For the purposes of this discussion, I want to focus on poor circulation related to the arteries, or blood vessels that bring blood to the foot. Another component of poor circulation includes the veins, or blood vessels that bring blood from the foot back to the heart. When veins become diseased, the leg and foot can swell, and varicose and spider veins can develop. The added fluid in the legs from the veins' inability to return blood back to the heart effectively can be a source of pain and discomfort, but this does not threaten the health of the leg in the same way that poor artery flow does. That is why I will concentrate on poor artery circulation, as it is much more serious and causes more significant pain.
Again, arteries bring blood to the foot. Blood contains vital oxygen and other nutrients that the tissue in the legs and feet need to survive. When the leg and foot is deprived of this nutrient source, the tissue begins to deteriorate and eventually, if the circulation is bad enough, will die. Poor arterial circulation is due to a number of different factors. Numerous conditions like high blood pressure, high cholesterol, obesity, diabetes, heart attacks, stroke, kidney disease, and smoking can lead to or indicate a higher risk for the development of blockages in the leg arteries. When these blockages occur, the body must find alternate channels for the blood to get to the feet. Sometimes there are 'side' channels the body can use to get the flow down. However, when these alternate routes do not exist, or when they themselves are blocked, the foot has no way of getting adequate blood flow. A little bit can trickle in, but not enough to cover the needs of the foot tissue. Slowly over time the tissue begins to die, and numerous symptoms begin to appear. Externally, the skin becomes thin, and the toes will develop a red-purple discoloration. The foot can feel cool to the touch, and foot hair will disappear. Wounds can develop out of minor injuries to the skin. Foot pain during this stage is only minimal to moderate in intensity, with most pain being felt in the calf or leg after exerting a mild amount of activity, like walking around the block. When the condition advances, the toes can turn a blue-black discolor, or develop a hard black crust, indicating the start of gangrene. It is during this time that the circulation must be surgically restored, or else the leg may be lost to amputation. The pain associated with these later stages of circulation loss can be excruciating. This pain becomes worse with elevation of the leg, and even a horizontal position in the bed can cause pain, forcing one to have to lower the leg off the bed. Even narcotic pain killers rarely help decrease this pain, and it is constantly felt. The pain can be described as searing, knife-like, and crushing. Only restoration of blood flow and nutrients will relieve the pain, outside of amputation.
People often associate certain pains, like tingling, burning, and numbness of the feet as being circulation related. Even the sensation of the feet falling asleep is mistakenly attributed to circulation. In actuality, these pains are usually related to disease of nerve tissue. This can be due to nerve 'pinching', pressure around a nerve, or nerve tissue disease itself such as seen in diabetes. Circulation problems rarely have anything to do with this type of pain, and attributing these less serious pains to poor circulation decreases the urgency of actual circulation-based pain.
A simple test can determine if poor arterial circulation is present, and if found early enough treatment can be performed well in advance of the pain developing. If you have any of the above risk factors, a simple examination to determine if this screening test is necessary can save a lot of pain from developing, and may even save your leg.
Until next time,
Scott R. Kilberg DPM
Serving the communities of Indianapolis, Fishers, Noblesville, Fortville, Carmel, and Westfield Indiana.
The varicose vein leg pain will be severe when swelled during the process. Sometimes we can remove it by some treatments.
ReplyDeleteI agree with all the points mentioned above. It is really hard to bear with foot pain. Sometimes there is such a bad foot pain due to which you have no other option left except for contacting professional doctors. I had a same problem few months back and to solve this I contacted Park Plaza Foot Specialists. The results were great and the foot problems were solved.
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ReplyDeleteI have lupus and fibromyalgia...ihave been suffering from this foo foot pain for months and nothingg is helping..insist this not related to either disease but feel it could be more of a circulation issue...what r the treatments of poor circulation and can it also effect the hands as well!?
ReplyDeletePoor circulation is uncommon in middle aged and young people, except for diseases affecting micro-circulation, which can affect both feet and hands. Even still, it is uncommon for these conditions to be painful. My suggestion is to see a foot specialist, who can determine if you have any circulatory component to your pain. Many people mistake nerve pain and other conditions as being related to circulation. Your physician should be able to make an accurate diagnosis, or refer you to someone who can.
ReplyDeleteEvery so often a disc in my back goes out but the last time the pain was so bad I ended up in the ER.It felt like the disc was strangling the nerves in my leg and foot.Ever since my foot is numb and toes turn blue at times.What do you think I should do about this ?
ReplyDeleteYou need to see an orthopedic back specialist or a neurosurgeon.
ReplyDeleteI am 47 and recently noticed these symptoms: cold feet and/or extremely sensitive to cold temps and varicose veins appearing on my feet. It can be painful, however in warmer temps it is not as bad. I recently had a checkup and the only thing they found was slightly high cholesterol. I somehow didn't thing the 2 were related.
ReplyDeleteI have had poor cicurlation in my feet since I was little. First my feet would be cold to the touch then they would hurt. But as I have gotten older, now they turn red,hurt, I have shoot pains in my feet and leg. I either over sleep or have insomina. I am also sensitve to the heaat I sleep with two fans both pointing at my feet. My feet make me jump out of my sleep then they get red almost purple and hurt. I don't think it fibormyaliga anymore. But lately cause I am off my meds Lyrica and Cymbalta I will get inflamation everywhere and hurt I jump in my sleep. The Lyrica and Cymbalta helps but I still have insomina and fatigue and inflamtion in my feet. I am fustrated and want an answer before I loose my hands and legs for good I am scared now that the doctors will decide to cut off my legs and hands what do I do.
DeleteTo Anonymous replying June 30th to this thread:
DeleteYou may also have a neurological condition called erythromelalgia, which can be quite painful but can be managed. You need to have a pain management specialist evaluate you. Rest assured, unless there is true arterial blockage that cannot be repaired leading to gangrene, amputations are not performed.
They are probably not related if the elevation is only minor. See a foot specialist or vascular specialist for a more detailed foot/leg evaluation.
ReplyDeleteMy feet pain occurs mainly at night - and if I lay down at nite - and get up outta bed - I can barely walk. It is sooo painful that I have to use a walker to go to the bathroom in the middle of the nite. I am only 44 yr old - I am overweight, but I am a Very active person. My feet turn blueishpurple whenever I am sitting throughout the day. Should I be alarmed about circulation?
ReplyDeleteSounds like a problem with your circulation flow out of the leg, but you really should see a foot specialist for an exam and further testing. Your symptoms could be due to any number of different problems.
ReplyDeletehave been experiencing crampy sharp pain in my right foot for past few months.Past 2 weeks it has increased in serverity and is also affecting my left foot. concerned. What should I do
ReplyDeletehave been experiencing crampy sharp pain in my right foot for past few months.Past 2 weeks it has increased in serverity and is also affecting my left foot. concerned. What should I do
ReplyDeleteYou should see a foot specialist for a medical exam, especially since it is worsening.
ReplyDeleteThank you so much for your blog. A few months ago, I started running, and discovered a pain on the inside of my left foot, just behind my arch. As I increased running, the pain would get so bad that my entire leg would ache. I have since stuck to walking (I'm hoping to run again), but I still have pain, although now it seems to be just in front of my arch. I also have numbness after about thirty minutes of walking, and sensations of coldness in both feet when resting. Is this all a result of circulation?
ReplyDeleteWell, it sounds like you may have a problem with the nerve that runs in that area. Numbness and coldness are often mistakenly attributed to circulation, but are usually due to nerve disease. Since this can become a bigger problem if left untreated, I suggest you see a foot specialist for proper assessment and care.
ReplyDelete(Another component of poor circulation includes the veins, or blood vessels that bring blood from the foot back to the heart. When veins become diseased, the leg and foot can swell, and varicose and spider veins can develop. The added fluid in the legs from the veins' inability to return blood back to the heart effectively can be a source of pain and discomfort, but this does not threaten the health of the leg in the same way that poor artery flow does). Dr. Scott, this is my problem and putting on clothes at knee length has become an issue because of my swollen feet and ankles. it gets severe sometimes that even my toes swell and the feet will ache severly. please what can i do?
ReplyDeleteWell, you need to see you doctor first to ensure that the swelling is not part of a more serious problem. It it is not, as in most cases, then simple measures like compression stockings with the assistance of a donning cage (a metal frame that allows you to more easily put on the tight compression socks) may be of benefit. This is a treatment you doctor needs to direct, though.
ReplyDeleteI just had hip replacement 10 days ago and was of course in bed a few days and have had less mobility. I have pain in both heels that is acute at night. Due to the surgery I must sleep on back where heels touch the bed. Any suggestions to eliminate his pain?
ReplyDeleteYour heels should be elevated off the bed to reduce pressure, and you should have them evaluated by a foot specialist, or at least your orthopedic surgeon, to determine the cause of the pain, as night pain when you are not on them may have nothing to do with the heels themselves if there is no pressure sore to the skin.
ReplyDeleteIf your pain is at night, but only when you put weight on them to walk, then there can be multiple causes for this and a specialist evaluation is warranted.
After a doppler proceedure I have recently been informed that my right common iliac artery is 80/90% blocked.My right foot pain is absolutely excruciating and I am getting practically no sleep.I am trying to recover from a recent bowel operation due to chemo & radiation therapy.My main question is,"how long before permanant damage will render my foot and leg useless and what should I do?"
ReplyDeleteHI,
ReplyDeleteI have had severe foot pain on the tops of my feet going up my leg. I'm only 44- and have had numerous tests. I had an EMG that showed Darsel Tunnel (Not spelling it right sorry) in both feet-bone scans are normal and was also diagnosed with Chronic Regional Pain Syndrome-My question is can Darsel Tunnel cause the severe pain I'm in or is it the CRPS? I did see a foot surgeon and it was almost like after he heard I had CRPS he didn't know how to treat me. I did get orthodicts for my shoes and he gave me Ketamine cream with anti-inflammatory medicine in it but the pain never goes away. Any suggestions? My feet used to swell alot but is now down to a minimum but the veins are always stressed looking and feet purplish especially around my ankles in color. Thank you and I apologize this is so long.
To Anonymous with the blocked artery-
ReplyDeleteYou really should have a procedure to open or bypass the artery as soon as possible. Permanent damage depends on many factors, including on whether other blood vessels are allowing blood to essentially trickle down and bypass the blocked main artery supply. See a vascular surgeon as soon as possible.
To Anonymous with the Tarsal tunnel syndrome and CRPS-
ReplyDeleteCRPS is very challenging to treat, and treatment needs to be from several doctors, including pain management and physical therapy. Your foot surgeon will not likely be able to contribute much personally to this treatment other than to initiate it. They probably cannot accurately determine if your pain is mostly tarsal tunnel in origin or if it is CRPS, and surgery to release the tarsal tunnel may make the CRPS worse. A pain management specialist is probably the best physician to start with- the tarsal tunnel may have to wait.
Great Site Dr. Killberg. I'm 38, overweight male 215 lbs 5'8", and have high cholesterol. And to top it off I'm a smoker I know, I know, trying to quit.
ReplyDeleteI am and had a two year bout with plantar facscitis which recently was treated with an endoscopic plantar fasciotomy. Basically, I still have pain when I get up from sitting on all areas of my foot now, not just the heel. Also lately I've developed quite alot of leg stiffness and foot stiffness now in both feet.
It's just starting to dawn on me that the fact my plantar fascitis wouldn't heal through conservative treatment and this leg and foot pain is due to circulation issues because of smoking and cholerstoral.
Am I on the right track? Interesting none of these issues came up during exams although I am fully to blame for this.
You are a bit young to have circulation problems severe enough to cause leg pain (ischemic pain), even as a smoker with high cholesterol. It would be very unusual for this to be contributing to your symptoms, and at your age a vascular screening is rarely if ever done as it is rare to have arterial blockages in the legs this early unless you have some unusual genetic predisposition for early arterial plaques. Heel pain can have multiple causes, and if it is continuing after surgical endoscopic release, your surgeon needs to take a fresh look at other contributing causes, including why you are having stiffness in both feet.
ReplyDeleteHappy New Year Dr. Kilberg,
ReplyDeleteI am 58 yo male, in very good shape via yoga for the past 10 years, and for the last 6 months I have had a right heel problem. It started as a morning pain when I got out of bed each morning. The heel pain caused me to tip toe for a minute or two until it went away. More recently in addition, anytime I raise my feet to relax on the couch to watch tv for an hour a slight heel pain occurs, though it quickly goes away in seconds. Also recently I occasionally realize that I do feel slight discomfort in that right heel when walking during the day.
My GP suggests it is plantar facscitis. Do you agree?
And also is it possible I have a circulation problem since this issue mostly occurs after having the heel elevated?
ps, the raised feet heel pain is not while elevated but after getting up from the couch when I walk on it.
ReplyDeleteSounds like fasciitis overall based on your description but many conditions can cause similar symptoms and without examining you I can offer no concrete diagnosis. See a foot specialist for comprehensive treatment.
ReplyDeleteHi Dr Scott
ReplyDeleteThanks for a really informative blog.
I am early 40s and overweight but fit and active - running 20-25 Kms most weeks.
I have had varicose veins in my calf ever since I can remember but in my mid 30s they spread my my leg with blood pooling behind the knee and in 3 points up my thigh. There is no pain from this. However I often get night cramps in this calf - wake with lots of pain as if feels my calf is trying to turn itself inside out, and this leaves a swollen and tender calf for 12-36 hours.
I also had a bad sprain on my ankle about 4 years ago and the ankle on this leg is now bigger than the left side and weak.
Recently my calf is swollen - 3 - 4 cms bigger circumference than the left leg - but not painful at any time, even running. At the same time but I have a dull ache across the outside on the ankle joint and top of my foot and a strange sensation in my toes. They are not exactly numb but I have a strong desire to stretch them or wiggle them to 'improve circulation'.
The only thing I did differently last was a couple of days with long drives in traffic so overused the bad ankle. Could this be a circulation issue or could the old ankle injury cause the calf to swell and the toes to feel funny too?
The ankle injury should not cause any new symptoms. If your toes are feeling funny, you may be experiencing nerve compression from the swelling. The more recent swelling may even be a sign of a vein blood clot, which can be a serious health issue. Regardless, you should have a physician examine your legs as soon as possible.
DeleteThanks for the reply.
DeleteI have since seen a doctor, been referred and had surgery to remove / strip the saphenous vein in that leg. Ultra sound showed 'reflux' and 'chronic venous insufficiency' and the surgeon also talked about 'restless leg syndrome' and 'klippel-Trenaunay' syndrome (due to the appearance of veins from early childhood and the oversized leg). Interestingly I had an extra 'great saphenous vein (I.e there were 2 of them removed from my right leg).
Surgery 10 days ago so leg still bruised and swollen but hoping the swelling and strange feelings in my toes will disappear, and the circulation gets better throughout the leg.
Thanks again for taking the time to answer my question and I am glad I sought the medical advice as you sguggested.
My husband had hip surgery 16 months ago. He had a DVT history from several years prior to the surgery. First problem after his hip revision they over-prescribed the Coumadin within a week of surgery. Ended up in ER. Then they went the opposite way, stopped the Rx for Coumadin completely. Several weeks later he was back in ER and hospital with major clots in both legs. His legs/feet are damaged for blood flow. If he walks or stands for very long his legs and feet hurt,swell and/or the leg goes to sleep, this has been ongoing. About a week ago his one foot developed terrible pain at the bottom of the heal area. It is very painful just putting weight on it to walk. It worsens if he tries to walk even a short distance. There isn't any visible bruising. The only relief is to get off his feet and elevate them. Any recommendations? What kind of specialist?
ReplyDeleteIt sounds like there is a couple different problems which may not necessarily be related. The leg circulatory issue should probably be managed by a vascular specialist, and the heel pain should be evaluated by a podiatrist to rule out any injury or issue within the heel itself. Many different causes of heel pain in this situation and some times circulatory issues contribute to this pain as opposed to it being strictly from a heel problem- his doctor will need to assess the pain and come up with treatment recommendations.
DeleteI am a 50yr old male in good shape. The last year I have experienced pain on the top of both feet. The pain starts in late evening and is gone by morning. No discoloration or apparent swelling. Tried different shoes in case it was related but no success. Over the counter pain relievers don't seem to help. I remember my mother used to complain about the same thing. Xrays and bloodwork ruled out gout and arthritis.
ReplyDeleteStress reactions of the bones on the top of the midfoot due to compression from even mild foot flattening can cause similar symptoms, and would not show up on x-rays. An MRI would demonstrate the problem. Other potential problems include tendon inflammation/strain, and nerve compression.
DeleteI am 31 overweight and a smoker. I have been having the sharp pain in the bottom of my foot every morning when I wake up and my feet and calves are swollen all te time. I have also noticed little red marks on te sides of my feet now and red marks that look like bruising or little tiny veins popping out on my legs and calves. I know I need to go to the dr but I saw this blog and was hoping for some relief of my fears of a blood clot or something bad. What can I do
ReplyDeleteYou really do need to see a doctor. I can not offer you any concrete medical advice online regarding leg swelling and pain, especially for concerns as to whether or not you have something serious. If you are concerned you have a blood clot in the leg, you need to go to an ER. The foot pain may be unrelated, and subsequently can be treated by a foot specialist.
ReplyDeleteI am 41 and have just started getting pains in my toes and fingers. Mainly thumbs and big toes on both feet. I have had a blood test which revealed nothing so the doctor prescribed naproxen 500mg twice a day. Sounds like a fob off to me. What would you suggest next. thanks
ReplyDeleteMay be neurological, that would be a good place to start.
DeleteHi Doc
ReplyDeleteI am 23 and recently had surgery on my calves for deformity correction (bow leg). After surgery I spent several days in bed. I can't walk without a walker for a month but when I sit my feet turn dark red/purple. They hurt a lot and are numb to touch, though getting better. I feel pins/needles all the time, especially in bed.
I have Raynauds so I know poor circulation is probably a component. What do you think?
You need to discuss this with your surgeon as soon as possible, this is not normal even with Raynaulds and may be something more significant.
DeleteYou describe the symptoms of my mother's foot pain from adanced PAD very accurately. She is 92 so surgery is not an option. Are there non surgical ways to restore blood flow? You mention that there are nutrients that could help. Could you talk more about these? Thanks so much
ReplyDeleteThe nutrients I mentioned were referring to the chemicals, oxygen, and vital compounds delivered by the blood stream itself, not a supplement nutrient that can be taken by mouth. There is a medication that can change the pliability and shape of red blood cells to help them squeeze through tight arteries, otherwise there are limited options for non-surgical improvement of advanced blood flow loss.
DeleteWow, someone who understands my feet! At least I hope..I am 37, 190lbs, male, and just under 6ft. I have had pain in my feet since I can remember taking off my boots and raising them for relief, in the Marines. So...20 years of pain, everyday.
ReplyDeleteThe pain is in the whole bottom of my foot, and occasionally the calf, about half way up, when standing for long periods. It throbs, burns, completely disables me. I've asked my doctor about amputating both feet. My feet are always cold, I need neoprene socks when in cold weather.
Elevating my feet helps, but I mean above my head elevating. Just for a short time though. I've used every kind of opiate pain relief, but only tramadol works, and works particularly well. When the tramadol starts to wear off, the pain starts to come back, in sync. Nerve conduction tests have shown nothing. My neurologist has prescribed nortriptiline, which after 2 months has done nothing. The pain is even, in both feet, from the heel to the toes. They do look slightly purple, but nothing dramatic.
I hatE having to rely on tramadol. Which only really helps if I am not on my feet for too long. My feet are ruining my life. None of my doctors, so far, have been able to fix them. Does this sound like some sort of circulation issue? I have to figure this out, for my 4 year old.
If elevation helps, it is probably not poor circulation in the traditional sense (as this decreases blood flow to the foot), but may have to do with a mix of microcirculation issues during cold stimulus and a neurological disorder. You may want to see a pain management specialist for alternate options and a more specialized diagnosis, assuming a foot specialist has ruled out conditions like tarsal tunnel syndrome in the foot.
DeleteJoneser!! Get off the tramadol asap, I fractured my vert, while horse riding, started on 50mg then 150mg up to 400mg a day for 3 yrs!! Absolute nightmare!! Could not move any part of my body if I was due to take it!! Woke up in agony all over every morning, thought I had something very wrong, doctor saying no Tramadol not really addictive!!! My bum it's not, soon as I stopped I could not sleep or move at all for 2 weeks then took another 4 weeks to feel better! Pain everywhere, very grumpy and desperate behavious ! Never taking these again!!! Worst nightmare ever , harder than ciggs to stop as the body pain was chronic! Now no pain at all for me!!! Please google tramadol addictions!!!
DeleteWhat is the simple test called that you refer to as being able to determine whether it is a nerve or circulation problem?
ReplyDeleteIt is called an ankle-brachial index, and often is performed with an arterial doppler test. It is quick, noninvasive, and tests the general health of blood flow to the legs.
DeleteI am 61 years old and was an avid bowler. I recently had arthroscopic knee surgery to remove and repair some torn meniscus. About one week before the procedure I started getting a burning pain on the front of my ankle a little to the left of center. It was mostly happening while driving and while at work sitting at my desk. I would have to stand and put weight on it for about 30 seconds and it would go away. I thought it might be related to the knee problem. I had the surgery and I still have the pain when sitting. The length of time now is shorter and I find myself standing most of the time. It is causing some problems with my rehab of the knee. Doing a lot of the excersises are causing more pain in the ankle then the knee. Got any ideas of what kind of problem I have.
ReplyDeleteHard to say without examining the ankle. Usually foot or ankle pain of a burning nature while sitting often indicates a problem in the lower back if that same pain is not present during activity or actual use of the foot or ankle. You should have both your ankle and possibly lower back evaluated.
DeleteI had a MRI done to my back and my doctor has sent me to physical therapy for treatment. I have had four visits so far and do not see any change in the pain. I have a herniated disk which several years ago gave me pain in the opposite leg, but have not had any further problems with that side. I am going Saturday for a diabetes test. When I had the surgery on my leg they noted that my blood sugar was high and that I should see my regular doctor and check my history. I did that and he agreed that it was unusually high and sent me for this test. I have read that diabetes can cause ankle pain. I also think that it maybe a blood circulation problem. That when I sit that it restricts the flow of blood out of my leg. Is there an easy way of checking to see if that is the problem? Thanks for your help. I have been having this pain for two months now and it is getting to be mentally draining.
DeleteAnonymousAugust 22, 2012 7:52 AM
ReplyDeleteI am the bowler, age 61. This was my reply to your reply. Since you did not respond, I thought you may have missed my reply.
I had a MRI done to my back and my doctor has sent me to physical therapy for treatment. I have had four visits so far and do not see any change in the pain. I have a herniated disk which several years ago gave me pain in the opposite leg, but have not had any further problems with that side. I am going Saturday for a diabetes test. When I had the surgery on my leg they noted that my blood sugar was high and that I should see my regular doctor and check my history. I did that and he agreed that it was unusually high and sent me for this test. I have read that diabetes can cause ankle pain. I also think that it maybe a blood circulation problem. That when I sit that it restricts the flow of blood out of my leg. Is there an easy way of checking to see if that is the problem? Thanks for your help. I have been having this pain for two months now and it is getting to be mentally draining
RON-
DeleteI did receive your reply, but you have to understand I am very busy with my own patients and only have time to address the questions from my blog on a weekly basis.
That being said, decreased blood circulation out of the foot/leg, through venous channels, does not generally cause that type of pain. Leg and ankle swelling results from poor blood outflow, but pain is not typically a part of this picture until later on after a long period of chronic leg swelling. Diabetic neuropathy can cause foot, ankle, and leg pain/numbness/burning/tingling, although it is usually felt in both legs, not just one. You probably need to start with a foot/ankle specialist looking at your foot to rule out a specific ankle problem, and may need to see other specialists if that exam is negative and the problem is coming from nerve damage further up. I wish you a speedy recovery.
Thanks for your help. From the sounds of it, I can rule out the blood circulation problem and the diabetes. So it seems I am right back to the sciatic. My rehab on the knee is going pretty well, but like I said before, on some of the exercises the knee is fine but the ankle burns. I have to walk it off to go on to the next one. I guess I am going to have to have the ankle checked, but I still dont think anything is actually wrong with the ankle. I never had any previous pain there and did not injure it in any way. This is very frustrating.
DeleteI am a 44 year old female. I am a smoker though I am trying to quit. Over the past two years I have lost 170 lbs and have about 60 more to go. I never had any foot pain problems when I was heavier. In the last eight months I have started having issues ( mainly at night after I take my shoes off ) I get sharp stabbing pains in my toes that last a few seconds and go away then come back after a few minutes and are painful enough to make me cry. I also get a burning sensation in my feet and sometimes it feels like I'm wearing socks when I'm not. The only thing that seems to help is to get up and walk for about 30 minutes. Even if it's the middle of the night I have to get out of bed and take a brisk walk. Good for weight loss but not so good for staying awake the next day. Today I wore a pair of knee high stockings for the first time, fashion reasons not because of my feet ( not compression stockings ) and I notice a lot of relief tonight.. just a slight burning sensation but nothing like what I usually go thru at the end of the day. Also there is never any swelling, redness, discoloration of any sort. I do have varicose veins at the top of my thighs.. and I have to sit a lot for my job.. although I do work out every morning and I get up to walk around frequently. I am self employed and have no insurance and don't want to go to multiple doctors to get to the right one. So far my general practice doctor has been of no help, except to tell me that I'm not diabetic and I don't have high blood pressure. So where do I start? Foot doctor, orthopedic doctor, vein doctor or shrink? Sorry this was so long but I wanted to give you as much info as possible. I really appreciate any advice.
ReplyDeleteThank you.
Sounds like there is some form of nerve damage or neuropathy involved based on your symptom description. This can be due to lower back spinal disease, various forms of nerve disease from things like vitamin B and folate deficiency or thyroid disease, or multiple other causes. A nerve can be pinched in the ankle that can cause these symptoms, but they will typically appear when walking, not as much at rest. Varicose veins can possibly impinge on nerves, but again pain from this is not typically felt when inactive as opposed to when walking when the veins become engorged. However, it sounds like you did get some relief with some light leg compression from simple stockings, I can't say if that may be clinically relevant now since you only did it once. Unfortunately, you will probably have to see one or two specialists to find the cause if you primary care doctor is not helping. An interventional pain management specialist or neurologist may be a better place to start than a podiatrist, as the problem may not lie in your foot, although a podiatrist could certainly rule out any foot involvement.
ReplyDeleteI wish you a speedy diagnosis and recovery.
Hello there, I don't know if you are still answering responses to this article or not. I'm a 37 year old woman and I'm having some issues with what I THINK is my circulation. I've seen eight doctors in two months and none of them know what is wrong. I've seen a Cardiologist, a Neurologist,a Vascular Surgeon (at a Cosmetic Pain Center) 3 E.R. doctors, and 2 Pain Management doctors. I'm at a loss as to what is happening to me. The veins in my hands and feet are bulging, especially in the heat, my feet turn VERY red with very little time on my feet. Once my feet are rested they start to burn on the tops of them and the burning is moving up my calves. It's almost a numb/burning type feeling. I get muscle twitching when my feet are tired. I've also had large blue veins show up on my chest and on my left temple. The veins in my feet, especially my right foot are VERY visible now. The bulging veins in my hands are much worse in my right hand. My veins never bulged before in my life. When my hands hang by my sides they feel like my circulation has been cut off and they feel heavy and the veins are bulging badly. Any insight would be great. There are other symptoms but I've already taken up enough of your time.
ReplyDeleteI wish I had an easy answer for you but it sounds like your case is complex, possibly involving both circulation and the nervous system. Perhaps your family doctor should consider a referral to the Mayo clinic if no one else locally in multiple specialities can come up with a diagnosis.
DeleteMy father is 92 yrs old and has blocked arteries in his lower legs and veins leading to his feet. Surgery is out of the question. He has severe pain in his toes especially at night.
ReplyDeleteHe takes Alleve for pain but does not help much.
What can be done to alleviate this pain at night.
Unfortunately there is not much out there that can relieve the pain from poor circulation, even narcotics are often ineffective. It may be helpful to make sure his feet are not elevated at night, hanging them down often helps improve a little more blood flow in the arteries.
Deletemy problem started over 2yrs ago, it began with the sensation of heat in my thigh area and about 2 weeks later numbness came to the right leg then came the problem with the foot. for the first couple of months i felt heat but people that touched it said it was normal. i describe it like when i was a kid and went out and played in snow then run hot water over my hands to warm them. how it changes hot then cold and so much pain. it get worst at night when i get off it and get in bed. i am serverely over weight, have health problems but not diabetes. eve n though it runs in family i do have Fibro.
ReplyDeleteYour symptoms sound more like a neurological problem than a problem with circulation. You should have your family doctor begin to evaluate this condition.
DeleteDr. Kilberg,
ReplyDeleteMany thanks for this most helpful article. I've been trying to understand symptoms I have regularly in the many months since my angiogram in the right femoral artery last May. Both the angiogram and the ultrasounds of the cath site area showed healthy, normal results. I'm an active 40-year-old male with no other medical concerns.
Often when I wake up in the morning I feel tingling in my right foot. When I get up from the bed, I notice the right foot turns a deep red, but then goes away after several minutes. The tingling takes longer to subside, and usually improves with yoga and physical therapy exercises. Sometimes I will also feel numbness and a warmer temperature in my right quadricep upon waking, which also eventually subsides.
Is this an issue related to blood flow, or a pinched nerve, or something else? I'm able to walk fine, but sometimes the symptoms and discomfort in my right leg make me concerned. Thanks for any advice you may have.
Tingling, numbness, and warm/burning sensations are almost exclusively related to nerve disease of some sort, of which there are many causes. I recommend you get this evaluated, as it may progressively worsen.
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