Cold Feet

Do you have cold feet?

If you have cold feet and the rest of you is warm, it could be a sign of poor circulation.

Particularly this time of year I seem to spend a lot of time doing vascular assessments. The colder weather often exacerbates poor circulation resulting in cold feet, colour changes, chilblains, discomfort and in some cases ulceration to the feet.

Although feeling pulses in the feet is a good initial way of assessing circulation. There are some basic observations that can also give clues to what arterial blood supply (that’s blood coming down to the feet) is like. Skin texture can be a good pointer, thin shiny skin and lack of hairs often indicates that blood supply is not very good. Capillary refill time is the time it takes for the blood to come back after it has been squeezed out, for example if you press your finger when it is raised above your heart, you will see the skin go white. Capillary refill time is the time it takes for the blood to come back to the skin, the normal is two seconds or less.

Other symptoms of poor circulation can be pain in the calf muscle when walking, this is known as claudication pain. The pain will come on after a certain distance, known as the claudication distance. What is happening here is when you walk the calf muscle requires blood and if circulation is poor after walking a while the muscle has used the available blood and the resulting pain is the muscle telling us it needs more blood. Normally people will stop walking and the pain will subside. Claudication distance will decrease with incline, so for example if your claudication distance is 150 m on the flat it may be only 50m on a hill due to the muscles having to work harder.

Although vascular assessment is about patient history, physical signs and symptoms. Doppler is a great tool. Doppler assessment is a method of listening to the pulses in the feet. Doppler uses ultrasound to to bounce off circulating red blood cells to measure blood flow. Doppler is non invasive and painless an can give a very accurate picture of what the circulation is like in the feet.

If needed or requested Vascular assessment including doppler is part of a normal appointment. So why not have your circulation checked.

Philip Mann Podiatrist/Chiropodist 686912307