What causes cold pain in the instep?

When the instep feels cold and painful, the first feeling it gives is that the blood circulation in the foot has deteriorated, causing the coldness. The cause of this symptom may be vasculitis. We know that vasculitis is a relatively serious disease, which is mainly caused by blockage of arterial blood vessels. At this time, it often leads to poor blood supply to the foot, a drop in local temperature, and sometimes painful symptoms.

Clinical manifestations : This disease is more common in young and middle-aged people, and is prone to occur in the lower limbs. The affected limb presents temporary or persistent pallor, cyanosis, burning and tingling. The skin turns red when the affected limb is hanging down and turns white when it is raised. Then there is numbness in the toes and pain in the calf muscles. The pain is stimulated when walking and disappears when resting.

Superficial phlebitis and edema often occur in the lower legs. During the examination, it was found that the dorsalis pedis artery pulse was weakened or disappeared. As the disease progresses, intermittent claudication and Raynaud's phenomenon may occur, pain may intensify at night, the toes may become extremely painful, the skin may become cyanotic, and then the toe tips may ulcerate or become gangrenous and turn black, gradually spreading to the proximal end.

Treatment methods 1. Drug therapy (1) Dextran-40: Dextran with a molecular weight of 5,000 to 20,000 is administered by intravenous drip. Long-term use may cause bleeding and it is not suitable for patients in the acute development stage or those with ulcer gangrene and secondary infection. (2) Vasodilators include tolazoline hydrochloride, niacin, and benzylamine hydrochloride. (3) Antibiotics: For patients with local and systemic infections, appropriate antibiotics should be selected for treatment. (4) Glucocorticoids may be considered in the acute phase of the disease, with daily oral prednisone or intravenous hydrocortisone. (5) Painkillers: For patients with significant pain, various analgesics can be used, or procaine acupuncture injection, intravenous blockade or femoral artery periartery blockade, or even lumbar sympathetic ganglion block or epidural anesthesia can be performed. (6) Local treatment: For dry gangrene, sterile bandage can be used to prevent infection, and for ulcers, Kangfuxin dressing can be applied externally.