DR FLO: Why do my feet ache when it's cold?

Dr Flo, my feet usually ache and swell during the cold season. I went to the doctor a few months ago and was tested for rheumatoid factor, but it was negative. What’s ailing me? Margaret

Dear Margaret,

Pain and swelling in the feet in the cold season could be due to inflammatory conditions like arthritis. Having a negative rheumatoid arthritis factor test does not necessarily mean you do not have arthritis.

Arthritis means you have pain and swelling around a joint, and this may be from rheumatoid arthritis, osteoarthritis or arthritis caused by other inflammatory conditions like lupus, multiple sclerosis, etc.

The swelling could also be due to poor blood circulation, causing oedema, with fluid accumulating under the skin causing discomfort and pain. This occurs if you are immobile for long or if you stand for long. It can also happen due to contraceptive use, pregnancy and other problems like kidney, liver, heart, lung and thyroid diseases.

It is advisable for you to visit a doctor so that the exact cause of the problem can be identified. This may involve some blood tests, x-rays and/or scans. The doctor may also take some fluid from the affected joint to test it.

To manage it, keep your feet warm in the cold season, avoid standing for long and elevate your feet to help reduce the swelling. Exercise regularly and lose weight if you are overweight. Anti-inflammatory medications can help manage the pain.

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Dr Flo, my right big toe gets numb sometimes. It takes days to lose the numbness. I have not had this experience for long. What's wrong with my toe? Gitachu

Dear Gitachu,

Numbness of the toes can occur because of poor blood circulation, or due to injury to the nerves of the foot caused by uncomfortable shoes, or from nerve injury caused by low back problems or diabetes, excessive alcohol consumption, smoking, kidney or thyroid problems, vitamin B deficiency, heavy metal poisoning (e.g. lead, mercury, arsenic), infections like herpes and HIV, some inflammatory conditions (e.g. Guillan Barre syndrome, vasculitis, sarcoidosis, etc), and as a side effect of some medications like chemotherapy, anti-retrovirals, TB medicines, etc.

Some tests that can be done include a blood sugar test, vitamin deficiency test, nerve conduction study and if a particular illness is suspected, tests targeting that illness.

If an underlying cause is identified, treating the cause will stop any further nerve damage. Unfortunately, nerves do not heal easily and any damage they may have suffered already may not be reversible.

At home, soak your feet in warm water for some time and massage them to relax the muscles and improve blood circulation. Wear good, comfortable shoes, with good insoles, wear cotton socks and rest your feet as often as possible.

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Dr Flo, I am 20 years old. I was diagnosed with a urinary tract infection and put on antibiotics for a week. The medicine helped, but it didn’t get the whole job done.

Last week I went to another hospital and my urine was tested, but no bacteria was found. I was given cital and another medicine that made the pain go away.

Yesterday, I got the same abdominal pains that got me diagnosed with a UTI in the first place. I feel pain when I want to go to the toilet and when I drink water. Please tell me what’s going on. Elisha

Dear Elisha,

Urinary tract infections (UTIs) are commonly caused by bacteria that live in the intestines. They can travel from the anus to the urethral opening (where urine comes out), since the two are not far from each other.

Women are more likely to get UTIs because they have a shorter urethra (the tube that carries urine to the outside) compared to men, which makes it easier for bacteria to travel up to the bladder and cause infection.

A man has a greater risk of getting UTI if he doesn’t drink enough water, is immobile for long, if the prostate is enlarged (more common in men over 50) or engages in anal intercourse.

UTIs are easily treated with antibiotics. If the symptoms do not clear, you may need a longer course of antibiotics or a different type of antibiotic to clear the infection, even though the urine test may be normal.

Take a lot of fluids, about 1.5 to two litres a day; urinate when you need to and do not delay, wipe your perineum from front to back and keep the genital area clean and dry.

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