It is common to have your feet ache and hurt after a marathon day of shopping, hiking or work. But most of the time your feet should be tough and resistant to this kind of symptom. If your feet aren’t working well, people slow down, they don’t burn calories and they gain weight. Not a very healthy situation. It's important to pay attention to your feet and what they may be telling you about your health.
I see patients every day with foot pain since it is a common symptom of vein reflux, and of note, their foot and leg symptoms are always worse in the evening. I’m often asked “Should I worry if my feet are numb or cold? What if they burn or sting?” Let me share with you what I have learned from patients in my practice about foot symptoms.
If you experience burning, stinging, aching pain on a regular basis, first and foremost - know that it is not normal. Other warning signs are numbness, tingling or cold feet. These symptoms are a definite warning that it’s time to figure out what the cause is and determine a solution.
There's no one answer to why your foot problems are happening. These symptoms can be due to a number of conditions. Here are a few concepts to help you sort them out so you can bring your concerns to your provider.
Are your symptoms constant? This suggests a medical condition such as diabetes, thyroid or liver disease or nutritional deficiency. It can also be due to neuropathy which means the cause is unknown. This cause is more likely if you also have similar symptoms in your hands. The best place to start is a conversation with your primary care provider.
Do you have a sensation of something crawling on your skin? People often say it feels like insects, and the medical term is called “formication” with an “m.” It is often associated with vein reflux and resolves with vein treatments.
Are the symptoms worse after you are up and walking and improve after resting? This suggests arthritis or a condition in your feet or joints. A podiatrist can help evaluate this.
Are your symptoms related to use of certain shoes or boots? If so it may mean that evaluation for orthotics may help. An orthotist or podiatrist can help evaluate this.
Are the symptoms worse in the middle of the night and are relieved when you sit up and walk a little? This is the pattern seen with advanced artery blockages in the legs which depend on the aid of gravity at night to keep the blood flowing. Without the aid of gravity when you lay flat the blood flow decreases and symptoms worsen. An artery ultrasound and most important, ankle - brachial blood pressure measurement, is critical to sort out and your PCP can order this if they feel it is appropriate.
Is the foot pain constant and present in the area at the base of the toes? It can be due to severe artery blockages in the leg and if this is the problem it is always associated with calf pain when walking. An artery ultrasound with blood pressure measurement is key to sort this out, and your Primary Care Provider can decide if this is appropriate.
Do you have foot cramps especially at night? This is often due to vein reflux and resolves promptly after treatments. A vein screening is a good way to get this sorted out.
If the pain is sharp and stabbing, you may have a neuroma or scar tissue irritating the nerves. This can also occur if you have had prior surgery in the feet. Evaluation with a podiatrist can help here.
If you have constant burning stinging and numbness with diabetes, you may have diabetic neuropathy. Control of your blood sugar helps, and some patients have gotten some relief with a more powerful vitamin supplement metanx, which allows you to start with a money-back 3 month trial. If it works (not everyone gets relief), you will likely buy it for the rest of your life because of the relief it provides.
Constant burning, stinging, numbness and tingling can be due to vitamin B deficiency and taking supplements can help.
If your foot symptoms are worse with swelling in your feet and legs, then getting the swelling under control will likely improve the situation. Common causes are: summer heat (normal), excess salt (fast food, restaurant, snack food), lymphedema, and vein reflux. Less common causes include heart or kidney disease.
If your burning, stinging, numbness, cold feet, tingling is worse at the end of the day, this is the typical pattern seen with vein reflux and will improve with treatment. Vein reflux is the only condition which causes this pattern of worsening of symptoms in the evening and it predicts relief with treatments. These symptoms are usually associated with other calf symptoms such as nighttime cramps, restless legs, calf swelling or aching. Patients are very pleased and surprised after vein treatments with the improvement and resolution of their symptoms. A video or in-person vein screen is the easiest way to sort this out.
Listen to your body. Don't ignore foot symptoms.
Foot symptoms can be a signal from your body that you have a medical condition or an abnormality in your feet. Evaluation with your podiatrist or Primary Care Provider is a good place to start. If your symptoms are worse in the evening, it is highly likely that they are due to a vein condition and a vein screening can sort this out.
