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Forum Name: Rheumatology Topics

Question: ankle swelling-part of my raynauds?


 greenwood - Mon Jul 20, 2009 1:21 pm

Hello,

I have had raunauds for a number of years although it was just actually diagnosed by my doctor this past winter. I had not bothered to mention it to him before, because it is just something I am used to. The reason for mentioning it this past winter was because it seemed to be getting worse and I was getting painful blisters on my toes as a result. I tried calcium channel blockers for about 2 days but they made my heart race and I felt jittery.

Now, for the past few months (since about March) I have been getting burning feet and ankles at night and occasionally during the day. Usually it happens about three hours after going to bed. My feet and ankles will swell, turn red and throb. The heat is unbearable and cannot be relieved easily. Temporary relief comes when I run them under cold water. It is causing serious disruption to my sleep and I have now started getting up for relief while still sleeping. The other morning, after thinking I had slept through the night, I woke up with a very sore toe. When I looked at it, the nail was badly broken off and the toe was quite bloody. I had obviously stubbed it quite badly. Beside my bed was an ice pack which I have used before for cooling my feet in the night. I have no memory of getting up for the ice pack and no recollection of stubbing my toe.

Is this burning and swelling part of the Raynauds or a sign of something else? Why would it be getting worse after so many years of being predictable? Can I get any relief apart from calcium channel blockers? My doctor just about laughed me out of his office when I mentioned this in passing when it first started. Do I just have to live with this?

Age: 32
Sex: female
Other medical issues: vulvar vestibulitis, gastritis
Medications: topical gabapentin, pariet
mild complaints not likely relevant: bruise of no origin that never went away (2 yrs old), mouth ulcers, frequent muscle pain and mild hip pain.
 Tom Plamondon PA-C - Mon Aug 03, 2009 11:28 am

User avatar Hello,
Usually Raynaud's syndrome is a vascular response to the cold. I am not sure why the ice helps relieve the symptoms but it seems like ice would make the Raynaud's worse instead of better.

Treatment for Raynaud's includes smoking cessation, stopping medicines which may trigger Raynauds, and avoiding cold exposure.

Medicine for Raynauds includes calcium channel blockers.

I would investigate other sources of the pain, swelling, and redness. This would include infection, peripheral vascular disease, and skin conditions (e.g. dermatitis).

So a revisit to the family physician would be in order.

Take care.
 greenwood - Mon Aug 03, 2009 7:14 pm

Thanks for your response! I just wanted to clarify one thing. My normal Raynauds is the typical symptoms of pallor, purple, red in the winter and it is in response to cold. Now since March it's like I'm getting symptoms the opposite of Raynauds attacks. It's like my Raynauds went in reverse. Instead of the vessels being restricted and not letting blood through, it is like they are letting too much blood through and I can't get them to stop burning. I saw a pediatrist when it first started and he said there was nothing wrong with my actual feet. There were no signs of a fungal infection or anything that normally causes burning feet. It starts just above my ankle and seems to be brought on by heat at times but I don't know what is causing it in the night time.

You mentioned checking for infection. Do you know what kind of infection would cause similar symptoms?
 Tom Plamondon PA-C - Wed Aug 12, 2009 6:13 pm

User avatar Hello,
Certainly, if the blood vessels were dilating and causing the burning then ice would help (reverse Raynauds?!).
I was not thinking of any specific infection but with redness, swelling, and burning in or around a joint infection is a diagnosis to give some amount of consideration.
A CBC and other blood work (rheumatoid factor, sed rate and CRP) may also be in order.
Take care.

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