Foot swollen and pain on right side of foot walking

by Megan
(Richmond,va )

Hi my name is Megan and to start I have had two surgeries on my ankle due to torn ligaments about 10 years ago. For a couple months I have had a swollen ankle-shooting pain randomly - hard to walk in the morning after resting all night. For about a week now I started getting pain on the middle of the right side if my foot when I walk between my pinky toe and ankle- I have always had pain after my second surgery but the last few months it has intensified . Maybe a stress fracture or something else??

RESPONSE

Hi Megan,

Let me start off by stating the obvious, without the luxury of actually examining you I do not know what your actual problem is but I can offer some insight as to what might be going on.
A stress fracture is certainly a possibility but I am not leaning towards that for a couple of reasons. The first is that the fifth metatarsal bone (the bone involved in where your pain is located) generally is not the metatarsal bone most associated with stress fractures.
Secondly, fifth metatarsal bone fractures, particularly at the base of the fifth metatarsal, which would be approximately half way between your fifth toe and ankle, generally involve some sort of trauma, usually an inversion sprain, where the foot bends inwards. You did not mention any history of injury.
So what I am leaning more towards is a problem with one of your peroneal tendons. These are the tendons that originate on the outside of your leg, travel down and go underneath the outside of your ankle with one of them attaching into the base of the fifth metatarsal. They are also used in repairing lateral ankle ligament tears.
It sounds more to me like there is a possibility of the tendon being involved where it attaches into the base of the fifth metatarsal.
The problem here is that your pain and swelling has been going on for a couple of months, which tells me this problem is not going away on its own.
I know nothing else about you, such as your activity level, are you athletic, do you stand all day, your age, are you overweight, etc. Some of these factors may be aggravating the situation but all things being equal, I think you are in need of some medical attention.
At the very least it sounds like an x-ray would be in order, but I would not be surprised if an MRI was also indicated in order to get a better look at the peroneal tendons as well as the lateral ankle ligaments that were previously repaired.
Since I do not know exactly what is wrong with you, but am only "guessing" at this point, I cannot tell you what kind of treatment would be required. It could range all the way from rest and immobilization to physical therapy or even possibly further surgery. Since you have already had two surgeries for the same problem, if further surgery is suggested to you, at least make sure you get a second opinion. Sometimes "less is more" meaning too much surgery in the same area can have inherent problems leaving the patient with additional issues going forward.
Good luck.

Marc Mitnick DPM
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