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Hello
by Abdul Malik
(Karachi, Sindh, Pakistan)
I am a male 22 years old, I pulled up a sac weighing around 160 pounds, i was just holding it up there and a breaking sound came from my right foot from centre. After that my foot swelled up and in emergency i went to a near by hospital where doctor had an x ray for my ankle, and nothing was in the xray. i am having pain above my fingers what ankle have to do with that? should i refer to another doctor or get an other xray for my foot for the fingers or what i can't walk it just swells up and pains alot.
He casted my foot for three weeks, n its itching inside what should i do for that?
Hi Abdul,
Many times a small fracture will not initially show up on x-ray and if the foot is still painful it should be x-rayed again after about ten days. If that x-ray is normal and you are still in a lot of pain, a bone scan or MRI would be helpful in finding a fracture site. The MRI would also be helpful in observing any soft tissue injuries.
The itching? Stick a wire hanger down the cast.
Marc Mitnick DPM
by Carmen
(Puerto Rico)
Jabs of pain in my right big toe, the left side of my toe is swollen. It started hurting, all of a sudden, in the afternoon. It has gotten worse in the course of the day.
Hi Carmen,
The most common cause for that type of foot pain is an ingrown nail. It needs to be seen by a doctor.
Marc Mitnick DPM
My husband is having foot pain. The pain starts form the inside of the left pinky toe which has a foul odor when it is pulled open and the pain radiates up the top portion of the foot no matter whether it is manipulated or not. The area at the top of the foot is also red now and goes down toward the infected toe.. What can this be?
Hi,
More than likely your husband developed a fungal infection in between his toes or had a corn that broke down. In either event the are has developed a bacterial infection and he should be seen immediately by a doctor. This is not something to ignore.
Marc Mitnick DPM
by Laura
(Lakewood, CO )
A couple of days ago I started having extreme pain in the top of my right foot. I did drive for 3 hours straight that day and I thought that might be it. Well its been three days and it seems to just be getting worse. As far as I can tell there is no swelling and no brusing. But it hurts really bad. It's right below my third and fourth toe and goes through my foot. It hurts especially bad when I try to walk or move my foot. I'm getting worried what could this be from and how do I make it feel better?
Hi Laura,
Two things come to mind, either tendonitis on the top of the foot that allows you to bend your toes upwards, or the possibility of a stress fracture, not so much from driving but possibly occurring just from walking.
Your best bet would be to see a doctor, you may need an x-ray (depending on how far along you are in your pregnancy)
Marc Mitnick DPM
by Diana
(Lansdale, PA)
I went on vacation about 2 weeks ago and on a Sunday starting riding my bike at the shore and doing a lot of walking. By Tuesday night while I was laying on the couch watching TV I started feeling numbness on the bottom of my right foot near the last 3 toes. Now 2 weeks later my foot hurts when I wake up and put it down. The toes are not as numb, but still have some numbness. I am 54 years old and fairly active. I have back pain too. Do you have any suggestions as to what this may be.
Hi Diana,
The pain in your right foot may be from irritation of the local nerve which occurred while you were bike riding. See my article on Mortons neuroma. If it is a neuroma and it was a direct result of bike riding, it may resolve by itself as long as you no longer ride your bike. In general if the pain does not slowly resolve over a period of say four weeks, then you may have to seek medical attention. Certainly if it starts to worsen you would be wise to have it checked out sooner.
I do not think there is a connection between your foot pain and your lower back pain other then they may have both been caused by your bike riding.
Marc Mitnick DPM
by Autumn
(TN)
Hello. When I sit with my legs down towards the ground, my feet turn purple/blue. From the ankle down, I stay cold. My hands usually do not bother me. I have noticed that all the veins on both sides of my feet are starting to bust and show a red color all over the sides of my feet. What could this be?
Thanks
Hi Autumn,
Any color changes such as you mention are highly suggestive of a circulatory issue. Since I do not know anything else about your medical history, I would suggest you see a vascular specialist just to make sure it is nothing serious.
Marc Mitnick DPM
On May 2, 2008, as I was walking through my apartment complex, either returning home or leaving I fell. The foot has been in excruciating pain ever since. It seems the heal of my foot is in constant pain. No matter what I do to relieve the pain, nothing helps. As I am sitting here typing this e-mail to you, my foot is constantly aching. I have been to the doctors three times to no avail. I have another appointment with the doctor I saw a couple of weeks ago on Monday, September 8, 2008. The heal will not stop hurting. It hurts all of the time. Is there something that the doctors are not seeing. The last doctor told me I might injured a tendon. However, at this time I am not sure. All I know is that the foot has been in constant pain for exactly 4 months. It really is noticiable when I first have to arise and use it and then I have to hold to walls, furniture or whatever to arrive to wherever I need too in the apartment. When I am out and about, I use a walking cane to help tolerate the pain.
Can you please help eleviate the pain? I would greatly appreciate any help you maybe able to give me at this time.
Sincerely yours,
Theresa
Hi Theresa,
Pain of this duration especially due to trauma, requires an MRI. Most sprains and bruises from falls will go through their normal healing process which should last a couple of weeks at most.
I do not think an x-ray alone will help. Insist on an MRI which will give more insight into what is going on with both your bones and the soft tissue surrounding the area.
Marc Mitnick DPM
by Ann R.
(Missouri)
Hi. Three weeks ago, I twisted my ankle and fell. As I fell, my right foot must have caught on the edge of my front porch. I've had three sets of xrays done, and all of them were negative for a fracture. The problem is that I have constant pain in the area around my little toe, and all along the bottom of my right foot (I guess the ball of my foot on the right side). It's a sharp stabbing pain, and I can barely put any pressure on it. Do you have any ideas? Thanks!
Hi Ann,
If you are still having pain I would suggest a new set of x-rays or perhaps even an MRI. Sometimes small fractures will not show up initially on x-ray, but may later on. An MRI may show signs of a fracture but perhaps more important it may also show soft tissue damage which may actually be the source of your pain. Assuming no pathology can be found, then I would suggest a round of physical therapy.
Marc Mitnick DPM
by Calesse
(Zionvsville, IN USA)
my left foot on top about two inches toward my ankel from my toes hurts when I run or walk. I am a cross country runner and recently bought new shoes, the same as my old ones, just a new pair. I have never had pain like this before, only IT band problems in my other hip and knee.
Hi Calesse,
On the surface at least it would seem the new running shoes are the source of your problem. There is a difference between the new ones and the old ones and that it that the new ones are not yet broken in and are probably too stiff.
I would think if you are a serious runner you will probably need to break in the shoes before you actually go out for any serious running.
The problem on top of your foot is probably just a tendonitis (read my section on tendonitis), but unless you do something first about your shoes the foot may continue to hurt.
Marc Mitnick DPM
by Tracy
(Calgary Alberta Canada)
I had a Morton's neuroma removed from my right foot 10 weeks ago. The doctor said there was two neuromas and one was a huge neuroma they basically filled the entire space in my foot.
Every day since the surgery there has been pain, but nothing that was to severe. This pain is directly near the incision site, and it raidates to my toes in the form of shooting pains on occasion. If my foot is bumped the pain is awful. Since my surgery there has always been swelling but the past two days the swelling has increased as well. Along with my foot feeling "fat" it feels like the pad of my foot is swollen so that I feel like I am stepping on a balloon. I did call my doctor but can't get in for 5 days and I am just wondering if I should go to emergency or wait.
Thank you
Hi Tracy,
A good rule of thumb in surgery is that you should always see a gradual diminishment of pain; if for some reason the pain should increase that would be reason for concern.
Since it has been 10 weeks, and assuming your incision has been completely closed for some time, then the chance of infection is almost nil and an infection is probably the only thing the ER could accurately treat you for.
Your symptoms sound like a complication from the surgery and the person best equipped to treat that would be your surgeon.
Marc Mitnick DPM
by Linda
(West Virginia)
Hi Doctor,
I'm a 46 year old female. I have a long history of plantar fascitis which has been treated with injections, orthotics, and physical therapy over the years. I continued wearing orthotics even after the PF pain subsided. Several months ago, I noticed a tingling and numbness in my toes. Over the course of a few months, the tingling turned into burning, searing pain on the soles of both feet (left worse than right), electrical type jolts that occur on the soles of both feet and sometimes in my toes. I also have tenderness and pain in the metatarsals, with terrible pain when my feet are squeezed from the sides. Worst of all is pain (significantly worsens when on my feet) at the top of the ball of my foot (again, worse on left than right), up close to my toes from the big toe to the fourth toe; it's a sensation that something is wadded up under the skin, very painful, but no redness or rash or swelling there. I do get significant swelling across the top of my left foot and in both ankles, worsening as the day progresses.
My podiatrist took me out of orthotics because he thought the synovitis was related to wearing only half-length orthotics. He sent me for iontophoresis which didn't help. He sent me to a rheumatologist, who gave me a questionable "it's possible" diagnosis of RA, supported by slightly elevated RA factor in my bloodwork, negative for lupus. I have tested negative for diabetes. EMG on both feet essentially negative. Last visit to podiatrist had him "thinking outside the box" and sent me for Anodyne therapy and a course of Metanx, which doesn't seem to be helping now that I'm three weeks into it. I'm also taking Lyrica (helps pretty well with the searing pain, but still more painful at night than I'd like) and Plaquenil for the possible RA. Podiatrist says I'm a "complicated case."
The pain is getting worse and I'm afraid I'm moving towards total debility if this doesn't get a proper diagnosis and treatment. I should mention that I'm about 100 pounds overweight, with a frustrating inability to exercise because of significant foot pain. Wonder also if there's a connection with bad left knee (orthopedist recommends uni-compartmental knee replacement) and fractured tailbone about a year and a half ago. Also history of sacroiliac joint problems on the left.
Any help appreciated.
Hi Linda,
The first two thirds of your note sound like classic neuroma to me. Read my section on Morton's neuroma and see if you don't agree.
Marc Mitnick DPM
by Donna
(Orlando, FL)
I have been exercising for 7 wks, 4-6 times per wk for about 30-40 minutes, primarily on the treadmill. I walk up to 3.6mph but do not run. For approximately the past 5 days, I now have pain on the outer part of my left foot, about an inch and a half forward of the ankle bone, just above the edge of the foot. There is a little bump there, but anatomically, there is a bump in the same place on my right foot, but it does not hurt at all on the right side. It does not hurt constantly, but it does hurt everyday and when it hurts, I really cannot walk on it. I was about 35 lbs overweight when I started 7 wks ago. What could this be?
Hi Donna,
The cause of your foot pain may be due to irritation of the "bump" on the side of your foot which would be the base of the fifth metatarsal bone, or aggravation of the tendon that cuts under the foot at that location. The most common cause of pain in that area is from shoes that are too narrow, so if your sneakers happen to be too narrow in that area, compounded by the amount of exercise you are now doing, I would not be surprised to hear that you have pain.
If that "bump" seems to be hanging over the sole of your shoe then that may be your problem. A wider athletic shoe will go a long way to solving the problem.
Marc Mitnick DPM
by Richard Vazuqez
(Corona, CA, USA)
About three years ago I was running with out shoes or socks at a park and I was pretty much running at top speed, and there was a pot hole that I didn't see and well my left foot fell in and I fell putting all my weight on my left foot. The ankle is fine but the medial cuneiform I believe is what its called hurts all the way to about the first metatarsal and then from there the pain shoots out everywhere. I cannot stand for more then ten minutes without it hurting. When I did fall I did not hear it break nor was it disfigured in anyway, no one was around to help me at first when I tried to get up I fell the pain was just to bad so I forced myself to walk on it. If it was broken I probably wouldnt of been able to stand on it. Anyway I never went to the doctors because I didn't have any type of insurance I wrapped my foot up myself and tried to just ignore the pain. It has been 3 years and the pain is still with me. I have tried going to a regular doctor and he took an x-ray and said that my foot was fine. Then I went to a podiatrist and he taped my foot and told me to walk around without taking the tape off, I stopped going because his appts were 125 dollars each visit and I am full time student that doesnt have that kind of money. The taping of the foot didn't do much the pain was still there. From what I have explained do you think it is possible for it ever to be normal? or because I have had the pain this long will it continue to stay. There have been times that I have wanted to just saw it off because it stops me from trying to work.
Hi Richard,
My "guess" would be you tore a tendon where it attaches into the area of the cuneiform bone, more likely the navicular. This would not show up on x-ray, but signs of a previous fracture or disfigurement from a previous fracture would.
So, if your recent x-ray was normal and you are in a lot of pain, then we can assume you have soft tissue damage.
I am not clear as to if you have health insurance at this point, but if so, I would recommend an MRI to look for soft tissue damage.
Your other issue is that it has been three years since the injury and because of that time span some of your injury may be permanent; physical therapy may or may not be of any benefit at this point.
Marc Mitnick DPM
by Warren T Ulrich
(Portland, OR , USA)
I have had two crush injuries to my right foot. They happend with in 2 years of each other. Both resulted in no fractures, but i had alot swelling, pain and tissue damage. I have recovered for the mostpart, but my right foot is still swollen were the impacts were, and the swelling gets worse with any activity, even standing for a long period of time. It also can be pretty painfull. I have also noticed changes in color at some times. I also stubbed my toe, about a month ago and it became infected. It cleared up on its own but it took a few weeks. I recently stubbed the toe again, and it again became infected almost immedietly. I am wondering if anything at all can be done, or if this is a result of the injures i will just have to deal with. The first injury was in 2002 , and the second in 2004.
Thanks for you help
Warren
Hi Warren,
I am not sure of your question but your toe infections have nothing to do with your foot injuries of a couple of years ago. Avoid stubbing your toe and I think you will solve that problem. The bigger issue is what you are left with as a result of the two foot injuries. If you are having pain and I am not surprised based on the type of injury you sustained, you might want to work with a podiatrist and try an orthotic in your shoes to better stabilize the foot when you walk. Although it has been two years, physical therapy might be very beneficial in reducing the discomfort in the injured area.
Marc Mitnick DPM
by Nancy
(Va. Beach, Va.)
My eleven year old grandson is having a lot of pain on the top of his foot. What could the cause be. He is a baseball player and has been out of playing for over 10 months due to Tanners disease in his elbow. This is almost completely healed and now he is experiencing this pain on the top of his foot. My daughter mentioned this to his orthopedic when he went for the monthly appt. for his arm. The Dr. said just give his advil and ice. What are some of the things that he could be having.
Thank you, A concerned Grandmother
Hi Nancy,
Two possible causes would be tendonitis and possibly a stress fracture. Since the advil did not work I think the foot needs to be examined. Based on his current doctor's attitude, I would seek a second opinion.
Marc Mitnick DPM
by june charlene thomas
(trenton sc u.s)
my son who is 8 fell 2 weeks ago he was running and a rope caught him across his neck well he is a big boy ,he fell backward and we dont now if he fractured it or sprained it really bad because we cannot get him off the couch to go have x-rays done he is scared to put his foot down ..please help ,thank you.
Hi June,
Well....the only way you are going to know if he fractured a bone is to have an x-ray. If it is still hurting two weeks after the injury, there is a fair chance he may have broken something.
Get him to the doctor.
Marc Mitnick DPM
my husband complains of aching in both feet which goes away while walking and hiking but as soon as he stops and sits down the aching starts. He usually has the aching when he is not active. He denies burning, tingling or numbness, only aching and it is relieved by aspirin.He was overweight but is not now and he says it was the same at both weights.He also was diagnosed with type 2 diabetes but since his 40+lb. weight loss his glucose is always in the norm. Any info. would be appreciated. Sincerely, Peggy
Hi Peggy,
Read my section of arthritis. Pain and stiffness in the feet on initial ambulation is usually a cardinal sign of arthritis. In most cases, as is true with your husband, the pain diminishes as you walk.
Marc Mitnick DPM
by Katherine
(Dallas, Texas)
I have pain from about the top of my foot around the area where metatarsalgia is described as to about the heel of my foot. I feel more pain in-between more like its in my arch of my foot. It hurts to stand on it shoes or bare foot. And its only my right foot. The pain feel like shooting needle pain that you commonly feel when you have carpel tunnel syndrome. Sometimes it burns. It hurts to stretch my foot downward and up and to the sides. I've tried puting insoles in my shoes and it helps somewhat but the insole wears out due to my line of work, where all I do is stand on concrete (retail industry). The pain has gotten worse in the past month and I don't have health insurance to go see a foot doctor. What can you suggest to help me alliviate the pain?
Hi Katherine,
While I cannot make a diagnosis I would think if inexpensive insoles have helped, then a better insole might give you even more relief. Generally the cheaper insoles do not give enough support, whereas the more expensive ones will support your foot better and may make a bigger difference.
Marc Mitnick DPM
by Gloria
(Michigan)
I had surgery Feb 2008 for bone fusion in foot. There are five screws in my foot. My ankle started swelling a few weeks after surgery and after months of agonizing pain I was given an injection of cortizone? Problem on ankle solved. All of a sudden my foot feels like it exploded near the big toe. Extreme pain runs through my foot if I wiggle my big toe or put pressure on my foot. It hurts even if I take a deep breath. Sounds bizarre. Any suggestions?
Gloria,
It does sound bizarre and since your case is so complicated (especially not being able to examine you) I cannot offer any logical explanation.
The only advice I can offer is to call your doctor and tell he or she about it.
Marc Mitnick DPM
by Tracie
(Blanchard, OK)
I am having trouble with the outside of my left foot from the toe to the arch to the heel and sometimes (after I have worked all day) even up on the outside of my ankle to my knee. It is a dull ache when I wake in the morning, but when I get out of bed it really is painful until I walk on it for a while.
I broke my "pinkie" toe about 2 yrs. ago on this same foot, I never went to the doctor, always thought there was nothing that could be done about it.
Now I am wondering if the pain could be related to that.
When I come home from work (only 10 minutes away) I can hardly walk when I go to get out of the car, I have to stretch it and the first couple of steps are really painful. I just want to get this taken care of. Please help! Thank you.
Hi Tracie,
I doubt the broken toe of two years ago is the source of your pain, unless the pain has been present since the day your broke the toe, but by your description that does not seem to be the case.
Your best bet would be to see a podiatrist who should be able to help you with this problem. Although I cannot give you a diagnosis, it sounds like a problem related to the way you walk and perhaps an insert into your shoe could be beneficial, but that is why you need to see a doctor.
Marc Mitnick DPM
by kay
(Bowling Green, Ky USA)
Yesterday I stepped off the steps and when I did I stepped on the edge of sidewalk turning my foot outward and fell to ground. Minimal swelling on the outside of the foot. Can walk as long as I do not move the foot and keep it straight. If I move foot upward or to the sides I feel pain on the inside of my foot and down toward the arch. I have some light bruising around the medial malleolus. Did not go to hospital but kept ice on it the rest of the afternoon and kept it elevated. I didn't think it would be as sore as it is today. Should I just put it in a wrap to keep it straight?
Hi Kay,
You should see a doctor and have the foot and ankle x-rayed. At a minimum you have probable strained/torn your medial ankle ligaments, but there is always a chance you suffered a fracture.
The problem is in either scenario if the foot and ankle are not properly treated you may end up having residual pain for an indefinite period of time. I see this type of situation on a regular basis (improperly treated injuries).
Marc Mitnick DPM
by Kerry conner
(Maupin,Oregon)
Both feet ache, burn, tingle terribly, primarily at night in bed while laying down. I have had a broken bone in my right foot on the side about 1 inch down from little toe, but that has healed and pain is equally bad in both feet. When asked to identify a spacific area of the foot where it hurts it is difficult as the whole foot hurts.
Hi Kerry,
There are a number of conditions that can cause tingling particularly at night, including but not limited to poor circulation or a nerve entrapment in the lower back.
The pain you are describing could be indicative of something more serious so your best bet would be to seek medical care to determine the cause of your symptoms.
Marc Mitnick DPM
by Pat
(Tampa, FL)
I went to a podiatrist here in Tampa for an ingrown toenail. I had been treating it for some months by my self trying to avoid what I knew would be a painfull ordeal, but when the pain became so bad that I thought why not just get it over with,I went in. The doctor numbed my toe with several shots, then proceded to cut away half of the nail, and going deep into the side of the nail also cut a bit of the nailbed. When I asked for pain med the doctor responded by saying that they did not give pain med there. I was shocked. As a nurse I learned that pain is the fifth vital sign. I pressed the issue and was awarded with 10 Darvocet. Although not happy I thought, with the $20.00 tube of Amerigel maybe I would be alright.
Unfortunately I developed an infection. I felt reluctant to visit the DR, I was in great pain now and the toe was draining copious amounts of green liquid. So happens that the MD who performed the excision was not in. His partner, a women saw me and as she sat down while I explained about the drainage, dismissed it saying, "you would expect alot of drainage anyway". (My hopes of some sympathy were dashed.) I would not have expected it since this was my first experience with a toe infection. While she dressed the toe, she squeezed it, causing me to nearly jump off the table her comment, I barely touched it. When I asked for pain med her response was "we don't give pain medicine". "you can take ibuprofen". Well I had taken it prior to comming back, which I had explained to the DR, and it was not a great help, also having had bariatric surgery two months prior, damage to my pouch is a great concern. I explained this to the DR and she continued to deny me any pain relief. Finally after several tries she agreed to write a prescription for a few pills.
My question is; Is there some type of mandate, criteria for practice , or guideline that instructs Podiatrists not to give pain meds? , Do they believe or are taught that there is less pain in the foot? What is best practice?
Hi Pat,
I cannot comment on the actions of the two podiatrists you saw because I have not heard their "story", but generally in my practice I will write for pain medication as needed.
Most ingrown nails when removed properly are not terribly painful afterwards. (there are exceptions to this). Advil or Motrin generally work fine. But on occasion I will prescribe something stronger particularly if I know the patient cannot go home and rest the foot, but must go back to work or is going to be on their feet for the rest of the day, for whatever reason.
Writing a prescription for any medication should be tailored to the patient and the problem being treated, so you cannot make blanket statements.
My suggestion would be to find another podiatrist if you were dissatisfied with the service you received.
Marc Mitnick DPM
by pat
(melbourne fl)
top of the foot dropped a can on the top of my foot a week ago. I have swelling and when I bend my foot i can not bend it as far as my other foot . I bend my toe and my second two dosent bend as far it hurt aroud the top wear the foot meet the leg, i had an exray but it ndidn't show any thing
Hi Pat,
If there is no fracture then it is safe to say you did not some soft tissue damage to the top of the foot probably to one of the tendons that bends the toes upwards.
Speak to your doctor about this, some physical therapy may be helpful.
Marc Mitnick DPM
by c. brown
(usa)
I have been diagnosed with tarsal tunnel, sesamoiditis, crushed sesamoid bones. This happened from a injury at my employment. I have had MRI's and bone scans to rule out RSD. THe doctors that I have been doctoring with are not sure why I am still having sharp pain, walking on outside of my foot, or the numbness. The scans show no signs of RSD.
Can you help in telling me what else could cause all of these problems?
Hi,
I am not sure that an MRI or bone scan can diagnose RSD. It is usually based on clinical grounds. This is important. MOST DOCTORS CANNOT DIAGNOSE RSD. I would suggest that you see a neurologist or pain management doctor to accurately rule out RSD.
If you end up not having RSD and you are walking on the side of your foot to avoid the sesamoid bone, then that bone needs to adequately treated. If you are just having pain on the side of your foot from walking (I am unclear why you are walking on the side of your foot), then I would suggest a round of physical therapy.
Marc Mitnick DPM
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