Question
QUESTION: My father is 66, slightly overweight not diabetic and has several different symptoms.  Non-weight bearing, his skin to his feet is pale ... when he places his foot on the floor, blood red. He c/o both numbness (he falls, says he has to look at his feet on rough terrain) but also c/o pain -- he can barely walk.  States better when barefoot.
Podiatrist says not heel spur or sciaticia.  Has had doppler study, according to him, nothing wrong with circulation.
ANSWER: Hi Teresa,

The symptoms you describe are classic symptoms of poor circulation.  This is known as pallor(pale or white) on elevation, rubor (red) on dependency (with feet down).  Is he a smoker?  Alcohol drinker?  Ever have chemotherapy?

There are several avenues to consider.  A doppler is a screening test and depends on who performed the test and how detailed they were.  I would make sure that it was a detailed test, read by a Radiologist.  Even with a doppler there may be a condition known as small vessel disease which can cause pain in the feet.  When in doubt, I would see a vascular surgeon and order an angiogram for a more thorough exam.

Now the other aspect that needs to be explored is a neurologic origin.  I would highly recommend that your father see a neurologist for an evaluation.  Especially with  the numbness and falls.

Heel spurs and sciatica do not typically cause the types of problems that your father is experiencing.  He needs to be examined in a more thorough manner as described above.

There are many conditions that can cause his symptoms. Let's start with some of the ideas above and please write with any further questions.

Hope that gets you started.

Good Luck.

Sincerely,

Marc Katz, DPM
Tampa, FL
Advanced Podiatry
www.thetampapodiatrist.com
www.tampacryosurgery.com
www.fix-my-foot.com


---------- FOLLOW-UP ----------

QUESTION: One last followup question --my father does have hx of carpal tunnel, bilateral wrists.  Could this be root of this new problem?  If so, are there non-surgical alternatives to try?

Thank you for your concise answers and your quick replies each time.

Answer
Hi Teresa,

I would think that carpal tunnel could be related if there is neuropathy.  Some people with foot neuropathy also get neuropathy of the hands. The nerve conduction studies by a neurologist should detect problems with the nerves that cause carpal tunnel.

Neuropathy and falls are often related as well.

Hope you get it figured out.

Sincerely,

Marc Katz, DPM
Tampa, FL
Advanced Podiatry
www.thetampapodiatrist.com
www.tampacryosurgery.com
www.fix-my-foot.com