Lymphedema and PVD as a cause of Bilateral Foot Pain

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As a Chiropractor who specializes in treating running, foot and knee related injuries I have examined many patients who think they have one type of condition when in fact they have something completely different.   I share these types of cases in the hopes that someone who is experiencing a similar situation will read this and realize there might be an answer for their” mysterious” problem and that they should not give up.  It happened yesterday while examining a new patient who had a long list of doctors and tests that had all been negative in diagnosing his condition.  It is unfortunate that many patients see a litany of doctors but never seem to see the “right” doctor.   In this case the gentleman had been suffering from foot related pain that he said seemed pressure related.  He was not suffered any trauma, was not a runner and in fact was mostly sedentary.  I performed a thorough history, visual inspection and careful palpatory exam to establish what he had tried in the past, what had been recommended, and to see where his pain was originating from.   His history revealed that he had been to multiple doctors and had X-rays…….negative, MRI’s…..negative, Nerve Conduction Velocity tests…..negative, orthotics……no help (they actually hurt) and had recently been diagnosed with high blood pressure.   I visually examined him and noted that he was overweight and that both of his ankles and feet were swollen and discolored….as if they were bruised.  I pressed on the area and noted that not only were they swollen but that he had pitting edema and no hair on his lower legs.  

         Swelling of part of your arm or leg or your entire arm or leg, including your fingers or toes

         A feeling of heaviness or tightness in your arm or leg or feet

         Restricted range of motion in your arm or leg or feet

         Aching or discomfort in your arm or leg or feet

         Recurring infections in your affected limb

         Hardening and thickening of the skin on your arm or leg

The swelling caused by lymphedema ranges from mild, hardly noticeable changes in the size of your arm, leg or feet to extreme swelling that can make it impossible to use the affected limb.  In this patients case he was unable to walk or weight bear for any significant time due to the pain.  This resulted in gradual but significant weight gain due in part to his inability to exercise.  I counseled the patient on his condition, provided him with multiple, credible links so that he may read and better understand his condition and went over all of the available treatment options he might want to consider.  We discussed exercise and weight loss, compression garments, Kinesiotaping and therapeutic exercise to help with lymphatic drainage.  This is vital because your lymphatic system is crucial to keeping your body healthy. It circulates protein-rich lymph fluid throughout your body, collecting bacteria, viruses and waste products. Your lymphatic system carries this fluid and harmful substances through your lymph vessels, which lead to lymph nodes. The wastes are then filtered out by lymphocytes — infection-fighting cells that live in your lymph nodes — and ultimately flushed from your body.  Lymphedema is also part of a group of disorders known as PVD’s or Peripheral Vascular Disease.  PVD’s can be reversed in their early stages by lifestyle modifications (exercising, losing weight, lowering blood pressure etc).  If left to progress serious adverse events such as stroke and death can occur.

There are more sinister causes of lymphedema such as cancer and so a referral was also made to a vascular specialist.  I have encouraged the patient to allow me to help him with lifestyle changes such as getting on an exercise program and following a specific diet.  This case is a clear example of how patients are not given accurate information regarding their condition or are the potential side effects of doing nothing stressed enough.  The leading causes of death in this country are heart disease, cancer, stroke and diabetes……all prevented or reversed through diet and exercise.  But our country keeps getting fatter and more deconditioned.  Doctors continue to take power away from patients treating their symptoms and not the primary cause of their condition.  Maybe if patients were educated on the real cause of their condition they would take matters into their own hands and do something about it.  Instead they are often led to believe that some “magic pill” is going to solve their problem.  It’s not.

 

By | 2013-07-24T11:30:17+00:00 July 24th, 2013|Running Injuries|4 Comments

About the Author:

Dr. Runco is a U.S. Navy and Gulf War Veteran. He began private practice in 2000 primarily treating and fixing running injuries. He has been a professor of Anatomy, Physiology, and Biomechanics at various colleges and continues to teach continuing education in the fields of rehabilitation, custom orthotics and athletic taping. He is also a member of the American College of Sports Medicine, National Strength and Conditioning Association and is a Certified Strength and Conditioning Specialist. He has completed over 15 Marathons in 15 states and has run 11 50 mile Ultramarathons.

4 Comments

  1. Hannah October 2, 2014 at 12:03 pm - Reply

    I was born with a swollen left ankle and was disregarded in the fact doctors thought it would cause no problems. 26 years later it is and I’m struggling to get a diagnosis.
    My ankle and foot doubled in size a year ago and has gradually started causing other problems, dry leathery brown skin on my toes, it itches, there are tiny wart like marks on the side of my foot, excruciating pain in the ball of my foot when I walk (esp bare footed) and it’s pitting edema.
    I’ve seen numerous doctors, ruled out gout, tried diuretics, physiotherapy (the physio believes it’s circulatory related) and I’ve had routine bloods and an MRI scan which was ‘fine’. Doctors have been visibly baffled and I’m currently waiting to see a lymphoedema specialist.
    I was told by my father that his grandmother had lymphoedema, could I have it too?
    What is the pain in the ball of my foot? It feels as though I’ve badly bruised the bone but it’s been painful for months.
    I’m worried that I may have skin infections but the doctors just tell me to use hydrocortisone cream! They claim they can’t ‘see’ the warts I’m talking about…how can I get these doctors to take me seriously? They also don’t agree that it could be lymphoedema. I’m at the end of my tether!

    • Dr. Runco October 2, 2014 at 12:13 pm - Reply

      I don’t know if you are in England or Australia but either way you make the case for captitalistic medicine instead of socialistic. In America they scream “we want “free” health care like they have in England! Your email shows why it is probably a bad idea. If in fact what you are saying is true, that your ankle is 2x the size with warts, pain in the ball of your foot and dry leathery brown skin and the doctor’s think its “fine” and “can’t see it” then I would recommend taking your vacation in the United States and paying me a visit…..or keep going to useless doctors that are not helping you.
      Sorry I can’t help you much via blog but what you are describing is not something I am used to hearing or have any simple answer for. If you want to take pictures of both your right and left feet and ankles and email it to me I may be able to shed more light on it for you Hannah Drrunco@sdri.net

  2. Debby Jackson April 8, 2017 at 1:52 pm - Reply

    Right now I am in a similar situation. My daughter (a nurse) is positive my condition is PVD. This condition has been chronic with occasional flare ups and i have had lymphedema treatments with relatively good results. The doctors cannot even name the condition. We have done blood cultures, chest exray and sonograms of my legs. Csn it be a mix of both conditions? HELP!3

    • Dr. Runco April 10, 2017 at 6:35 pm - Reply

      Sure it is possible you have PVD and lymphadedema….it sounds like you are getting good results so keep it up!

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