Troubling feeling of numbness in the legs

Monday April 16 2018

 

By Dr Lugano Wilson

One of the complaints that my patients report at the outpatient department on record numbers is the feeling of numbness, tingling sensation associated with leg pain.

Most of them say they experience numbness in legs/burning pain whereas others report complete loss of ability to sense anything noxious including pain.

So, it’s not strange to hear such reports, actually what is reported by these patients is what we describe in medicine as peripheral neuropathy.

Many of the victims are usually elderly, and most of them are diabetic patients, and some of them have HIV.

Today let’s look at the salient causes and how to forfend the condition.

Peripheral neuropathy is the disorder of the nerve which is a result of the damage to your peripheral nerves, normally it causes burning pain, numbness, weakness usually in your hands, feet, but doesn’t prevent other parts of the body to move.

What are my patients interested to know?

I know that many will call asking what causes this condition, at times it’s difficult to know the real causes especially when the common causes have been ruled out, and that’s in Tanzania sometimes a medical practioner will just want to prescribe medicines whilst contemplating the cause.

Generally, this condition can result from traumatic injuries, infections, metabolic problems, exposure to toxins.

However, one of the most common cause that I always grapple with is Diabetes as I have mentioned earlier.

Anyway, other causes include alcoholism, as you know people take a lot of local liquor and they make poor dietary choices which can lead to vitamin deficiencies.

Infections can also be the cause whereby HIV/Aids is the leading cause in our Tanzanian setting among all infections, followed by Shingles as I can observe from my Doctor’s Diary, though globally more causes include Hepatitis C, Epstein Barr Virus, and Diphtheria.

Some medicines can also cause it including some anticancer and few anti TB medicines , here a Doctor in Tanzania will never leave you in a lurch, she/he will find a way to escape that side effect- peripheral neuropathy.

Vitamin deficiency is the most common factor in most rural areas and doctors attribute this problem to lack of vitamins like B1, B6, B12 and Vitamin E are important to nerve health.

Other causes include Bone marrow disorders, tumors can compress nerves, trauma and anything that cause pressure/ compression on the nerve, sometimes Kidney and Liver disease.

What are the sob stories with regard to peripheral neuropathy?

Burn and infection- many victims can be injured without being aware, you know when the feet/leg is numb you may not be able to feel any changes including fire, as a result you may trample on fire without being aware

You can get infections at the injury site; sometimes falling can be experienced due to lack of balance.

Can we prevent it?

Eat diet containing the aforementioned vitamins, e.g. fruits, vegetables, whole grains, lean proteins, B12 sources- eat meat, fish, eggs, low fatty dairy products, fortified cereals, exercise regularly, avoid alcohol, avoid toxins, avoid any action that impinges on the nerves like repetitive motion, cramped position.

Challenges in Tanzania is in determining the causes apart from the common ones, treatment costs and costs for diagnostic and treatment evaluation tests, absence of nerve ability evaluation tests such as electromyogram /EMG.

My honest advice to you:- If you have been told that your neuropathic pains are here to stay, lay your hands on the arc of history and bend it once more to optimistic feelings of healthier and more functional legs and feet. Free of all the tribulations brought forth by peripheral neuropathy since some nerves may regenerate, Don’t hesitate to seek a doctors’ help.

(lugano_wilson@yahoo.com)

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