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Q. My right foot is going cold at night while sleeping. Why?

Answered by
Dr. Anuj Gupta
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on Jul 05, 2020

Hello doctor,

I am a 50-year-old female. I have a history of back spasms, disk degeneration of lower back and cervical issues. I probably had Raynaud (could hands/feet) all through life.

I had an issue on lower right side sciatica type pain traveling through lower back down back of the leg to the right foot. It progressed during the last few weeks after kayaking and sleeping on the floor with just cheap foam mattress.

Concern: My right foot went cold to touch at night when sleeping. Last night, I have the same with the leg. It is fine once I started moving. But still numb and goes down back of the leg, but the foot is warm. No pain on walking. Right ACL had a complete tear on the right knee for five years. Doctor wants to leave it alone. All blood work normal two months ago thyroid, etc. Normal abdominal ultrasound that I felt yearly for family kidney cancer.

My doctor took BP and did an ankle bracket index test. All are normal. My doctor want me take my BP and ankle BP on both sides during the night episodes. All normal on both sides. Almost equal.

We have heavy COVID-19 in our area right now. I debated going to hospital, but hesitant. Unless it is an emergency lot of places are closing elective procedures.

Do I need to get a Doppler ultrasound for blood clots? Or can muscle spams which I get used to cause these issues?

I am currently on Propanolol for ADHD.

Dr. Anuj Gupta

Orthopedics And Traumatology Spine Surgery
#

Hello,

Welcome to icliniq.com.

First tell me, what you do and how much physical activity you have in your daily routine?


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Thank you doctor,

I do not do much since COVID-19. I use to go to the gym every day. I now just hang around the house and lay around.

Finally, after we opened up I started kayaking three weeks ago almost nightly. I could feel my lower back tightening and pain in my right glut at night. In the kayak I could tell when seating my back would hurt, especially my hips. Eventually, my legs and feet would go numb in the kayak. Once I got them off the legs and moved them I was fine.

Today I did go to the ER. They were busy dealing with COVID patients and were very concerned with my safety of exposure. The ER quickly checked my foot pulses with his hand, examined both legs and feet. I listened to what I shared with you and said that it did not sound like a blood clot. He felt better I had been taking the blood pressure of the ankles during the episodes and that was normal. I had a great pulse rate. He did not feel an ultrasound was necessary. I was in no immediate danger. I could still go hiking this weekend.

He worried about my exposure to the virus in the hospital. But he did call in a second ER to take a look both agreed with the same thoughts. Both were very experienced by ER doctors. So I felt better. They had no answer why. Except probably my Raynaud's with the sciatica progression and me ignoring the spams just set off a chain reaction. Any thoughts?

Dr. Anuj Gupta

Orthopedics And Traumatology Spine Surgery
#

Hello,

Welcome back to icliniq.com.

Well to me it does not sound like a blood clot. It seems to be nerve pain. It is not Raynaud. Basically it is due to disc prolapse in your lumbar spine. I asked about your physical activity because disc problems normally seen with sedentary patients.

But you seem to be quite active. Still, it can be seen normally 90-95 percent of patients can be managed with medications and conservative treatment but you need to be in regular follow up with me. Kindly tell what all medications you have tried and currently taking?


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Thank you doctor,

I have zero medications for it. I have a high pain tolerance. I do have Lyme disease. Five years ago, I still have achy joints. I take high vitamin C about five times a year to manage the Lyme. I was on antibiotics for six months. I had two other tic infections that showed up active in the lab work.

I was concerned about the foot/leg because I did not think a physical to the touch cold foot or leg could occur. But as I ignored the symptoms of muscle spasms and radiating cramping from the butt that spread down my leg, I realized that I let it go too far. What causes the foot or leg to go cold when only sleeping? Leaves when I move around. That was scary.

I am taking it easy. Just going to walk. No kayaking until things calms down in my body. I am seeing a chiropractor. The rest of the doctors are not really wanting to see patients. .

Dr. Anuj Gupta

Orthopedics And Traumatology Spine Surgery
#

Hello,

Welcome back to icliniq.com.

Well, this is all nerve pain. I would suggest you to go for an MRI (magnetic resonance imaging) lumbar spine. You have mentioned something previously about disc degeneration but you have not mentioned it in detail. Start capsule Pregabalin 75 mg at night. Stay in regular follow up with me and if you have an MRI report then kindly send me.


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