Questions posted in the Neurology and Neurosurgery Forum have been answered by doctors from The Cleveland Clinic Foundation.

Subject: Re: Raynaud's phenomenon
Forum: The Neurology and Neurosurgery Forum
Topic Area:
Posted by CCF Neuro MD on June 10, 1997 at 11:40:00:
In Reply to: Raynaud's phenomenon posted by Barbara Shelton on June 04, 1997 at 00:06:15:


: I had back surgery approximately one year ago. Since this proceedure was done-fusion at L4-L5 and S1-my right foot has been cold incomparison to the other foot. The surgery required a vascular surgeon. The proceedure was done both through the front and the back. My doctor thinks that a nerve was damaged during the surgery and that since the condition has not improved in the year's time it most likely will never. My question, is this Raynaud's phenomenon or is this nerve damage and should I be concerned with the difference in temperature. During the winter months the discomfort is great. My right foot tends to "freeze" when we go to the mountains. I am concerned and would like to know if there is any testing to be done to make sure that all is a ok and there is no danger to my toes or foot.



Hello Barbara,

I am a bit confused as to what type of surgery you had and what part the vascular surgeon played in your treatment. However, there are a number of possibilities that could cause the symptoms that you are experiencing. Raynauds phenomenon is a condition in which typically affects the digits of your hands or feet and causes them to change color and temperature either spontaneously or in response to a change in ambient temperature. The digits can become red then change to blue then become pale in a matter of minutes. It is often associated with various rheumatologic disorders that are termed connective tissue disease although it can occur in isolation. These disorders falls in the realm of rheumatology and not neurology so I would suggest you speak to a rheumatologist for further information.
With your complaints that your entire foot is involved I would expect that your doctors would be interested in making sure that you do not have a decrease in blood supply to your foot. This could be caused by either an emboli (clot) in one of the arteries of your leg or by a blockage in the artery from atherosclerosis. This problem can be evaluated in part by a ultrasound test of the arteries of your leg and also by more involved and invasive tests such as an arteriogram.
The other possibility that was mentioned by your doctor is that these problems were produced by nerve damage. This falls in the category of disorders termed reflex sympathetic dystrophy and causalgia in which ther is pain and alteration of temperature and color in the affected limb. This disease likely represents a mixed bag of various different disorders. It can be a challenge to diagnose correctly as well as treat.
This information is provided for general medical education purposes only. Please consult your physician for diagnostic and treatment options of your specific medical condition.

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