Members do not see these Ads. Sign Up.

Had a male patient ( in 30s) in the clinic c/o numbness in both heels (no pain felt). Not diabetic, NAD in blood tests - only reduced vitamin D, for which he had taken supplements late last year and has forgotten to take since. Could detect monofilament at all sites tested, good palpable pulses, no heel pad atrophy, some HK around heels posteriorly, wears good supportive/cushioning shoes which are relatively new. Biomechanically ok, just heavy heel strike. Could vit D deficiency be causing 'numb' feeling..........any thoughts?

 

never heard of it causing neuropathy. occasionaly it does cause a proximal myopathy

 

If he has a heavy heel strike it could just be exanguination causing the numbness. I see it a lot in late pronation manifesting in the medial area of the 1st IPJ.
Maybe a cushioning insole or lateral wedged orthotic device could reduce it.
Mahtay

 

Thanks - just wanting to make sure I hadn't missed anything metabolic. Thanks for the feedback :)

 

A numb-like feeling but with full sensation, ie can feel monofilament, sounds like a sensation called 'Nulliness' by the pioneers of prolotherapy. The area under the heel(s) is an area that the sacrospinous ligaments and the sacrotuberous ligaments refer pain or nulliness to. I have seen a patient who had pain in this area who was tender in the buttock in the correct spot, who responded with complete relief of pain to two treatments of 20% glucose and 0.5% lignocaine to the tender areas and no treatment at all to the heel. Vitamin D deficiency is so common that it is probably coincidental.