If foot thumb is not moving and not feeling sensation in a lady of ,70yrs
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foot drop AND evaluation
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sudden numbness weakness foot stroke emergency signs official
A 70-year-old with a big toe that cannot move and has loss of sensation needs urgent medical assessment today. If this started suddenly, call emergency services now, especially if it affects one side.
Possible causes include a pinched nerve in the back (often L5), pressure/injury to the peroneal nerve, reduced blood supply to the leg, or less commonly a stroke. Sudden leg or foot numbness/weakness can be a stroke warning sign, particularly with facial drooping, arm weakness, speech difficulty, dizziness, or trouble walking. The American Stroke Association advises calling emergency services immediately for these symptoms.
Go to the emergency department immediately if any of these are present:
- Symptoms began suddenly or are worsening
- Face droop, arm weakness, speech or vision changes, confusion, imbalance
- Foot is cold, pale, blue, very painful, swollen, or has no detectable pulse
- Severe back pain, new difficulty passing urine/stool, or numbness around the groin
- Recent fall, injury, or diabetes with a foot wound
Do not let her drive herself. Note the exact time she was last normal, keep the leg protected, and avoid tight footwear or massaging the leg.
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lumbar spinal stenosis AND management
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NHS cauda equina syndrome emergency symptoms bladder bowel saddle numbness
This is an MRI of the lower back (lumbar spine) for an 80-year-old woman. It shows significant age-related wear-and-tear changes that are narrowing the spaces for the spinal nerves, most severely at L4-L5.
Main findings in simple language
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Lumbar spondylosis
- Arthritis and degeneration of the lower-back bones, discs, and small facet joints.
- There are bone spurs and dried/thinned discs at several levels. This is common with age but can become symptomatic when nerves are compressed.
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L4 slipping forward over L5
- Called anterolisthesis or degenerative spondylolisthesis.
- The L4 vertebra has moved slightly forward relative to L5, contributing to narrowing around the nerves.
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Disc bulges and protrusions
- At L2-L3, a broad disc bulge is pressing on the covering around the nerve structures and narrowing the exit passages for nerves on both sides.
- At L3-L4 and especially L4-L5, disc bulges/protrusions, together with thickening of a spinal ligament, cause more marked narrowing.
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Spinal canal stenosis
- “Stenosis” means narrowing of the spinal canal and nerve passages.
- The narrowest level is L4-L5, where the report measures only 3.9 mm of canal space. The report specifically says the nerve roots are compressed at L3-L4 and L4-L5.
- This can cause low-back pain, pain running into the leg, numbness, tingling, weakness, and difficulty walking or standing.
Does this explain the big-toe weakness and numbness?
Yes, it may. The nerve commonly responsible for lifting the big toe is the L5 nerve root. The MRI shows compression/narrowing around nerves at L3-L4 and L4-L5, which can affect the L5 nerve pathway. This could cause inability to lift the big toe, numbness on the foot, or “foot drop.”
However, an MRI alone cannot confirm the exact cause. A doctor must test her strength, reflexes, sensation, walking, and circulation. Other causes, such as a nerve problem around the knee, diabetes-related neuropathy, or rarely stroke, may also need consideration.
What to do now
Because she has loss of movement and sensation in the toe/foot, arrange an urgent assessment by a spine specialist, orthopaedic surgeon, neurosurgeon, or neurologist, ideally today or within 24 hours, particularly if this weakness is new or worsening. She may need a focused neurological examination and discussion of options such as medications, supervised physiotherapy, injections, or, if weakness/nerve compression is significant, spinal decompression surgery.
Go to emergency care immediately if she has:
- New or worsening weakness in the foot or leg, trouble walking, or repeated falls
- Numbness in both legs
- Numbness around the genitals, inner thighs, or buttocks
- New difficulty passing urine, urine leakage, loss of bowel control, or constipation with inability to feel when passing stool
- Severe rapidly worsening back and leg pain
These can indicate serious compression of the lower spinal nerves, called cauda equina syndrome, which needs urgent treatment. The NHS emergency guidance specifically lists new leg or foot weakness, saddle numbness, and bladder or bowel changes as warning signs.
Bottom line: This MRI shows multi-level degeneration with significant nerve-space narrowing, worst at L4-L5, and it is a plausible explanation for her big-toe weakness and loss of sensation. Do not treat the weakness as just routine back pain.
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Is there is anything that can relate to report of loss of sensation in big toe
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Yes. The lumbar MRI report has a finding that can directly explain loss of sensation in the big toe.
The big toe is mainly supplied by the L5 nerve root:
- Sensation: top of the foot and big toe, especially the space between the big toe and second toe
- Movement: lifting the big toe upward
In her report, the important findings are:
- L4-L5 disc bulge/protrusion with severe spinal canal narrowing. The canal space is reported as 3.9 mm, which is markedly narrow.
- It states there is compression of the traversing and exiting nerve roots at L3-L4 and L4-L5.
- L4 has slipped forward over L5 (anterolisthesis), further reducing nerve space.
- At L2-L3, there is also narrowing of the nerve exit openings on both sides.
At the L4-L5 level, the nerve that travels downward is commonly the L5 nerve root. Therefore, compression at this level is a good anatomical match for:
- numbness or tingling of the big toe/top of the foot
- weakness when lifting the big toe
- possible foot drop or tripping
The photographed MRI films themselves are too dark and not detailed enough to safely interpret further, but the written MRI report already clearly documents the nerve compression.
Because she has both sensory loss and inability to move the toe, this should be assessed promptly by a neurosurgeon, spine orthopaedic surgeon, or neurologist. Take the MRI report and films with her.
Go to emergency care today if weakness is new or increasing, walking is becoming difficult, or there is any loss of urine/bowel control or numbness around the buttocks/genital area.
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