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Spreading little toe sideways...

Posted by Barbara E on 9/06/02 at 21:37 (094657)

I was at the neurologist yesterday to have the 'shock' test and 'stick needles in muscles' test to try and confirm the TTS diagnosis. (I had a wonderful doctor who explained everything he was doing and gave me all the proper names, etc. - but I forgot them. )

Anyway, we talked a bit before he got started and he asked if I had noticed anything different since the last time I saw him. I mentioned that I could not spread my toes (big/little toes) out sideways. I could move them 'up-and-down' but not 'out'.

(Doesn't hurt when I try to do it - in fact, it feels like I'm doing it - but they don't move. Weird.)

Anyway, he explained that it made sense for the big toe to be like this but TTS shouldn't affect the little toe this way. But then he paused for a moment and asked me to wait while he checked something out. Came back after a couple of minutes and said that he was wrong - that the little toe should be affected just as I'd described. (He went into it in quite some detail but - again - I don't remember all the terms he used.)

I just thought that was interesting. Has anyone else noticed this?? I have a relatively mild case of TTS because it doesn't hurt, the bottom of my foot is just numb. It did hurt for awhile but eased off after about 4 days (this happened twice).

By the way, the two tests weren't nearly as bad as I feared. And they confirmed TTS. The nerve test was nothing (a '1' on a scale of 1-to-10) while the needle test was a '1' (in the calf) but it probably hit a '4' for a couple of seconds when doing it in the foot itself. But I do have a high pain threshold. In fact, the only time I've taken pain medication in my life were the two episodes when my foot hurt. That was rough.

Re: Spreading little toe sideways...

Rebecca C. on 9/09/02 at 16:15 (094835)

You know, I my right foot does EXACTLY the same thing! This foot had open pf surgery in Jan. 2002 and I'm having some ongoing problems, however no TT. I showed it to my doctor and he didn't seem that impressed...

Re: Spreading little toe sideways...

Barbara E on 9/09/02 at 16:53 (094842)

I'm not surprised that your doctor didn't seem impressed. I think most doctors react that way when their patient tells them something. That's why I like my doctor so much.

My brother-in-law (emergency room doctor) did some checking around to find me 'the best neurologist in Greenville'. His name is Dr. Millar and he's great - explains everything, listens to you, etc. When I first went to him, he asked me to explain my symptoms. So I told him about it and also mentioned that I had gone on the internet and figured out that it was TTS (which my family doctor was unfamiliar with). Dr. Millar thought it was great that I had done some investigating!!

This last visit - the one when I mentioned the toe - he also initially said he didn't think there was any connection and that perhaps my foot had always been that way. But I assured him that I knew there was a difference. And he trusted me enough to go do some further investigating himself. (That impressed me, many doctors have a tendency to assume that the patient isn't too bright. ) After he checked and found out that there was indeed a connection - he looked like a kid who'd just found out something new and exciting!! He acted thrilled to learn something new - as opposed to many people who might get upset because they feel that they've been 'shown up'.

By the way - he's been with this practice for three years and this is the first case of TTS he's seen. Lots of carpel tunnel syndrome but not this.

Anyway, is your big toe the same way (in terms of spreading sideways)?? I also can no longer 'point' my big toe. If you have both these symptoms (big toe and little toe), it indicates a possible problem with the nerve where it comes through the tarsal tunnel area. You might want to have it checked out further. (This makes sense to me because these are different muscles, different tendons, ligaments, etc. The only connection they have is that they are both influenced by a nerve that splits just before it goes through the tarsal tunnel area.)

Re: Spreading little toe sideways...

Rebecca C. on 9/09/02 at 20:58 (094865)

All my toes of my right foot will move down and up but won't spread. I read something interesting about this in an abstract about entrapment of the first branch of the lateral plantar nerve: 'There may be associated motor weakness of the abductor digiti minimi indicated by the patient's inability to abduct the fifth toe (Fig. 2). Abduction of the fifth toe may be a difficult task for many people to perform, but in some individuals with this entrapment, a difference may be observed between the symptomatic and asymptomatic sides.' Do you think that is what your doc was talking about?

Re: Spreading little toe sideways...

BREN P. on 9/11/02 at 22:28 (095098)

It is so ironic that I happened on this board tonight, I left the orthopedic's office today at 4:30 for the same thing. I had an EMG, & NERVE CONDUCTION study done last week, by a neurologist, and as you say it smarts a little. He even went on up onto my back to make sure I did not havev a disc problem, I did not.

For the last 3-4 months, I have been taking Neurontin. We keep increasing it every week or so, I am now on 900 MG 3-4 times daily. I, also, take Elavil at night (he told me to take it in the early PM, and I would not be drowsy in the AM) they (neurologist & Orthopedic) both state this allows the body nerves to calm so the Neurontin can work better. I SURE HOPE SO. Just started the Elavil, we'll see. BUT-- the Orthopedic noticed the same thing you are talking about that my outer toes do not move on either foot and my big toe wants to turn upwards.---I have TTS in both feet (which I have been told is rare to have it at the same time) but left one is much worse, intense burning, and maybe tomorrow it might be extremely cold. One night its ice packs and the other its the heating pad, BUT ,mostly hot searing pain both feet as if they were skinned and fried. I know the numb feeling you feel, it isn't numb, you can touch and feel it, but it feels extremely tight. The Orthopedic told me today that he felt that I had a pinched nerve in the left foot back side of the arch and injected it today and casted the foot to immobolize it. HOPE IT WORKS. We'll see

I truly hope you do not get any worse, but a couple of years ago I began having little spells of foot burning (only on the bottoms) if I walked a lot and I would nuture them and they would be okay, but I really had to pay attention to the type of shoe I would wear depending on the occasions.
THEN, I made a couple of trips out of the country last May and again this
past April, did a lot of power walking through other countries, and when I returned this time 3-4 weeks later, EVERYTHING seemed to fall apart and I have had a horrible time getting it under control. SO PLEASE PAY ATTENTION AND WEAR GOOD SUPPORT AND INSOLES WHEN YOU KNOW YOU ARE GoiNG TO BE WALKING A LOT.

Geez, didn't mean to get so wordy, but hang in there. They do tell me it will get better.

I am in the Atlanta area and the physicians I believe are very good here, I work in the medical field so I am like you, have a little inside help.

Take care,
Bren

Re: Spreading little toe sideways...

Rebecca C. on 9/09/02 at 16:15 (094835)

You know, I my right foot does EXACTLY the same thing! This foot had open pf surgery in Jan. 2002 and I'm having some ongoing problems, however no TT. I showed it to my doctor and he didn't seem that impressed...

Re: Spreading little toe sideways...

Barbara E on 9/09/02 at 16:53 (094842)

I'm not surprised that your doctor didn't seem impressed. I think most doctors react that way when their patient tells them something. That's why I like my doctor so much.

My brother-in-law (emergency room doctor) did some checking around to find me 'the best neurologist in Greenville'. His name is Dr. Millar and he's great - explains everything, listens to you, etc. When I first went to him, he asked me to explain my symptoms. So I told him about it and also mentioned that I had gone on the internet and figured out that it was TTS (which my family doctor was unfamiliar with). Dr. Millar thought it was great that I had done some investigating!!

This last visit - the one when I mentioned the toe - he also initially said he didn't think there was any connection and that perhaps my foot had always been that way. But I assured him that I knew there was a difference. And he trusted me enough to go do some further investigating himself. (That impressed me, many doctors have a tendency to assume that the patient isn't too bright. ) After he checked and found out that there was indeed a connection - he looked like a kid who'd just found out something new and exciting!! He acted thrilled to learn something new - as opposed to many people who might get upset because they feel that they've been 'shown up'.

By the way - he's been with this practice for three years and this is the first case of TTS he's seen. Lots of carpel tunnel syndrome but not this.

Anyway, is your big toe the same way (in terms of spreading sideways)?? I also can no longer 'point' my big toe. If you have both these symptoms (big toe and little toe), it indicates a possible problem with the nerve where it comes through the tarsal tunnel area. You might want to have it checked out further. (This makes sense to me because these are different muscles, different tendons, ligaments, etc. The only connection they have is that they are both influenced by a nerve that splits just before it goes through the tarsal tunnel area.)

Re: Spreading little toe sideways...

Rebecca C. on 9/09/02 at 20:58 (094865)

All my toes of my right foot will move down and up but won't spread. I read something interesting about this in an abstract about entrapment of the first branch of the lateral plantar nerve: 'There may be associated motor weakness of the abductor digiti minimi indicated by the patient's inability to abduct the fifth toe (Fig. 2). Abduction of the fifth toe may be a difficult task for many people to perform, but in some individuals with this entrapment, a difference may be observed between the symptomatic and asymptomatic sides.' Do you think that is what your doc was talking about?

Re: Spreading little toe sideways...

BREN P. on 9/11/02 at 22:28 (095098)

It is so ironic that I happened on this board tonight, I left the orthopedic's office today at 4:30 for the same thing. I had an EMG, & NERVE CONDUCTION study done last week, by a neurologist, and as you say it smarts a little. He even went on up onto my back to make sure I did not havev a disc problem, I did not.

For the last 3-4 months, I have been taking Neurontin. We keep increasing it every week or so, I am now on 900 MG 3-4 times daily. I, also, take Elavil at night (he told me to take it in the early PM, and I would not be drowsy in the AM) they (neurologist & Orthopedic) both state this allows the body nerves to calm so the Neurontin can work better. I SURE HOPE SO. Just started the Elavil, we'll see. BUT-- the Orthopedic noticed the same thing you are talking about that my outer toes do not move on either foot and my big toe wants to turn upwards.---I have TTS in both feet (which I have been told is rare to have it at the same time) but left one is much worse, intense burning, and maybe tomorrow it might be extremely cold. One night its ice packs and the other its the heating pad, BUT ,mostly hot searing pain both feet as if they were skinned and fried. I know the numb feeling you feel, it isn't numb, you can touch and feel it, but it feels extremely tight. The Orthopedic told me today that he felt that I had a pinched nerve in the left foot back side of the arch and injected it today and casted the foot to immobolize it. HOPE IT WORKS. We'll see

I truly hope you do not get any worse, but a couple of years ago I began having little spells of foot burning (only on the bottoms) if I walked a lot and I would nuture them and they would be okay, but I really had to pay attention to the type of shoe I would wear depending on the occasions.
THEN, I made a couple of trips out of the country last May and again this
past April, did a lot of power walking through other countries, and when I returned this time 3-4 weeks later, EVERYTHING seemed to fall apart and I have had a horrible time getting it under control. SO PLEASE PAY ATTENTION AND WEAR GOOD SUPPORT AND INSOLES WHEN YOU KNOW YOU ARE GoiNG TO BE WALKING A LOT.

Geez, didn't mean to get so wordy, but hang in there. They do tell me it will get better.

I am in the Atlanta area and the physicians I believe are very good here, I work in the medical field so I am like you, have a little inside help.

Take care,
Bren