Vascular and Nerve Issues

In addition to injury and disease, pain, numbness, tingling, and other foot and leg problems can be caused by vascular and nerve issues. Some vascular and nerve issues may seem like minor nuisances; but if they remain untreated, they can lead to serious issues. The following are common vascular and nerve issues that can affect your feet or legs.

  • Acrocyanosis.

  • Alcoholic Neuropathy.

  • Chilblains.

  • Diabetic Neuropathy.

  • Erythromelalgia.

  • Ischemic Foot.

  • Neuroma.

  • Spasms.

  • Venous Stasis.

If you are suffering from nerve and vascular issues, you should visit your doctor for an examination and treatment.

Acrocyanosis

If your feet turn blue when exposed to cold, you may be experiencing the effects of acrocyanosis.

Acrocyanosis is a condition in which your feet and other extremities turn a bluish color in response to cold. The color change affects both sides of your body equally and takes time to reverse. The condition is painless but may be accompanied by localized swelling. Acrocyanosis often occurs by itself but can be associated with a more serious condition, such as a connective tissue disorder. Women are more often affected than men.

Causes of acrocyanosis

Acrocyanosis occurs when the small arteries are suddenly constricted. This reduces blood flow and the amount of oxygen being delivered to the feet and other extremities. Cold temperatures typically trigger the arteries to suddenly constrict, while emotional stress may worsen the symptoms.

There are two forms of the condition, primary and secondary. Primary acrocyanosis occurs by itself, apart from any other condition, while secondary acrocyanosis is associated with a more serious condition, such as a connective tissue disorder.

Acrocyanosis symptoms

Acrocyanosis is a painless condition which may involve:

  • Bluish discoloration of your feet that lasts for an extended period of time.

  • Cold, sweaty feet.

  • Localized swelling.

Treatment of acrocyanosis

Treatment for acrocyanosis typically involves keeping your feet warm and the blood circulating. To do this, cold temperatures should be avoided whenever possible. If you are suffering from acrocyanosis, you may also benefit from wearing insulated boots to keep your feet warm. Insulated socks or thin polypropylene liner socks that keep moisture away from your skin may also help.

Since acrocyanosis could be a sign of a more serious condition such as a connective tissue disorder, it is important to consult a doctor to determine if there is an underlying condition that requires treatment.

Alcoholic Neuropathy

There are several causes of muscle weakness or a tingling feeling in your feet. However, if you have a history of excessive alcohol consumption, these symptoms may be related to alcoholic neuropathy.

Alcoholic neuropathy is a disorder characterized by decreased nerve function that occurs as a result of drinking excessive amounts of alcohol. Individuals who have excessively consumed alcohol for 10 or more years are at the highest risk for developing the disorder. Alcoholic neuropathy is not life-threatening, but nerve damage is permanent and can cause a wide variety of symptoms that range from mild to severe. In addition to other areas and functions of the body, alcoholic neuropathy can cause issues with your feet and with muscles in your legs.

Causes of alcoholic neuropathy

The cause of alcoholic neuropathy is not completely clear, and there has been some debate regarding the exact cause. One theory is that the disorder is caused by ethanol itself while the other theory is that it is caused by nutritional deficiencies which are often associated with long-term alcohol abuse.

Alcoholic neuropathy symptoms

If you have alcoholic neuropathy, you may experience:

  • Burning in the feet.

  • Muscle cramps.

  • Muscle weakness.

  • Numbness.

  • Pain.

  • Tingling.

The disorder may also affect the nerves that control bodily functions and cause other symptoms including:

  • Constipation.

  • Diarrhea.

  • Difficulty urinating.

  • Incontinence.

  • Vomiting.

Treatment of alcoholic neuropathy

Nerve damage that results from alcoholic neuropathy is usually permanent, but the symptoms can be treated. The first step to treating the condition is to limit or avoid alcohol intake in order to prevent further nerve damage. Vitamin supplements should also be taken to ensure proper nutrition. The next step is to work on controlling symptoms.

Pain Treatment

The pain associated with alcoholic neuropathy can often be controlled with over-the-counter pain relievers. Anti-depressants or anticonvulsant medications may also be helpful if you are suffering from sharp, stabbing pains.

Muscle Weakness Treatment

If you are suffering from muscle weakness, you may benefit from using splints to help support weak limbs and improve movement. Physical therapy can also help to increase the strength of weakened muscles.

Because numbness is often a symptom of alcoholic neuropathy, it is important to check regularly for cuts and sores, and be particularly careful to prevent injury.

If you or a family member is suffering from alcoholic neuropathy, consult a physician to determine the full extent of the nerve damage and the most appropriate treatment options.

Chilblains

If exposure to cold temperatures creates small, itchy bumps on your toes and other areas of your feet, you may be suffering from chilblains.

Chilblains, also known as pernio and perniosis, are small, itchy red swellings that form on the toes and pressure areas of the feet several hours after being exposed to cold temperatures. The lesions change in color from red to blue at which time they also become painful and inflamed. Chilblains are the result of an abnormal reaction to cold temperatures and usually affect individuals in the winter months. Women are more likely to suffer from chilblains than men.

Causes of chilblains

Chilblains are the result of an abnormal reaction to cold temperatures in which the blood vessels do not respond quickly enough to a change from cold to hot. When it gets cold, the small blood vessels constrict; if your feet are warmed again too quickly and the blood vessels don't respond fast enough, blood leaks into the tissues causing chilblains.

The exact cause of chilblains is not fully known, but some people are more susceptible to the disorder, including individuals who:

  • Are affected by anemia.

  • Are experiencing hormonal changes.

  • Consume a diet of poor nutritional choices.

  • Have a connective tissue disorder or a bone marrow disorder.

  • Have poor circulation.

Chilblains symptoms

Chilblains begin as small, itchy, red, swollen bumps on the toes and pressure areas of the feet that form several hours after exposure to cold temperatures. The itching usually intensifies when going into a warm room or heated area. These bumps then turn from red to dark blue and become painful and inflamed. The skin may also become dry and begin to crack, which can increase the risk of infection.

Treatment of chilblains

Once chilblains develop, they may itch, but it is important to avoid scratching the sores. Cortisone creams can be applied to the area to relieve itching. Another important part of treatment is improving circulation. Applying lotion to the skin can help stimulate circulation and moisturize the skin to prevent cracking. If the skin does crack, be sure to keep the area clean to prevent infection.

A recurrence of chilblains can often be prevented by keeping the feet warm. This can be done by wearing thermal or insulating insoles in cold temperatures. If the feet do get cold it is important to warm them gradually to help the blood circulate. Wearing socks can help warm the feet slowly, but avoid putting them directly in front of a heat source, as this may warm them too quickly.

Diabetic Neuropathy

Loss of sensation in your feet may be caused by several different factors. However, if you are diabetic, numb or tingling feet may be an indication of nerve damage caused by diabetic neuropathy.

Diabetic neuropathy is a complication of diabetes in which high blood sugar (glucose) levels damage the nerves. Nerve damage may be temporary or permanent and can involve a range of symptoms including foot pain, numbness, muscle weakness, and muscle cramps. Other nerves throughout the body such as those that control bodily functions may also be affected.

Diabetic neuropathy typically occurs 10 to 20 years after you are diagnosed with diabetes. If you are a diabetic and do not have your blood sugar levels well-controlled, you have an increased risk for diabetic neuropathy.

Causes of diabetic neuropathy

Nerve damage associated with diabetic neuropathy is caused by high glucose levels. However, other factors that contribute to the disorder include abnormal blood fat levels, low insulin levels and a genetic predisposition to nerve disease. The risk of diabetic neuropathy increases the longer you have diabetes. However, diabetics who have not kept their blood sugar level under control and those who smoke or consume alcohol are more likely to suffer nerve damage.

Diabetic neuropathy symptoms

Symptoms of diabetic neuropathy affecting the feet include:

  • Loss of sensation

  • Tingling

  • Burning

  • Pain

  • Numbness

  • Muscle weakness

  • Muscle cramps

The disorder may also affect the nerves that control bodily functions and cause other symptoms including:

  • Constipation

  • Diarrhea

  • Vomiting

  • Incontinence

  • Difficulty urinating

  • Dizziness

Treatment of diabetic neuropathy

While there is no cure for diabetic neuropathy, the condition can be managed. Treating diabetic neuropathy begins by controlling blood sugar levels. This can be done by taking insulin and medication as prescribed. It is also important to maintain a healthy weight by eating a well-balanced diet and exercising regularly.

The next step is to treat the symptoms associated with the condition.

Treating pain and muscle weakness

Pain can usually be treated with over-the-counter medication, but anti-depressants may be more effective for sharp pains. Muscle weakness can often be treated by using a splint to support the weakened muscle.

Avoiding infections

Since the feet often become numb as a result of nerve damage, it is important to protect them from injury and check them regularly for cuts or sores. If a sore develops, wash the area and keep it clean to prevent infection. If there are any signs of infection seek medical attention as soon as possible.

It is important for those suffering from diabetes, especially when there are complications such as diabetic neuropathy, to be under the care of a medical professional. Consult your doctor for more information about the symptoms of diabetic neuropathy and the treatment options available.

Erythromelalgia

If your feet become inflamed or have a burning sensation triggered by warmth, the culprit may be erthromelalgia.

Erythromelalgia is a disorder of the arteries that causes pain and inflammation of the feet. Symptoms may be mild or debilitating and can last from a few minutes to several hours. Erythromelalgia can affect individuals in all decades of life, but usually affects individuals 20 years of age or older.

Causes of erythromelalgia

Erythromelalgia may occur as a primary or secondary disorder.

Primary erythromelalgia

The primary form of erythromelalgia is not associated with another condition, and the cause is usually unknown. In rare cases, the disorder is inherited, and symptoms present themselves during childhood.

Secondary erythromelalgia

Secondary erythromelalgia is associated with an underlying condition. Myeloproliferative (bone marrow) disorders such as polycythemia vera or thrombocythemia are the most common causes of secondary erythromelalgia. However, erythromelalgia often occurs two or three years before a myeloproliferative disorder can be diagnosed.

Secondary erythromelalgia can also be associated with other conditions including:

  • Certain medications (i.e. bromocriptine, which is used to treat Parkinson's disease).

  • Diabetes mellitus.

  • Gout.

  • Hypertension.

  • Lead poisoning.

  • Lichen sclerosus.

  • Multiple sclerosis.

  • Rheumatoid arthritis (RA).

  • Spinal cord disorders.

  • Systemic lupus erythematosus (SLE).

  • Venous insufficiency.

Erythromelalgia symptoms

In both primary and secondary erythromelalgia, symptoms are typically triggered by warmth and may include:

  • Inflammation.

  • Itching that progresses to burning pain.

  • Redness.

  • Warm skin.

Episodes of erythromelalgia may last anywhere from a few minutes to a few hours. Symptoms may remain mild or become more severe over time. In some cases, the pain can be debilitating, and individuals may not be able to walk during an episode.

Treatment of erythromelalgia

During an episode of erythromelalgia, it is important to rest and elevate your feet. Keeping your feet cool can help to relieve symptoms. This can be done by applying an ice pack or placing your feet in cold water. Warming the affected area should be avoided however, as this can exacerbate symptoms. If an underlying condition such as a myeloproliferative disorder is the root cause of erythromelalgia, aspirin may help to relieve the symptoms.

Individuals with secondary erythromelalgia can prevent another episode by treating the underlying condition. To determine whether you have primary or secondary erythromelalgia, consult your physician.

Ischemic Foot

If your feet are constantly cold or discolored, you may be suffering from ischemic foot or another circulatory issue.

Ischemic foot refers to inadequate blood flow to your foot due to poor arterial circulation. Without sufficient blood flow, your foot does not receive the necessary oxygen and nutrients for the cells to function properly. As a result, sores on your foot may never fully heal, and if left untreated, the tissue may eventually die and require amputation.

Causes of ischemic foot

The most common cause of ischemic foot is atherosclerosis, a buildup of plaque in the arteries. Arterial build up is commonly seen in individuals who have hypertension (high blood pressure), hypercholesterolemia (high cholesterol), or diabetes.

Some other less common causes of ischemic foot include arterial blood clots, arterial spasms, and arterial injuries.

Ischemic foot symptoms

Symptoms of ischemic foot in its early stages may include:

  • Cold feet.

  • Muscle cramps after walking.

  • Purple or red discoloration of your toes.

  • As the condition becomes more advanced, symptoms may include:

  • An ischemic ulcer or a sore that won't heal.

  • Burning pain in the ball of your foot and toes while resting.

  • Gangrene or tissue death.

Treatment of ischemic foot

In its early stages, ischemic foot can be treated by increasing blood flow to your feet and protecting the skin in order to prevent sores from forming. Exercise such as walking can help increase blood flow. Medication may also be prescribed to promote better circulation. Walking in bare feet should be avoided as this can increase the risk of injury. Instead, socks, comfortable shoes, or insoles should be worn to prevent rubbing and irritation which can lead to ulcers.

As symptoms of ischemic foot worsens or if there is a risk of gangrene (tissue death), surgery might be necessary to avoid amputation. Surgery is usually performed to either clear the blockage or bypass the artery. There are risks associated with surgery, so it is important to consult a physician to determine if surgery is the most appropriate treatment option for you.

Neuroma

If you are experiencing a stabbing pain, burning, or numbness in the toes, you may be suffering from a neuroma.

A neuroma is a swelling and thickening of nerve tissue caused by pressure or trauma. The most common type of neuroma affecting the feet is Morton's neuroma which develops in the area between the third and fourth toes. Fortunately, neuromas are benign and treatable.

Causes of a neuroma

Anything that irritates or compresses a nerve in the feet can cause neuromas. Compression in a confined space leads to enlargement of the nerve, which can eventually cause permanent nerve damage.

High heels and narrow toe boxes
Neuromas are more common in women than men, largely because one of the most common causes of neuromas is poorly fitting shoes. Wearing high-heeled shoes or any type of shoe that has a tapered or narrowed toe box can force the toes together, compressing the nerves on all sides.

Abnormal foot structure
Abnormal foot structure can also lead to the development of neuromas. People with bunions, flat feet, and hammertoes are all at a higher risk of developing neuromas.

Injury or trauma
Trauma may also lead to neuromas. Injury from a puncture wound, laceration, or the cutting of a nerve during foot surgery can all damage the nerves, resulting in the development of a neuroma.

Neuroma symptoms

The most common symptom of a neuroma is localized pain where the nerve damage is occurring. If you have Morton's neuroma, the pain will occur in the space between the third and fourth toes. You may also experience the following in the affected area:

  • Burning sensation.

  • Cramping.

  • Sensation of something inside the ball of the foot.

  • Sensation of something stuck in your shoe.

  • Sharp or stabbing pain.

  • Tingling and numbness.

Symptoms associated with neuromas will appear gradually. At first, the pain may only be aggravated by wearing narrow or high-heeled shoes. The pain may go away after you remove your shoes and massage the foot. Over time, pain will become more intense and can persist for days, even weeks, without abating.

Neuroma treatment

Neuromas will respond to treatment if detected early. Mild to moderate neuromas can be treated with the following:

  • Activity modification.

  • Anti-inflammatory drugs to reduce pain.

  • Changes in shoe wear (avoid high heels and shoes with a narrow toe box).

  • Cortisone injections (to shrink swelling of the nerves).

  • Metatarsal pads (to take pressure off the nerves).

  • Orthotic devices.

  • Rest and icing.

If conservative treatment does not relieve symptoms, surgery may be necessary. Surgery can involve cutting the intermetatarsal ligament or removing the thickened nerve.

Your physician will be able to recommend a long-term treatment plan to keep neuroma symptoms from returning.

Spasms

Hand and foot spasms, or carpopedal spasms, are a common complaint. Almost everyone has experienced a hand or foot spasm at one time or another. They can be brought on by everything from overexertion to use of certain medications.

Despite how common spasms can be, it is important to realize that frequent hand and foot spasms can also be a sign of a more serious condition, tetany, which is caused by a severe degree of hypocalcemia (low calcium levels in the blood).

Causes of spasms

The medical conditions listed below can all cause carpopedal spasms. There may be additional factors involved, so it is best to consult a physician for a comprehensive diagnosis.

  • Huntington's disease.

  • Hyperventilation (the body loses calcium temporarily).

  • Hypocalcemia (low calcium levels in the blood).

  • Medications.

  • Multiple sclerosis.

  • Muscle cramps (usually caused by overexertion, dehydration, or holding the hands and feet in a flexed position for a prolonged period).

  • Parkinson's disease.

  • Thyroid disorders.

Spasms symptoms

Carpopedal spasms are characterized by severe contractions of the hands and feet. The spasms may also be accompanied by the following:

  • Convulsions.

  • Fatigue.

  • Muscle cramping.

  • Muscle weakness.

  • Numbness or tingling (pins and needles feeling in the toes, fingers, and around the mouth).

  • Twitching.

  • Uncontrolled movement.

Carpopedal spasms can be violent and extremely painful. If you are experiencing recurrent spasms, contact a doctor immediately.

Spasms treatment

Hand and feet spasms may be a symptom of a more serious condition. If you notice spasms occurring on a regular basis, your doctor will likely conduct several diagnostic tests to determine the cause including blood tests to measure calcium, magnesium, and Vitamin D levels, kidney function tests, and hormone level testing.

If you are suffering from hypocalcemia, treatment will likely include Vitamin D and calcium supplements. Consult a physician to learn more about the treatment options for recurrent carpopedal spasms.

Venous stasis

If you are experiencing swelling in your legs and ankles, you may be suffering from venous stasis.

Venous stasis, or venostasis, refers to diminished blood flow in the veins of the legs and feet. The condition is characterized by enlarged veins, swelling, and accumulation of fluid in your lower legs.

If left untreated, the skin of your lower extremities will eventually break down, resulting in venous stasis ulcers. Patients with venous stasis are also more prone to developing blood clots, particularly in the deep veins of the legs.

Causes of venous stasis

Venous stasis is caused by an accumulation of excess fluid in the legs. This occurs when blood flow from the lower extremities to the heart is restricted. As a result, blood begins to pool and fluid begins to build up in the legs and feet, resulting in pain and severe swelling.

Venous stasis can occur following injury to the veins or following a blood clot. Swelling and fluid accumulation are also associated with certain medical conditions, including:

  • Congestive heart failure.

  • Coronary artery disease.

  • Kidney disease.

Pregnancy may also contribute to restricted blood flow to the extremities.

Venous stasis symptoms

Venous stasis is a progressive condition. Initially there may be swelling of your legs and ankles, as well as enlarged veins, or varicose veins. The accumulation of fluid causes a feeling of fullness in your legs and you may experience tiredness and aching, particularly when standing.

As blood continues to pool in your legs, skin can become stained from the inside, resulting in a change in pigmentation known as venous stasis dermatitis. In severe cases, skin will begin to stretch and lose its elasticity. Open wounds or sores can develop; these are known as venous stasis ulcers.

Venous stasis treatment

Treatment of venous stasis begins with rest and elevation of your feet and legs. The ideal position is to place your feet above the level of your heart. This allows for unrestricted blood flow from the legs back toward the heart.

To control swelling and fluid build-up, your doctor may recommend compression stockings of varying strengths or prescribe diuretics.

In severe cases, surgical removal of veins may be necessary. Treatment for advanced venous stasis may also include care of any open sores or wounds.

 

Glendale Podiatry

 

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