leg problems

[Colleen P.]

Dear Doctor,

I am 26 years old and have recently been having problems with my legs falling "half asleep" when I stand or walk for a long period of time.  It starts in my feet and then works its way up to my calves and finally my thighs.  They also feel stiff and heavy, as though I am walking through water.  My feet and legs are also very sensitive to cold, such as air conditioning in a car.  They will go numb and fall asleep or get pins and needles as soon as cold air blows on them.  These problems appear to affect me for a while, and then disappear for a while, only to return later in greater severity than before.  I am wondering what you think could be causing these problems?  I am confident that it is not simply my socks or shoes as I have changed these around, but I do have narrow, flat feet and wonder if this could be a factor.  Could a problem with my back cause troubles like this?

Many thanks,
Colleen P.

[CCF Neuro[P] MD, RPS]

Dear Colleen:

Sorry to hear about your leg problems.  I must tell you that there are a myraid of things that can cause a peipheral sensory neuropathy (if this is indeed what you have).  I would suggest seeing a neurologist and getting a good neurological exam, some labs together with a good neurological history.  Based on these your neurologist will be able to further define the potential etiologies of your problem and begin a more directed search.  Without more informatin, I cannot give you a good idea about what is going on.

Sincerely,

CCF Neuro MD

[Judy - Follow-up question]

Here is an algorithm for diagnosing peripheral neuropathy.
I found it quite interesting.

http://www.aafp.org/afp/980215ap/poncelet.html