<s>[INST] I am having tingling, numbness and occasional pain in my toes. They also get very cold. My feet hurt so badly most of the time. My lower legs and feet swell. I take Lasix 40mg/day for that. I had bilateral knee replacements 3 years ago. What would cause my feet to hurt so much? [/INST] Hi,Thanks  for  your query.Most likely cause for numbness in feet  is peripheral neuropathy. I would recommend you to get vitamin B 12 levels done.There are chances of Raynaud's phenomenon. In this condition, people will experience numbness in feet with similar cold feeling. Cold stimulation test confirms it.We should also rule out hypothyroidism where few patient experience similar symptoms. Get T3, T4, and TSH done.Sometimes vascular occlusion of lower limb vessels also causes similar symptoms. To diagnose it we need to do Duplex ultrasound of lower limb vessels.I do hope that you have found something helpful and I will be glad to answer any further query.Take care </s>