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Long term foot and ankle pain
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Long term foot and ankle pain

Hello all,
  I have had the pain for about 8 years and docs have not been able to id. So, thought I might se if anyone has any other thoughts. I have pain when I stand, walk, seat or lay down (this is e order of level of pain as well - standing is the worse). When I stand the bottom of my feet will throb. Sometimes most of the bottom and sometimes I will get certain points like the heel or by the big toe that almost feels like a cigarette burn. Other time like when I seat from inside e ankle to my whole foot will burn/tingle. It's almost like the pressure on the back of my leg causes this. Also, sometimes if you run your hand from the top of my leg to the ankle you can feel,it go from warm to very cld at the ankle.

This has been gradually getting worse over the past 8 years and I have seen a ton of doctors. General doc, nuralagist, chiro, podiatrist, homeopathy, acupuncture, pulmutalagist,. I have had MRI leg, ankle, back, X-ray, blood pressure test, nerve conduction test, lots of blood work with nothing being found. I have also trid lots of drugs neurotics, cymbalta, niacin, vitamins like the Bs and other.

At is point not sure who else to talk to or what else to try, so any thoughts would be much appreciated:)

Sorry I am an awful speller
12 Comments
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1696489_tn?1370825574
Hi! :-)  I have foot problems, too, but they are not like yours.  Have you considered that you may have a pinched nerve, or even more than one?  This can cause alot of pain.  Blessings - Blu
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875426_tn?1325532016
I'm sorry you've had such a trial with this.  It does sound like there is a component here with the throbbing description with the cardiovascular system.  

A) You mentioned blood tests-
  1) what was your lipid panel and your magnesium level like?  
   2) Did they do a CRP test and if so, with what result?
   3) Did they check for anemia?
   4) Did they test for blood volume at all?  (A surrogate type test I've read about for blood volume and one I've had done myself is a 24 hour urine test for sodium level.)
    5) I imagine they ruled out diabetes?

B) You mentioned blood pressure testing, but did they also use a doppler machine checking on blood flow to your lower extremities?  Did they do it sitting and standing?

C) Did they generally (upper extremity) check your orthostatic blood pressures and pulses (lying down, sitting and standing)?  If so, was there any evidence of any kind of orthostatic intolerance (problem with standing with the numbers)?

D) If your lipid panel, magnesium level, CRP, and peripheral doppler testing were fine and your did any of the doctors suggest trying compression socks/hosiery?

E) How long did you try acupuncture for?  I know I had a tingling place in my leg when the needle was put in to a certain acupuncture point in my left leg.  It took a really long time of treatments for that tingling to go away (while treatments continued, I think it's back now).

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4851940_tn?1385441629
I am surprised that no one has been able to find out what is causing your problem.

Have you ever been prescribed with any antibiotics, pain relief, or anti-inflammatory medications?  

With all the tests you have had done, it does not appear that you have been checked for arthritic problems and blood tests done for autoimmune disorders or abnormalities, Lupus or gout.

Are you diabetic at all?

Foot pain can also be referred from elsewhere in the body, as well as from damaged tendons and muscles as well as from flat feet.  If you have lower back problems you can feel pain in your feet.

Has the doctor ever referred you to physiotherapy?  Sounds like you need some special insoles in your shoes and shoes that support the feet.

Make sure you rest your feet and elevate them as much as you can.  I found applying a lot of cold natural yogurt helped with my very painful foot problem.

If you are overweight, losing weight will help.

Best wishes.
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Avatar_m_tn
Wow, great comments!

Coupe extra things:
1. I also started having migraines around the same time as my lower extremity pain
2. Lately I have started to get a pain burning in my wrist - seems it happens at night
3. I can make my feet turn a purple if i seat on anything that I hang my legs off of like a chair or doctors table
4. I eat a fairly clean diet no dairy, no soy and I have tried:
  - Palio diet
  - Eat for your blood type
  - Atkins
  - Chinese Med diet
5. I have also tried several foot insert from the store and 3 different type made by a doctor (from a mold, using pins, metal mold). None helped

Drugs I have tried:
AMLODIPINE BESYLATE 2.5 MG TAB
HYDROCODON-ACETAMINOPHEN 5-325
GABAPENTIN 300 MG CAPSULE
VOLTAREN 1% GEL
TRAMADOL HCL 50 MG TABLET
TIZANIDINE HCL 4 MG TABLET
CIPRODEX OTIC SUSPENSION
POTASSIUM CITRATE ER 10 MEQ TB
CEPHALEXIN 500 MG CAPSULE
ALTACE 2.5 MG CAPSULE
NORTRIPTYLINE HCL 25 MG CAP
CYMBALTA 60 MG CAPSULE
TRILYTE WITH FLAVOR PACKETS
MAXALT 10 MG TABLET
ERY-TAB EC 333 MG TABLET
LYRICA 75 MG CAPSULE
NAPROXEN 500 MG TABLET
CIPRO HC OTIC SUSPENSION
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Avatar_m_tn
Also, here is the long list of test that have been run with nothing showing bad:

Tests & Procedures
Leg artery doppler ultrasound study
N-INVAS PHYSIOLOGIC STD LXTR ART COMPL BI


Intra-lesion injection
Triamcinolone injection
Autoantibody test
Complement blood test
COMPLEMENT FUNCTIONAL ACTIVITY EACH COMPONENT
CRYOGLOBULIN QUALITATIVE/SEMI-QUANTITATIVE
Fat blood tests
Immunofixation electrophoresis test
Rheumatoid factor assay
Knee MRI
Lower limb MRI
CIRCUMFERENCE.AT UMBILICUS
INTRAVASCULAR DIASTOLIC
INTRAVASCULAR SYSTOLIC
Chiropractic treatment
Electrical stimulation application
Chest spine X-ray
Lower spine X-ray
Brain MRI
ASSAY OF PORPHOBILINOGEN URINE QUANTITATIVE
ESR test
Ferritin blood test
General health panel
Limb vein doppler ultrasound study
Lyme disease antibody test
Noninfectious agent antibody test
Protein typing test
Total CPK blood test
Total protein blood test
Bone scan
Radioactive isotope supply
Foot X-ray
Sex hormone binding globulin blood test
Thyroid hormones uptake test
Total testosterone blood test
Total thyroxine blood test
Vitamin D-3 blood test
Nerve conduction study
Limb artery study
Immunization administration
Tdap vaccine
Urinalysis
Vitamin B12 blood test
Neck spine X-ray
@LABCATEGORY_HEMATOCRIT@
@LABCATEGORY_HEMOGLOBIN@
ALANINE AMINOTRANSFERASE
ALBUMIN
ALKALINE PHOSPHATASE
ASPARTATE AMINOTRANSFERASE
BASOPHILS
BASOPHILS/100 LEUKOCYTES
BILIRUBIN
BILIRUBIN.GLUCURONIDATED
Complete blood count
EOSINOPHILS
EOSINOPHILS/100 LEUKOCYTES
ERYTHROCYTE DISTRIBUTION WIDT
ERYTHROCYTE MEAN CORPUSCULAR HEMOGLOBIN
ERYTHROCYTE MEAN CORPUSCULAR HEMOGLOBIN CONCENTRATION
Date of Test/Procedure: 09/30/2010
ERYTHROCYTES
Granulocytes.immature
GRANULOCYTES.IMMATURE/100 LEUKOCYTES
LEUKOCYTES
Liver function tests
LYMPHOCYTES
LYMPHOCYTES/100 LEUKOCYTES
MEAN CORPUSCULAR VOLUME
MONOCYTES
MONOCYTES/100 LEUKOCYTES
NEUTROPHILS
NEUTROPHILS/100 LEUKOCYTES
PLATELETS
PROTEIN
CHOLINESTERASE
ASSAY OF ALUMINUM
ASSAY OF NICKEL
CADMIUM
HEAVY METAL SCREEN
Lead blood test
PHYS/QHP TELEPHONE EVALUATION 21-30 MIN
Pulse oximetry
MOLEC SIGNAL AMP NUCLEIC ACID EA SEQUENCE
Molecular study
DNA ANTIBODY SINGLE STRANDED
Muscle electric testing with needle
Kidney function tests
Creatinine urine test
Urinalysis
Glomerular filtration rate/1.73 sq M.predicted.black
Total protein urine test
ASSAY OF THIAMINE-VITAMIN B-1
Glomerular filtration rate/1.73 sq M.predicted.black
Glomerular filtration rate/1.73 sq M.predicted.black
ASSAY OF COPPER
Glycosylated hemoglobin test
Organic acid test
Antinuclear antibody (ANA) test
Syphillis (syphilis) test
Vein puncture
Lower spine MRI
Complete blood count
CRP blood test
Flow cytometry
Rheumatoid factor assay
Date of Test/Procedure: 09/25/2007
Uric acid blood test
Folic acid blood test
HLA typing
LIFT ELEVATION HEEL TAPERED METATARSALS PER INCH
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Avatar_m_tn
I'm sorry you've had such a trial with this.  It does sound like there is a component here with the throbbing description with the cardiovascular system.  

A) You mentioned blood tests-
  12, 3 all turned out normal
   4) Did they test for blood volume at all? - not sure if I had this done
    5) I imagine they ruled out diabetes? - yes no diabetes - tested several times

B) You mentioned blood pressure testing, but did they also use a doppler machine checking on blood flow to your lower extremities?  Did they do it sitting and standing? - did both and had the test done twice

C) Did they generally (upper extremity) check your orthostatic blood pressures and pulses (lying down, sitting and standing)?  If so, was there any evidence of any kind of orthostatic intolerance (problem with standing with the numbers)?  - did both and no issue - they keep saying i am healthy as an ox

D) If your lipid panel, magnesium level, CRP, and peripheral doppler testing were fine and your did any of the doctors suggest trying compression socks/hosiery? - I have tried hosiery and didnt help

E) How long did you try acupuncture for?  I know I had a tingling place in my leg when the needle was put in to a certain acupuncture point in my left leg.  It took a really long time of treatments for that tingling to go away (while treatments continued, I think it's back now). - I tried this 3 different times with multiple visits. I did try to intense version where they make the muscle fire and the times just normal

thanks a lot for the questions!
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4851940_tn?1385441629
Sorry, but I couldn't be bothered to read that dreadful long list that you wrote.  It means absolutely nothing to me as I am not a trained doctor.

I did read your reply to LivingInHope that you are not diabetic - which is good.  You can be glucose intolerant and get nerve damage through that.

As your foot goes purple when you do what you do with it, then it is clearly a circulation problem.

Problems in the wrist is likely to be carpal tunnel problems.  You can wear wrist splints at night to help with this and not use the hand repetitively.

Hope you find some relief somewhere.

Best wishes.
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Avatar_f_tn
I have found that Grapeseed extract helps with bone spurs, asthma, and other problems - including facsitis.  I prefer to go the "natural" route as I believe too many chemicals in our bodies only worsen the situation.   I hope Grapeseed works for you - it contains antioxidents and OPCs.
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875426_tn?1325532016
A)  

1) Did you get a copy of your results for your lipid panel, CRP, ferritin and your magnesium or did they just tell you they were normal?  

2) If you did get a copy of these results, what were your numbers?

3) If you didn't, you might want to get a copy and see the numbers for yourself, complete with ranges.  

4) I missed seeing CRP, blood iron, total iron binding capacity (T.I.B.C.), iron saturation percentage, and magnesium on your posted list of tests.    

5) As to blood volume, you may want to see about going to a dysautonomia specialist for testing.  With your migraines and what sounds like blood pooling (feet turning purple when hanging while sitting), it might be something you would want to consider.  Meanwhile, you might see if you can have your doctor order a 24 hour urine test for sodium level.

B) That's good news!

C) With what sounds like a blood pooling issue and migraine headaches (which are considered to have a vascular component) you may want to do orthostatic blood pressures and pulses at home at various times a day (for example: when you first wake up in the morning- take your blood pressure and pulse before you get up, stand and wait a minute, and take again).  Home blood pressure monitors can be bought over the counter- Omron is a respected brand over here- not sure if they have it in the UK.

D) Was it prescription compression hosiery or just over the counter type?

E) You say multiple visits- are you talking a couple of months or longer per attempt?  Were they trained in Chinese acupuncture or another kind? Did they try Chinese herbal remedies as well, try to flush toxins out of your body with all the prescriptions you've been taking?  There was 'Coptis Purgefire' by Health Concerns I took that seemed to help with my migraines for a time, but I learned later it had a high amount of natural estrogen, which likely made the endometriosis I had grow more.

F)
1) I notice you tried blood pressure medication (amlodipine)- do you normally have hypertension or were they trying that to see if it would work as a migraine preventative?  

2) I also notice you tried Altace- again, do you have high blood pressure?  Or did they think you might have CHF (congestive heart failure)?

G) I see potassium on your list of things tried- did you have a potassium deficiency?  If you did, that can cause cramps in your lower extremities.

H)  It looks like you've tried a number of pain medications, neurological drugs, a migraine abortive medication (Maxalt), antibiotics (do you get frequent infections?) and you took something for a bowel clean out- maybe had a colonoscopy?  

Has any of the pain medication, neurological drugs or the migraine abortive been of any help?  Have you had any rebound migraines from the pain meds or after taking Maxalt?  A wrap around ice pack has been oft' used on my head in the house and often is helpful- have you tried this for the migraines at all?  If so, do you find it helps at least at times?  

I) I notice you mention immature granulocytes- was this at a time where you had one of your infections?

J) You mention a pain burning in your wrist.  I'm having that in both wrists right now from overuse on the computer.  Do you use the computer at night?  Do you feel any heat to the touch in the area of the burning?  Have you reported this newer symptom to your physician?  
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Avatar_m_tn
Wow - you are great - are you a doctor?

A)  

1) Did you get a copy of your results for your lipid panel, CRP, ferritin and your magnesium or did they just tell you they were normal? - I need to see if I can find these      

5) As to blood volume, you may want to see about going to a dysautonomia specialist for testing.  With your migraines and what sounds like blood pooling (feet turning purple when hanging while sitting), it might be something you would want to consider.  Meanwhile, you might see if you can have your doctor order a 24 hour urine test for sodium level. - i have never looked into this but i will thanks

C) With what sounds like a blood pooling issue and migraine headaches (which are considered to have a vascular component) you may want to do orthostatic blood pressures and pulses at home at various times a day (for example: when you first wake up in the morning- take your blood pressure and pulse before you get up, stand and wait a minute, and take again).  Home blood pressure monitors can be bought over the counter- Omron is a respected brand over here- not sure if they have it in the UK. - i have one and will start to see

D) Was it prescription compression hosiery or just over the counter type? - over the counter. I tried for a couple days but seemed to make worse

E) You say multiple visits- are you talking a couple of months or longer per attempt?  Were they trained in Chinese acupuncture or another kind? Did they try Chinese herbal remedies as well, try to flush toxins out of your body with all the prescriptions you've been taking?  There was 'Coptis Purgefire' by Health Concerns I took that seemed to help with my migraines for a time, but I learned later it had a high amount of natural estrogen, which likely made the endometriosis I had grow more. - i went for sevearl treatments each time, one had studied in china and the other i am not 100%

F)
1) I notice you tried blood pressure medication (amlodipine)- do you normally have hypertension or were they trying that to see if it would work as a migraine preventative? - no this is what the cardio doctor tried

2) I also notice you tried Altace- again, do you have high blood pressure?  Or did they think you might have CHF (congestive heart failure)? - no high blood pressure

G) I see potassium on your list of things tried- did you have a potassium deficiency?  If you did, that can cause cramps in your lower extremities. -the cardo doc had me take this aspirin and the perscription

H)  It looks like you've tried a number of pain medications, neurological drugs, a migraine abortive medication (Maxalt), antibiotics (do you get frequent infections?) and you took something for a bowel clean out- maybe had a colonoscopy? no infection but was trying to help my feet at the time it felt more like pin and needle or a nerve issue but not anymore

Has any of the pain medication, neurological drugs or the migraine abortive been of any help?  Have you had any rebound migraines from the pain meds or after taking Maxalt?  A wrap around ice pack has been oft' used on my head in the house and often is helpful- have you tried this for the migraines at all?  If so, do you find it helps at least at times? - migraines are not that often and i jsut take migraine meds - 500Acp, asprin and caffine  

I) I notice you mention immature granulocytes- was this at a time where you had one of your infections? - no infection

J) You mention a pain burning in your wrist.  I'm having that in both wrists right now from overuse on the computer.  Do you use the computer at night?  Do you feel any heat to the touch in the area of the burning?  Have you reported this newer symptom to your physician?  - i work on a computer all day but doesnt hurt but it will hurt when i lay down at night and in the morning

thanks for the great comments
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875426_tn?1325532016
No- I have a background of graduating from vocational nursing school many years ago, but I'm definitely not a doctor! :0)

A) Hope you can get your hands on the copies of results- I'd be interested to know the numbers and reference ranges.  And I hope you can look into the things mentioned in number 5! :0)

C) Great- Keep me posted on your numbers?

D) Compression stockings, the prescription kind, can be hard to get on but they are supposed to help with the blood pooling problem.  Another thing to try if you don't want to pursue that is to pump your calf muscles.  This is something an internist recommended to me for my orthostatic intolerance.  He suggested to make the muscles act kind of like a heart muscle to send the blood back up that's collecting down there.

E) Well, with all the medication you've been on, you might want to check into Chinese herbs to see if you should try to detox your body of any possible build-up of these medications that might be affecting your health.

F) Did the cardio find something wrong with your heart function, that he was trying the medication?

G) So, without finding a result of low potassium, the doctor had you taking potassium, even though the medications he had you on were a calcium channel blocker and an ACE inhibitor, and apparently not a non-potassium sparing diuretic?  Potassium really needs to be in balance and it can be dangerous if your potassium level goes too high- did he at least monitor your level while he had you on this?

H) No infection, but had you on antibiotics for ear infection (otic suspension) and erythromycin.  If you had no infection and the problem was in your feet, not your ears, it sounds like you may have gone to a quack, not a doctor you'd ever want to go back to.

What is ACP?  Not taking Maxalt anymore then?  I am glad you don't suffer from frequent migraines.

I) Please tell me more then about your immature granulocytes or were they just checking for them and found none?  If they found some, was this flagged on your lab report?  Did your doctor send you to a hematologist if they were numerous?  What were your neutrophils, eosinoophils and basophils (all granulocytes) and their reference ranges?

J) Perhaps when you are busy, you tend not to notice the problem.  I have a parent who was like that with medical issues- the work distracted from noticing the problems.  It's sometimes when we're quiet that our mind hones in on the fact there's pain somewhere.

I'm blessed if I've been of help!





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Avatar_m_tn
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