Why do my feet feel so numb?

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For many months I've 苦しむd from numb feet. I have rheumatoid arthritis and have been on steroids for 12 months. Could this be to 非難する?

Mrs Sylvia ヒース／荒れ地, Saltash, Cornwall

As you 嫌疑者，容疑者／疑う, the numbness of your feet seems to be a 複雑化 of the rheumatoid arthritis. This ありふれた 条件 おもに 影響する／感情s the smaller 共同のs.

Unhappy feet: Numbness can be a complication of the rheumatoid arthritis

Unhappy feet: Numbness can be a 複雑化 of the rheumatoid arthritis

While the exact 原因（となる） of the 条件 is not （疑いを）晴らす, it’s 広範囲にわたって believed to be an autoimmune 病気, which means the 団体／死体’s 免疫の system 機能不全s? and starts attacking the tissue surrounding the 共同のs, 主要な to inflammation.

Just how 厳しい the 条件 is 変化させるs 広範囲にわたって with the individual.

Three times more women are 影響する／感情d than men, かもしれない because the 女性（の） hormone oestrogen 上げるs the 活動／戦闘 of? the 免疫の system, 同様に? as 増加するing the severity of? the attack.

Undoubtedly there are 与える／捧げるing 環境の factors, such as smoking; there may also be a genetic link and previous 感染 may be a 誘発する／引き起こす, though nothing is yet proven.

CONTACT DR SCURR

令状 to him at Good Health Daily Mail, 2 Derry Street, London W8 5TT or email? drmartin@dailymail.co.uk ― 含むing 接触する 詳細（に述べる）s.

Dr Scurr cannot enter into personal correspondence.

His replies cannot 適用する to individual 事例／患者s and should be taken in a general 状況.

Always 協議する your own GP with any health worries.

In 新規加入 to 影響する／感情ing the 共同のs, over time rheumatoid 病気 can begin to have a 普及した 影響 on the peripheral 神経s of the 団体／死体, typically in the 手渡すs and feet, which may explain the numbness you have been experiencing.

This tends to come on slowly, and in a 進歩／革新的な fashion. It never seems to become 厳しい, but does not 改善する with? steroids that are often 定める／命ずるd to 抑える the rheumatoid inflammation.

There are different ways in which 神経s can be 影響する／感情d. For example, the thickening and swelling around an 影響する／感情d 共同の may place 圧力 on the 神経, making it いっそう少なく efficient at sending signals.

Or the 条件 may 誘発する／引き起こす inflammation in the 塀で囲むs of 罰金 血 大型船s that 供給（する） oxygen and nutrients to the 神経s themselves. This 奪うs the 神経s of these 決定的な 構内／化合物s, and results in 多重の areas of 神経 dysfunction.

In the feet there is one particular 神経 that is 傾向がある to the 損失 ― the posterior tibial 神経, which passes の近くに to the inside of the ankle 共同の. Disruption to this 神経 results in tingling, 苦痛 or numbness in the 単独の of the foot and first three toes ― the area that the 神経 供給（する）s.

This is called tarsal tunnel syndrome. The good news is that 神経 損失 from rheumatoid arthritis tends to 結局 解決する itself. So do be 楽観的な, as I 嫌疑者，容疑者／疑う that over the next year or two your 条件 is likely to abate.

Earlier this year I developed lots of small blisters on my 手渡すs and some bigger ones 負かす／撃墜する the 味方するs of my fingers. My doctor 診断するd a type of eczema and has tried me on Permitabs (which made my nails go brown), Dermovate cream and Diprobase cream, but as yet my problem is not solved. The worse thing is that the itching keeps me awake at night. Any advice? I am 72.

Alan Symmington, Belfast

This unbearably itchy 爆発 goes by the 指名する of pompholyx, which comes from the Greek word meaning 泡, and 述べるs a type of itchy eczema characterised by a 無分別な of small blisters on the fingers, palms or 単独のs of the feet.

The attacks can be 激烈な／緊急の, 継続している just a few weeks, or chronic, 固執するing for much longer, as in your experience. The exact 原因（となる） is unknown, though sweating and 強調する／ストレス are both important factors, and it tends to be more ありふれた in the summer months.

There is also a link with アレルギー. 実体s such as nickel? may 原因（となる） it, as can the 抗生物質 neomycin, used to 扱う／治療する 肌 感染s, while some perfumes have also been 巻き込むd. And 感染s どこかよそで in the 団体／死体 ― whether bacterial, fungal or viral ― are another possible 誘発する／引き起こす.

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Indeed, a wise dermatologist, 現在のd with the 手渡すs of a 患者 such as yourself, will take off the shoes and socks to 検査／視察する for 競技者’s foot, which is 原因（となる）d by a fungus and could be the source of the problem.

There are many 治療 選択s ― all can be helpful, but 非，不，無 are 効果的な every time, as you have 設立する.

Permitabs, which you have tried, are tablets of the 穏やかな antiseptic potassium permanganate.

These are 解散させるd in water, in which a compress is then soaked and wrapped around the 肌. Your doctor is 井戸／弁護士席 知らせるd to have advised this.

It does, however, stain both the 肌 and fingernails a yellow-brown colour.

But used as a soak twice daily for two weeks it is a 複雑化-解放する／自由な way of bringing about 広大な／多数の／重要な 救済, so do not abandon it too soon because of that staining, which disappears after a month or so.

Strong steroid creams or ointments such as Dermovate can also be very 効果的な.

These are best 適用するd at night, and you should also wear 使い捨てできる polythene gloves, which help the 医薬 侵入する the 肌 (a 過程 known as occlusion).

If this fails to 達成する a cure, there are a number of 薬／医学s which can help by 抑えるing the 団体／死体’s 免疫の 返答 (eczema is a form of allergic reaction, where the 免疫の system overreacts to an irritant).

These work 井戸／弁護士席 for pompholyx and 含む methotrexate, azathioprine, mycophenolate mofetil, and ciclosporin.

技術 and experience are needed to 定める／命ずる and 監視する these 麻薬s, however, as all can have 味方する-影響s. Some can upset 肝臓 機能（する）／行事, others can 抑える bone 骨髄 機能（する）／行事, and all 影響する／感情 the 免疫の system in ways that can be 望ましくない.

For this 推論する／理由, their use is おもに the 州 of a 顧問 dermatologist.

Your problem appears to be 比較して intractable, 主要な me to believe that referral to a specialist is now necessary ― unless you 選ぶ for another period of 激しい daily soaks with? the Permitabs, one tablet in? 3.5 litres of water, 同様に as Dermovate every night for two to three weeks.

I wish you the best of luck.

By the way... NHS pen-麻薬売人s are putting lives at 危険

Time and again we hear that our 人物／姿／数字s for 癌 生き残り are low in comparison to other countries ― にもかかわらず the professed magnificence of the NHS.

In these 報告（する）／憶測s, there’s usually an underlying 疑惑 that the 原因（となる） is partly a 延期する in diagnosis 予定 to the unwieldy referral system we have.

Ther e has even been a hint that maybe GPs are 存在 説得するd to 言及する より小数の 患者s for ざっと目を通すs and other diagnostic 調査s that are 必須の in making 早期に 診断するs 予定 to NHS penny pinching.

Now I have come across another subtle spanner in the 作品: death by 行政の 過程.

I have in my 手渡す a letter to a GP 関心ing a 患者 who had two 肯定的な 実験（する）s for 血 in the stool, a 警告 調印する of bowel 癌.

Many people receive these 実験（する）s in the 地位，任命する once they reach 60, and have to 服従させる／提出する 見本s. By 実験（する）ing for the presence of 血, this 審査するs for growths (or polyps), as these 漏れる 血 and may turn cancerous.

A 肯定的な result ― meaning that 血 has been 設立する in the 見本 ― 長所s その上の 調査 by colonoscopy, where a 柔軟な 見解（をとる）ing 器具 is used to check for polyps, which can then be 除去するd.

And so, on the 贈呈 of two 肯定的な results for this particular 患者, the London 分割 of the Bowel 癌 審査 Programme wrote to the GP 説: ‘I would like to 知らせる you that two [stool] 見本s did have a trace of 血 in them.’

But, unbelievably, the letter had started by 説 : ‘.?.?.?she has been de-登録（する）d from your practice recently, therefore our system does not 許す us to take any その上の 活動／戦闘.’ 井戸／弁護士席, who designed that system? What difference does it make which practice the 患者 has? 登録（する）d with?

To create an 行政の 行き詰まり which now 妨げるs the 可能性のある for either 避けるing bowel 癌 ― by 除去するing the polyps ― or making an 早期に diagnosis of an already 現れるing 癌 is unethical, unprofessional, and 率直に devious.

You see, what they are trying to d o is save costs by 築くing a 障壁. But they save no costs in the end ― because 最終的に there will be a diagnosis.

Of course, the 行政官／管理者 is doing a perfect 職業: 固執するing 正確に／まさに to the proper written 過程.

They will no 疑問 get a good 年次の 評価, and be 調印するd off as 存在 最高の，を越す-notch and suitable for 昇進／宣伝.

Pity about the 患者, though.

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