Been diagnosed with neuropathy, but within last month or so, left foot/ankle have been swelling up throughout the day--by nighttime, very swelled. Had veins checked today, no problem found. Any suggestions???
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Without the ability to obtain a detailed history and to perform a physical exam, I cannot tell you what the cause of your symptoms is. I will provide some information that I hope will be useful.
Swelling can be caused by many causes, and basically what swelling represents is an accumulation of water, fluids, or an inflammatory process. Many times swelling is a manifestation of other conditions. Most of the time swelling is in gravity dependent areas, like the legs, however sometimes can represent a local problem in that area.
For example renal failure with decrease in renal function can lead to swelling because of accumulation of fluids, this type of swelling is most commonly in multiple areas of the body, and not only in one leg. Liver disease can also produce swelling but not usually limited to one leg. The same thing with something called congestive heart failure, in which the fluid accumulates in the legs (both legs), and gravity dependent regions, not usually limited. With these conditions, patients will usually have other symptoms and not only swelling.
When patients present with swelling in only one extremity, the conditions leading to it most likely are local problems. One important process that should be investigated is deep venous thrombosis (DVT), which is a clot in a vein in the leg, and leads to swelling, sometimes pain an erythema. This is important as the clot can migrate and produce more serious problems. I am not sure what kind of vein testing you had, but DVT is usually investigated with a venous ultrasound. Other venous processes can produce blood stasis and swelling. The problem does not have to be directly in the vein in the leg, and can be more proximal, like in the groin, producing stasis of fluids below the level.
Problems in the lymphatics can produce swelling as well, and usually the characteristic of the swelling can give a clue, as well as investigation for lymph nodes problems.
If there is pain, erythema, and warmth, an inflammatory process or even an infectious process should be ruled out. Usually an arthritis either inflammatory or infectious can produce swelling in the ankle. The treatment will be analgesics and antiinflammatory agents, and if needed, antibiotics.
Neuropathy does not usually cause swelling directly. Neuropathy can predispose to swelling by different mechanisms. For example someone with a neuropathy and weakness in that limb, will have decrease movement that can predispose to swelling. Also neuropathy with sensory compromise can lead the patient to not feel the limb, and hurt himself without noticing, leading to an infectious or inflammatory problem.
As I said, without being able to obtain a detailed history and examine you, I cannot tell you what your problem is. I think it is important to discuss with your physician about your symptoms and the swelling in your leg, and find out what is causing it.
I hope this information is useful. Good luck.
My 23-year-old daughter got lymphedema in one leg for no reason whatsoever. They tested her for blood clot with ultrasound, did a CT scan and bloodwork to rule out cancer, and never found the reason. If that's what it turns out to be, you can see a physical therapist who specializes in lymphema. She wears a special pressure garment on her foot which helps some. It's weird, esp. since we have no family history of this, but apparently it CAN happen for no apparent reason. Good luck.
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