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The response to the question below was authored by Marc Mitnick DPM
Extreme cold feet with walking on marbles pain in feet
by Denise
(Moose Jaw, Saskatchewan Canada)
Hi: my father has been suffering for the past month and a half with extremely cold feet that he wears 2 pairs of socks and knitted slippers and they are still very cold. He also has this terrible pain along with the cold feet in the soles of his feet, he describes it as "walking on marbles" every once in awhile his ankles will swell but it is not all the time. His Doctor has prescribed coritizone cream and Tylenol every 6-7 hours. if he dosen't do the cream twice a day and take the Tylenol on time he is in excruitiating pain and it radiates up his legs. He is 84 years old, do you have any idea what is going on. There is no rash on his feet that I can see.
RESPONSE
Hi Denise,
Feet that are extremely cold is usually indicative of poor circulation. The fact that your father is 84 years old would lead me to believe that lack of circulation into his feet is the cause of his pain and the discoloration.
If indeed poor circulation is in play here than what your doctor is perceiving as a rash is actually a sign of poor circulation.
When there is not enough blood coming down into the foot, aside from the foot and lower leg being cold to touch, what happens is that the capillaries dilate (expand) in an effort to create more blood flow. What essentially happens is the foot will be red in color and
I cannot make a diagnosis without actually examining your father but if he is a smoker or happens to be diabetic the chances of his problem being poor circulation is greatly increased.
If his feet are red when they are in a dependent position but return to a more normal color when they are elevated, such as lying in bed, then you can assume his problem is due to lack of blood flow into the feet.
If his feet happen to be pale in color regardless of whether or not they are elevated or in a dependent position then you have to be concerned about an arterial embolism which is a blockage of the arteries which is not allowing blood to flow down into his feet. This is considered a medical emergency as an embolism (blood clot) can move decreasing the blood flow enough to cause gangrene in the foot and eventually amputation.
Again, because I cannot examine your father I am not saying that is actually what he has but the possibility has to be ruled out.
My best advice to you would be to get your father to the hospital immediately and have his arterial circulation tested to see whether or not there is a blockage as that is potentially the most severe problem that could be causing his cold feet and pain.
Marc Mitnick DPM
DISCLAIMER
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ADDITIONAL REFERENCES
University of Rochester Medical Center
American Academy of Pediatrics
Columbia University Department of Rehabilitation
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