Help please...

Hi I have posted on here before but I have new issue lately.  I have noticed that when I stand or walk for any more than maybe 5 minutes my feet get hot and swollen (mostly the right one).  They look red (mostly on the toes) and feel warm to the touch.  My ankles don't really swell or my calves even though they also feel hot and heavy.  I have a whole lot of other neurological symptoms which have gone undiagnosed for over a year but this one is new to me. Up until now I have just really had paresethias in both legs but it didn't affect my walking much.  I would be interested to hear what this swelling could be.  Once I sit down or lay down the swelling goes down (esp if I elevate).  After too much walking or standing the swelling becomes painful and I have to rest.  I'm starting to get very scared but I keep going to the doctor for everything with no answers and they are starting to treat me like I'm crazy.  Please any insight?  

[S. Kaul, MD]

Hi there!

Well, without a detailed clinical evaluation it would be difficult to comment specifically on the issue. Discomfort and swelling of the feet on standing could be caused due to local issues such as joint inflammations, degeneration or systemic causes related to kidneys, liver, cardiac issues etc.  Other possibilities that may need to be considered include neuro-muscular causes such as neuropathies/ myopathies, micronutrient deficiencies etc. I would suggest a detailed initial evaluation by an internist and depending on the cause diagnosed/ suspected, it can be managed accordingly or specialist care may be sought.
Hope this is helpful.

Take care!