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Family Medicine (Expert Forum)
Bilateral foot problems
Answered by
Kevin Pho, MD - Internal Medicine
Kevin Pho, MD
Boston - MA
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Bilateral foot problems
by Jigger26, Jun 24, 2005 12:00AM
I'm a 35 year old marathon runner. I have been running 60 miles weekly for about 17 years.Lots of wear and tear on the body. About six months ago I developed burning,swelling, and tingling sensations bilaterally in my feet. This had actually been present for years but just got more noticeable. I had every test run known to man. MRI of C,L,and T spine. Bloodwork--no thyroid or glucose problems. We found that my L5-S1 is completely collapsed with severe bilateral foraminal stenosis. So my doctor felt we had our answer. I have started to worry that I might have a circulation issue. This is why. My feet will sometimes get cold and sting. I recently found that on my left foot I have a more dominant ankle pulse than the pedal pulse. I have a pedal pulse, but it is hard to find and not as strong as the one on my right foot. Both feet have very strong ankle pulses. My physician(who is my best friend) said that there is no way I have a circulatory issue. He said the structure of my foot just makes the pulse hard to feel. He said let it go that the stenosis is the problem and tight hamstring What do you think? The rest of the pulse in my body boom. Pulse is resting about 55-70. No cramping in calves or intermittent claudication. Could hamssting tightness cause tingling problems. Physical therapist working on my stenosis said she has never seen tighter hams ever!!!!!!
Doctor's Answer
by Kevin Pho, MD, Jun 26, 2005 12:00AM
, Jun 26, 2005 12:00AM
If pulses can be felt in both feet with the fingers, it is unlikely that a circulatory problem is present. You can consider measurement of the ankle-brachial index, segmental pressures and pulse volume recording amplitudes - all non-invasive tests to evaluate for peripheral vascular disease.
Physical therapy is reasonable - if there continues to be symptoms, you can consider a referral to a physiatrist (rehabilitation physician).
With the MRI findings, you can consider a neurosurgical evaluation to determine whether you have any surgical options.
These options can be discussed with your personal physician.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
Medical Weblog:
kevinmd_b
Physical therapy is reasonable - if there continues to be symptoms, you can consider a referral to a physiatrist (rehabilitation physician).
With the MRI findings, you can consider a neurosurgical evaluation to determine whether you have any surgical options.
These options can be discussed with your personal physician.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
Medical Weblog:
kevinmd_b
