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What Causes Tingling Sensation In The Foot While Having Raynaud's Disease?
Question: I hope so.... This is a question concerning my sister. She is having trouble with her leg and foot. The foot
tingles and is painful on the bottom. She does not have diabetes. She does have Raynauds syndrome in her
hands (so do I by the way), but she has not had an episode in some time. Her doctor has tried some sort of
'doppler' test on her veins in her legs/feet. In her good leg the test on the big and little toe makes a loud noise.
On her bad leg and foot the same test on her big and little toe makes no noise. What tests they have run
do not show any veins...the doctor says they are too small. Therefore, he cannot see where any blockage
for blood flow is coming from. He even tried to cut 3 small incisions to possibly put a splint in the veins higher up on her leg. He said he could not find any veins?? They are starting to talk about cutting off a few
toes!! This current doctor was recommended by a podiatrist. What type of specialist should she be talking
to? Is there anyone, or anything, that can deal with such small veins?
Please let me know. We are in the St XXXXXXX area - Barnes Hospital seems to have the best technology, I guess.
XXXXXXX XXXX
tingles and is painful on the bottom. She does not have diabetes. She does have Raynauds syndrome in her
hands (so do I by the way), but she has not had an episode in some time. Her doctor has tried some sort of
'doppler' test on her veins in her legs/feet. In her good leg the test on the big and little toe makes a loud noise.
On her bad leg and foot the same test on her big and little toe makes no noise. What tests they have run
do not show any veins...the doctor says they are too small. Therefore, he cannot see where any blockage
for blood flow is coming from. He even tried to cut 3 small incisions to possibly put a splint in the veins higher up on her leg. He said he could not find any veins?? They are starting to talk about cutting off a few
toes!! This current doctor was recommended by a podiatrist. What type of specialist should she be talking
to? Is there anyone, or anything, that can deal with such small veins?
Please let me know. We are in the St XXXXXXX area - Barnes Hospital seems to have the best technology, I guess.
XXXXXXX XXXX
Brief Answer:
Needs perfect diagnosis before surgery.
Detailed Answer:
Hi XXXX,
Thanks for the query under Health care magic . I have read it & understand your problem.
I feel before they take her for cutting of few toes... which do not show any color changes/ signs of loss of blood supply ( blue or black with loss of senses)- The amputation of toes can be done with signs of no vascularity/ gangrene only.she should be reevaluated specially for the cause of her trouble .
* Possibility of Raynaud's disease needs to be considered as a possibility.. with probable small veins which could not be traced in the test done.
- Alternatively Color Doppler testing with USG would give more specific results.
- Raynaud's being an auto immune disease,Antinuclear antibodies test & ESR test would support the possibility
* I would advise to get her investigated for her spinal problem . Spinal stenosis / disc problem can cause pain in the leg which she had before, extending down to foot as the nerve compression remains unattended/ gets advanced. This can cause tingling sensation in foot ( which is seen in Raynaud's after the warming of the part is done ) & foot pain can represent stress on arch of foot.
She should be investigated with MRI to note the extent of nerve compression. Consult a spinal surgeon for this
* Management -
If it's Raynaud's disease.. she may be offered with specific medicines/Blocking or removing sympathetic nerve supplying blood vessels & avoid spasm( by injections.. which need to be repeated / by surgery ). She would in that case need a physician/neurosurgeon
In case it turns out to be spinal - NSAID drugs, steroids,physiotherapy Or surgery would be the options .. selection to be done according to severity & cause .
I hope, that answers your query & is helpful for planning the management.
Any follow up query is welcome.
Thanks.
Needs perfect diagnosis before surgery.
Detailed Answer:
Hi XXXX,
Thanks for the query under Health care magic . I have read it & understand your problem.
I feel before they take her for cutting of few toes... which do not show any color changes/ signs of loss of blood supply ( blue or black with loss of senses)- The amputation of toes can be done with signs of no vascularity/ gangrene only.she should be reevaluated specially for the cause of her trouble .
* Possibility of Raynaud's disease needs to be considered as a possibility.. with probable small veins which could not be traced in the test done.
- Alternatively Color Doppler testing with USG would give more specific results.
- Raynaud's being an auto immune disease,Antinuclear antibodies test & ESR test would support the possibility
* I would advise to get her investigated for her spinal problem . Spinal stenosis / disc problem can cause pain in the leg which she had before, extending down to foot as the nerve compression remains unattended/ gets advanced. This can cause tingling sensation in foot ( which is seen in Raynaud's after the warming of the part is done ) & foot pain can represent stress on arch of foot.
She should be investigated with MRI to note the extent of nerve compression. Consult a spinal surgeon for this
* Management -
If it's Raynaud's disease.. she may be offered with specific medicines/Blocking or removing sympathetic nerve supplying blood vessels & avoid spasm( by injections.. which need to be repeated / by surgery ). She would in that case need a physician/neurosurgeon
In case it turns out to be spinal - NSAID drugs, steroids,physiotherapy Or surgery would be the options .. selection to be done according to severity & cause .
I hope, that answers your query & is helpful for planning the management.
Any follow up query is welcome.
Thanks.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you Dr. Athavale,
The first question concerns myself I posted awhile ago, leg problems. The second, most recent question shown above concerns my sister - foot and leg problems. I will suggest to my sister the Color Doppler testing with USG and
Antinuclear antibodies test & ESR test in case it is from the Raynauds.
Thanks, XXXXXXX XXXX
The first question concerns myself I posted awhile ago, leg problems. The second, most recent question shown above concerns my sister - foot and leg problems. I will suggest to my sister the Color Doppler testing with USG and
Antinuclear antibodies test & ESR test in case it is from the Raynauds.
Thanks, XXXXXXX XXXX
Brief Answer:
Consult an Orthopedic surgeon.
Detailed Answer:
Hi XXXX,
Thanks for feed back... sorry I was mislead about the previous query you asked being about your own. Let me clarify it now,
It's good you have picked up the tip & are ready to undergo some noninvasive investigations to affirm the symptoms to be due to Raynaoud's.( those test indicate presence of auto immune disease & Raynoud' is one. So the tests help doctor to confirm the suggestive symptoms being due to Raynoud's disease.)
Any how, Mr. XXXX, I would insist exclusion of nerve involvement as a cause of symptoms... as it is a commonest cause for the symptoms.( The damage can be at spinal level/ hip or lower down at local level . She needs investigations like MRI/ nerve conduction tests.. whatever the orthopedic surgeon suggests.)..-for the treatment plan totally changes with this diagnosis.
I hope you understand the thing.Any more suggestions you need I am open to discuss... please don't hesitate to ask.
Thanks.
Please grade the answer before you close the query.Thanks once more.
Consult an Orthopedic surgeon.
Detailed Answer:
Hi XXXX,
Thanks for feed back... sorry I was mislead about the previous query you asked being about your own. Let me clarify it now,
It's good you have picked up the tip & are ready to undergo some noninvasive investigations to affirm the symptoms to be due to Raynaoud's.( those test indicate presence of auto immune disease & Raynoud' is one. So the tests help doctor to confirm the suggestive symptoms being due to Raynoud's disease.)
Any how, Mr. XXXX, I would insist exclusion of nerve involvement as a cause of symptoms... as it is a commonest cause for the symptoms.( The damage can be at spinal level/ hip or lower down at local level . She needs investigations like MRI/ nerve conduction tests.. whatever the orthopedic surgeon suggests.)..-for the treatment plan totally changes with this diagnosis.
I hope you understand the thing.Any more suggestions you need I am open to discuss... please don't hesitate to ask.
Thanks.
Please grade the answer before you close the query.Thanks once more.
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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