foot and ankle hurts

by andrea
(huddersfield uk)

my big toe is leaning towards my other toes. i have lump on the side of foot next to the big which really hurts and i have trouble walking because it feels like a knife is cutting into the ball of my foot. i have swelling on top of the foot and round the ankle also i have muscle spasms which is really painful.it feels like my veins are going to snap.sometimes when i go to stand up i cant put weight on my foot beause its painful and my ankle locks and to top it off my foot burns on a night

RESPONSE
Hi Andrea,

From your description it appears you have a bunion deformity of your foot. This in itself can be a major source of pain in some people, while other people may exhibit a bunion have absolutely no pain at all.
Bunions tend to be an inherited trait and will be aggravated by the types of shoes that people wear. The higher the heel and the more narrow the front of the shoe, the more likely the bunion will be aggravated.
The usual protocol that I follow with my patients who present complaining of bunion pain is the following. The first thing to do is try and wear more conservative shoes, lower heels, boxier front, wide enough to accommodate the deformity and make sure the material is a soft leather or other material that will "give". This can be an issue with women who go to business and have to wear stylish shoes or those women who just want to wear stylish shoes.
If that fails to give significant relief the I have to introduce medication into the treatment plan. I usually start off with an oral anti-inflammatory medication maybe for two weeks, keeping in mind that chronic use of this type of medication is not a solution; it is only for short term use as the medication has side effects over long term use.
By definition a bunion usually includes an inflamed bursitis on the medial side of the foot. If your bump is red and somewhat spongy to touch, then there is a real chance you have a bursitis and many times a cortisone injection can be very helpful.
Additionally, a course of physical therapy may also be beneficial.
Obviously, the worse the bunion deformity, the less likely conservative therapy will be in alleviating the pain.
If conservative measures do not help, then the patient is looking at surgical intervention. There are various procedures performed for correction of bunions, based on the severity of the bunion and the overall age of the patient.
Now, you mention a multitude of other pain that you are experiencing on the same foot. There is a good chance these other pains are indirectly related to your bunion, because if the bunion hurts enough, it can change your gait pattern and cause additional foot and ankle pain. There is also the possibility that the foot and ankle pain you are experiencing is not related at all to the bunion deformity.
It sounds like the best advice I could give you would be to see a foot specialist in your area and be properly evaluated. Depending on your age and overall health I would assume various options will be presented to you and you will then be able to decide along with your doctor, the best course of treatment.

Marc Mitnick DPM
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