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Susan Ivy
Susan Ivy, Nurse (RN)
Category: Health
Satisfied Customers: 4058
Experience:  BSN, MSN, CNS
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Hi Susan. Ive been having trouble with my ankle and legs.

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Hi Susan. I've been having trouble with my ankle and legs. For several years now I've had occasional numbness in my toes during long walks. I've tried different shoes, etc. I've been trying to increase my running (normally only run 1/2 mile at a time...walk, run, walk); however, I have pain in my lower legs almost immediately. Also, for the last year or so, I've noticed I have a difficult time walking when I first wake, as the back of my heals and ankles are very tight. This week it has now become more persistent, and after a short run/walk, I had swelling in my front ankle, and an indentation on the front of my upper calf. This week I have felt a little numbness in my legs, and it seems like I'm stiff when I get up from sitting now as opposed to just in the morning after a night's sleep. I have osteoarthritis in my neck, and I know I have some sort of arthritis in my hands, because for the last year I try to sleep with my hands flattened to avoid cramping in the morning. I'm concerned it could be a number of things, and I'm not even sure which type of specialist I should see. I first thought I might have chronic compartment syndrome; however, I now fear it's something more debilitating. Any advice is appreciated. Thank you.
Hello and thank you for requesting me..

To begin with, because you have osteoarthritis in your neck, it is likely that you may be prone to this elsewhere in your spine and joints. Osteoarthritis is mostly a disease of cartilage. Cartilage allows bone to glide over each other. When the top layer begins to wear away (as it can in osteoarthritis) the bone rubs against each other and this can cause pain, swelling, and loss of motion of the joint. Bone spurs may develop on the joint edges and small pieces of bone or cartilage may break off and float in the joint space which causes increasing pain and damage. In the spine, osteoarthritis can cause result in compression of the spinal discs over time. The hand numbness could be due to pressure on the nerves in the upper back or thoracic spine (the nerves that go to the hands branch off here). Additionally, the numbness in your toes and even the pressure felt in the ankles could be to compression of the joint space in the lumbar spine. It is common to occur at the times you mention (in the morning upon wakening, and after aggravation of the lumbar spaces and joints - such as after running)

Of course definitive diagnosis can only be made after a thorough evaluation, which should include a history such as you describe above, a physical exam and likely new imaging studies of your spine.

Treatment of osteoarthritis can include medication and even supplements such as glucosamine. There are other changes in lifestyle that you may need to make in order to cope with this. For example, you may need to practice a different type of exercise than running. Something that is less stressful to the joints, such as swimming or possibly cycling. A routine of stretching similar to yoga or pilates will also be helpful, as this can help relieve some of the pressure on the joints in the spine as well as in the hips, knees, ankles, wrists and shoulders.

The swelling or edema in your lower extremities could be related to several things. In women it can even be related to hormones. But, it can also be a sign of a problem, such as electrolyte imbalance, high blood pressure, venous insufficiency, or over weight.

You mentioned you were trying to decide what type of doctor to see first. It would probably be a good idea to see a general practice or internal medicine physician first, since any underlying problems that could be causing the swelling need to be ruled out. A generalist may also be able to diagnose and treat your joint and spinal problems, or may need to refer you to an orthopedist (if it is determined that spinal deterioration is resulting in the symptoms you are developing in your hands and feet - which seems likely from your description).

I hope this discussion is helpful. Please reply if you have further questions. I hope the time it took me to answer has not been too long.... If you are away from the computer now, don't worry, I will be available to continue and answer any addition questions or clarify details in the morning as well.
Susan Ivy, Nurse (RN)
Category: Health
Satisfied Customers: 4058
Experience: BSN, MSN, CNS
Susan Ivy and 3 other Health Specialists are ready to help you
Customer: replied 3 years ago.

Thank you, Susan, for the information. I appreciate your thoroughness. Rose

You are so welcome, it is my pleasure to assist you! Hope you are feeling better soon and that you are able to get started on an exercise regimen that will be less stress ful to your joints.

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