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What Causes Progressive Odd Discomfort In Right Foot While Walking?
Question: Hi, I am experiencing a very odd sensation in my right lower leg above the ankle. I have had it now for 3 days. It's not exactly numb or tingling but feels more like something is brushing up against my skin. It is not painful, red or swollen and only affects my right leg. It seems to get worse when I walk. I am a 65 year-old male, 5'9", 200 lb. I have high cholesterol controlled by statins, very mild emphysema, severe sleep apnea. I also have moderate-advanced degenerative change involving the L3-4 through L5-S1 levels with space narrowing, subchondral sclerosis, and facet arthropathy. There is grade 1 spondylolisthesis at the L5-S1 level. There are more mild degenerative changes involving the remainder of the lumbar spine. I was a smoker for 40 years and quit 3 years ago. I believe it could be some kind of neuropathy but want to rule out anything more serious. Your thoughts?
Brief Answer:
Read below.
Detailed Answer:
I read your question and I understand your concern, considering also the many accompanying conditions you have.
Looking at the localization that you describe it doesn't sound like polyneuropathy. Peripheral polyneuropathy usually is bilateral, symmetrical, starting from the feet, and working its way up (socks like distribution).
So that leaves the possibility of involvement of an individual nerve or nerve root. That location is covered by the peroneal nerve and L5 nerve root. However, while you seem to have a predisposition to them (esp L5 compression considering your spine issues), the compression of any of them would involve a wider area than you describe and also be accompanied by other signs such as weakness or pain. Nevertheless if the symptom persists nerve conduction studies are recommended to look for those two causes. Since I don't consider them very likely I'd give it some more time though, it might just regress by itself.
Another explanation could be in relation to superficial veins changes which are common with age and extra weight (judging by your height and weight you are overweight). They should show visible changes though in your superficial veins and skin.
Anyway in any of those scenarios it's not serious and that presentation doesn't suggest any other serious condition.
I remain at your disposal for other questions.
Read below.
Detailed Answer:
I read your question and I understand your concern, considering also the many accompanying conditions you have.
Looking at the localization that you describe it doesn't sound like polyneuropathy. Peripheral polyneuropathy usually is bilateral, symmetrical, starting from the feet, and working its way up (socks like distribution).
So that leaves the possibility of involvement of an individual nerve or nerve root. That location is covered by the peroneal nerve and L5 nerve root. However, while you seem to have a predisposition to them (esp L5 compression considering your spine issues), the compression of any of them would involve a wider area than you describe and also be accompanied by other signs such as weakness or pain. Nevertheless if the symptom persists nerve conduction studies are recommended to look for those two causes. Since I don't consider them very likely I'd give it some more time though, it might just regress by itself.
Another explanation could be in relation to superficial veins changes which are common with age and extra weight (judging by your height and weight you are overweight). They should show visible changes though in your superficial veins and skin.
Anyway in any of those scenarios it's not serious and that presentation doesn't suggest any other serious condition.
I remain at your disposal for other questions.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hello Dr. Taka,
Thank you for the information. It was quite helpful. I was a little worried that it might be a bloot clot or peripheral artery disease. Is there anything I should or should not be doing or anything to look out for if it gets worse?
Thank you for the information. It was quite helpful. I was a little worried that it might be a bloot clot or peripheral artery disease. Is there anything I should or should not be doing or anything to look out for if it gets worse?
Brief Answer:
Read below.
Detailed Answer:
Your worries are more than justified.
Vessel disease did cross my mind but that symptoms is not typical.
Varicose veins or a superficial vein phlebitis as I mentioned are visible. There is the possibility of deep vein thrombosis but pain in the calf and/or leg is a prominent symptom and often accompanied by mild swelling, local temperature.
In peripheral artery disease again pain is a prominent symptom, it's a deep seated pain, usually in the calf muscle, exacerbated by walking. At times signs like lack of pulse, pallor, low skin temperature are present as well, though perhaps more discernible by a physician.
So as you can see, since you mention there not to be any pain, redness or swelling, vessel disease is unlikely.
All I can recommend is look out for any of those features which I mentioned appearing (as you already seem to have done) and continue your usual activity.
I hope to have been of help.
Read below.
Detailed Answer:
Your worries are more than justified.
Vessel disease did cross my mind but that symptoms is not typical.
Varicose veins or a superficial vein phlebitis as I mentioned are visible. There is the possibility of deep vein thrombosis but pain in the calf and/or leg is a prominent symptom and often accompanied by mild swelling, local temperature.
In peripheral artery disease again pain is a prominent symptom, it's a deep seated pain, usually in the calf muscle, exacerbated by walking. At times signs like lack of pulse, pallor, low skin temperature are present as well, though perhaps more discernible by a physician.
So as you can see, since you mention there not to be any pain, redness or swelling, vessel disease is unlikely.
All I can recommend is look out for any of those features which I mentioned appearing (as you already seem to have done) and continue your usual activity.
I hope to have been of help.
Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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