Numbness in hands and feet
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Understanding Numbness in Hands and Feet: Causes and Insights
Numbness in the hands and feet is a common symptom that can arise from various underlying conditions. This article synthesizes findings from multiple research studies to provide a comprehensive overview of the potential causes and characteristics of this symptom.
Peripheral Neuropathy: A Common Culprit
Chemotherapy-Induced Peripheral Neuropathy (CIPN)
Chemotherapy-induced peripheral neuropathy (CIPN) is a frequent side effect of cancer treatments involving taxane, platinum, or vinca alkaloid-based chemotherapies. Patients with CIPN often experience numbness, tingling, pain, and motor impairment in their hands and feet5 8. Exercise has been shown to reduce CIPN symptoms, suggesting it as a potential non-pharmacological intervention5 8.
Sensory and Motor Impairments
Peripheral neuropathy can present with a range of sensory and motor impairments. For instance, a 67-year-old woman exhibited progressive numbness, tingling, and weakness in her hands and feet, along with gait imbalance. Her neurological examination revealed decreased sensation to pinprick, vibration, and temperature in the distal extremities, and impaired proprioception at the toes1. Similarly, another patient experienced numbness and tingling in the hands and feet, with decreased vibratory and joint-position sensations bilaterally2.
Autoimmune and Systemic Conditions
Sjögren Syndrome
Sjögren syndrome, an autoimmune disorder, can also lead to numbness and tingling in the extremities. A case study of a 65-year-old woman highlighted symptoms such as severe dry eyes and mouth, progressive gait instability, and profound vibration and proprioceptive loss in all extremities. The patient was diagnosed with Sjögren sensory ganglionopathy, characterized by asymmetric sensory loss and neuropathic pain6.
Arsenic Poisoning
Arsenic poisoning is another potential cause of numbness and painful paresthesias in the limbs. A 40-year-old male presented with numbness and tingling that started distally in the hands and feet and progressed to the wrists and mid-legs. He also experienced imbalance while walking, generalized areflexia, and sensory ataxia7.
Neurological Disorders
Guillain-Barré Syndrome
Guillain-Barré syndrome (GBS) is a neurological disorder that can cause progressive mixed neuropathy. A 67-year-old man with GBS experienced numbness and burning pain in the soles and fingertips, muscle wasting, and gait instability. His symptoms included frequency of micturition and low back pain, but no bowel disturbances4.
Combined-System Disease
A 76-year-old woman with combined-system disease reported bilateral numbness and tingling in her hands and feet, along with Lhermitte's sign (tingling along the spine on neck flexion) and unsteady gait, particularly in the dark. Her examination revealed hypoesthesia to light touch and decreased vibratory and joint-position sensations2.
Conclusion
Numbness in the hands and feet can result from a variety of conditions, including peripheral neuropathy, autoimmune disorders, poisoning, and neurological diseases. Understanding the underlying cause is crucial for effective management and treatment. Exercise has shown promise in alleviating symptoms of chemotherapy-induced peripheral neuropathy, while specific treatments are required for conditions like Sjögren syndrome and Guillain-Barré syndrome. Further research and clinical evaluations are essential to tailor interventions for individual patients.
Sources and full results
Most relevant research papers on this topic
Clinical Reasoning: A 67-Year-Old Woman With Progressive Tingling Sensations and Imbalance
Progressive numbness, tingling, and weakness in hands and feet may be a sign of a neuromuscular disorder, but the patient had no family history of neuromuscular disorder.
Case Report
Rigorous JournalImages in clinical medicine. Combined-system disease.
A combined-system disease, involving multiple organ systems, may cause numbness, tingling, and memory loss in the hands and feet, with unsteady gait and memory difficulties.
Case ReportClinical Reasoning: A 49-Year-Old Woman With Progressive Numbness and Gait Instability
Progressive hand and foot paresthesia and gait instability in a 49-year-old woman suggest a possible neurological cause for her symptoms.
Case ReportRigorous JournalEffects of exercise during chemotherapy on chemotherapy-induced peripheral neuropathy: a multicenter, randomized controlled trial
Exercise during chemotherapy can reduce chemotherapy-induced peripheral neuropathy symptoms, particularly in older, male, and breast cancer patients.
RCT
Large Human TrialRigorous Journal
Highly CitedProgressive Numbness, Burning Pain, Imbalance, and Dryness
Sjögren sensory ganglionopathy can cause progressive numbness, tingling, and burning pain, with treatment refractory for sensory loss and ataxia.
Case ReportArsenic poisoning and Mees' lines.
Arsenic poisoning can cause numbness and paraesthesias in limbs, with Mees' lines being a potential cause.
Case ReportMechanisms, Mediators, and Moderators of the Effects of Exercise on Chemotherapy-Induced Peripheral Neuropathy
Exercise may help treat chemotherapy-induced peripheral neuropathy, with factors like age, sex, and exercise routines influencing its effectiveness.
Literature ReviewRigorous JournalContribution of Loss of Large Fiber Function to Pain in 2 Samples of Oncology Patients
Loss of function in myelinated, large diameter fibers contributes to the severity of neuropathic pain in oncology patients.
Observational StudyLongitudinal study of Inflammatory, Behavioral, Clinical and Psychosocial Risk Factors for Chemotherapy-Induced Peripheral Neuropathy
Pre-chemotherapy factors include worse fatigue, anxiety, depression, and baseline neuropathy, with inflammation playing a role in chemotherapy-induced peripheral neuropathy.
Observational StudyRigorous Journal