Lower Extremities Situation

By way of background, I am a 59 year old male widower who lives in a northern state, and who retired within the last year from a sedentary job.  I consider myself to be in good health.  For instance, I am a former distance runner, and I still do 3-4 workouts per week that total 25-30 miles.  Additionally, I swim 5 days per week and do Pilates 2 times per week.

Within the last 2-3 years a rather peculiar situation has developed.  When I have been to an indoor concert, show or sporting event, and then go outside where it is colder, I develop considerable shakiness in the lower extremities.  

This begins almost immediately after going from the inside to the outside, and it gets progressively worse within only a few minutes.  Extreme wobbliness and unsteadiness are experienced to the point that I sometimes wonder whether I will make it to my car.  

The outside conditions do not necessarily have to be all that cold; even 40-50 degress will produce it.  Nevertheless, I run outside in the winter, and do not experience the aforementioned symptoms, not even when I go out running in the early morning.

It is only when I have been sitting for a few hours at an event, although getting up and moving around somewhat during intermissions, and then going outside at the conclusion, that this phenomena occurs.

I have not been medically examined or evaluated for this matter.  The only prescribed medication that I take is for an enlarged prostate.  Also, I take magnesium due to leg cramps secondary to running.

Based upon the above discussion, it would be appreciated if you would kindly provide an assessment.  Thank you.

[Kevin Pho, MD]

Difficult to say without evaluation.

Sometimes cold weather can produce vasospasm in the lower extremity vasculature - which may lead to your symptoms.

You can also evaluate the neurological system via a neurologist evaluation.  An EMG or other electrodiagnostic testing can also persue this avenue.

Peripheral artery disease can also be considered.  Non-invasive testing like ankle/brachial index as well as ultrasound testing.

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.
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