discussed a number of nerve issues in the past (NY-euroma anyone?) involving significant derangement in the function of an otherwise normal nerve. But nerves, like any other body part are subject to the slings and arrows of outrageous and unfortunate NYC streets, in addition to the generalized abuse and pounding of our daily gait from the gate. And in that process, the nerves may be just a bit traumatized, whether from a tight shoe, soft tissue swelling, bone spur, or even the bone enlargement of a bunion or other foot or ankle deformity. This is what we refer to as a nerve entrapment, and it is as it sounds- an entrapment of a nerve within other tissues secondary to an extraordinary amount of pressure exerted on the nerve. Remember the tight shoe you wore to your cousin’s wedding and the resultant numbness in the toes for the rest of the evening, or the time grandma’s goulash required extra man time in the private room with the inability to place pressure on the numb limb for 10 minutes post evacuation? Those are nerve entrapments, the symptoms of which can generally be expected to resolve within a short time. However, there is an occasional lag effect between the time pressure is relieved from the nerve and resolution of symptoms, ranging from a few days to a few weeks. So the winter boot that presses on a foot nerve, causing numbness and pain, may produce a lingering effect that is felt even a few weeks after changing the shoe. And as in the above examples if it’s a temporary entrapment of the nerve the symptoms will resolve in most cases without any other treatment, however more advanced or complicated entrapment type of syndromes can last longer and may not resolve without active treatment, including, in some cases, surgical decompression of the nerve.
And there you have it my dear NYC podiatry patients. Nerves are indeed sensitive and may exhibit symptoms of what seems to be a relatively minor amount of pressure for an annoyingly long time. Of course my Mom would tell you that any unusual symptoms should be investigated expeditiously, and she would also tell you exactly whom to see for said investigation.
See you in the office.
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