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Tuesday, March 11, 2014
Ankle stiffness, foot numbness, knee pain
Hello. I`m a 36 year old male. Reasonably acitve and in shape. No running. About 2 months ago I developed some numbness on the top of my left foot, including big toe, and ankle. At such time my right foot would fall asleep while sitting. That has ceased. Still my left ankle is numb and stiff with big toe left foot numbness at times. Also, the knee hurts at times.
(As a sidenote, I believe I have Gout-still being looked into-as I get sharp pains in both feet and toes and knees at night, which I alleviated with gout treatments.)
Any ideas on my continuous left ankle stiffness and knee pain? Maybe tendonitus? I am seeing all kinds of doctors, so advice beyond that would be appreciated.
Numbness would not be due to gout, so you could have more than one diagnosis. If you are being treated for gout, I would presume/hope the diagnosis of gout is certain and not just assumed. The cause for your gout flare would then need to be determined, to hopefully help prevent recurrence.
Foot numbness could result from:
- nerve irritation in your lumbar spine (lower back),
- irritation of the peroneal nerve on the outer side of the knee (as can result from habitual leg crossing, prolonged squatting, or prolonged pressure against the outer knee),
- shoes/boots which are too tight (as could result from ankle/foot swelling), which can irritate superficial skin nerves, or
- neuropathy (abnormal nerve function which can result from such causes as diabetes, heavy alcohol use, or certain medications, among other causes).
Findings on physical examination should reveal whether you have nerve irritation, and/or tendinitis, and/or joint pain involving your knee and ankle. If results from diagnostic studies would potentially influence treatment, imaging studies (X-rays, MRI), and/or nerve testing (electrodiagnostic studies, including nerve conduction studies and electromyography) may be useful to confirm the suspected diagnosis.
The best course of treatment will be based on accurate diagnosis(es).
Brian L Bowyer, MD
Clinical Associate Professor
Physical Medicine & Rehabilitation
College of Medicine
The Ohio State University