toe tingles

by Bobbie
(Middletown, MD, USA)

my big toe tingles following surgery to remove a bone spur that was eating into a tendon and now that toes tingles all the time

I had a 3" incision on the top of my big toe and the bone spur that was eating the tendon was removed. Now a year an a half later my toe tingles all the time. What does this mean and can it be resolved?

ANSWER

Hi Bobbie,

Sounds like you may have a neuritis which is an inflammation of the nerve, in this case the local nerve that runs over the top of your big toe.
There is also the possibility that the local nerve was inadvertently severed, which can happen from time to time, but in those cases the area on top of the foot and the toe would feel more numb than tingling.
So assuming the nerve is inflamed it is usually a result of being caught up in the scar tissue that forms after any type of surgery. I would be curious to know when the tingling started. Was it pretty much right after surgery or were you fine for a while and then all of a sudden you noticed the tingling sensation?
You do not mention how long ago you had the surgery, but if it was fairly recent physical therapy might be helpful in breaking up any scar tissue and improve the function of the nerve to reduce the tingling effect. Fairly recent in my mind would be surgery within the last two to three months.
If the surgery was performed more than three months I am not so sure physical therapy would have any real benefit.
In this instance you could go back to your surgeon, let he or she know about your symptoms and you doctor might decide to give you a cortisone shot in an effort to reduce the inflammation around the nerve. You could have more than one injection, probably spaced over the period of a few weeks, to see if that reduces your symptoms.
In cases where the neuritis does not resolve and I should mention that sometimes it will resolve on its own, particularly if the source of the neuritis was just irritation to the nerve during surgery and not formation of scar tissue, but if it does not, and it annoys you enough, sometimes we go back in to free the entrapped nerve from the surrounding scar tissue.
Obviously, you should try the more simple solutions first, if they do not work, then decide whether you want to live with or without the tingling sensation and have a discussion with your surgeon about subsequent surgery.

Marc Mitnick DPM
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