red, swelling, hot foot/ankle

by jennifer
(USA)

my husband is on his feet all day, and three times this has happened. different foot every time. his foot hurts so bad he can barely walk. he has tough wolverine work boots. top of foot by ankle is swollen. his entire foot is warm-hot and his feet are never hot.

RESPONSE

Hi Jennifer,

The thing that struck me in your narrative is the fact that your husband is on his feet all day wearing work boots and I assume he works at least five days a week. Yet this problem he has experienced has "only" occurred three times. So from this I can assume it is not his work boots per se that is causing his pain.
The next thing I would have to consider is if these three incidents were due to a certain activity that your husband may have done, that he does not do on a regular basis.
For example, perhaps your husband never climbs ladders but on three occasions he climbed a ladder which just for the sake of discussion, climbing a ladder could put a lot of pressure on the tendons in front of the ankle. This could cause pain in the area that you mention.
So, the first thing I would do is ask your husband if he can relate any specific activity with the onset of his pain. In the case that there is any correlation, eliminating or being careful about the activity would probably eliminate his problem.
In reality, I do not think that is the problem, but I thought it was worth mentioning.
Two potential problems come to mind.
The first is tendonitis of the tendons that run down the front of the ankle, over the top of the foot and act to raise the toes. This would be consistent with a man who works on his feet all day particularly wearing work boots which tend to run up the ankle and depending on how tight the boots are laced could be aggravating the extensor tendons.
This would give the symptoms that you describe. This is also generally a self limiting condition that will respond to anti-inflammatory medication and in most cases will subside in a week or two. You do not mention how long these symptoms last as that would have been helpful.
The next possibility would be a gout attack. Gout is an accumulation of uric acid which accumulates in the joint, with the ankle joint being a fairly common joint for this problem to occur.
In a classic gout attack, the affected area will become red, hot and very painful. Typically the attack will last for a few days and then subside. It can occur again for no apparent reason; these attacks may or may not keep repeating themselves.
It is beyond the scope of this response to make an actual diagnosis as I would have to examine your husband and have blood work performed.
These are the two most common causes of your husband's pain that come to mind, but certainly not the only potential problems.
My advice would be for your husband to see a foot specialist in your area for a work up to determine the actual cause of his pain.

see related article....gout

see related article....tendonitis


Marc Mitnick DPM
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