Top of foot bruising with pain

by Kimberly
(Parker, CO United States)

I tripped over a cable cord to a computer 4 days ago. No pain first couple days, thought I'd just have a slight bruise. On the 3rd day I woke up it looked worse and bruising spread and pain began with a little swelling. Went to the ER had xrays no bones broken. Day 4 even more bruising and the pain is about the same. Is this something I need to be concerned about. I do take an aspirin 1x daily for a heart condition.

RESPONSE

Hi Kimberly,

I would really need to know more about your overall health to determine whether or not you have an issue here.

Usually, if there is no bruising, swelling or pain the first 24 hours, then I would think there would be nothing to worry about. Additionally, you have had x-rays and have been examined by a doctor so one would think you are "home free", BUT, you state that the pain appears to still be present and there is still swelling. The bruising part does not concern me that much.
Since the sequence is out of whack (pain and swelling should occur initially, then begin to subside), I have to wonder about a couple of things.

First, are you overweight? If so and if you are forced to be on your feet a lot, like at work, then that could explain why the foot seems to be worsening.

How old are you? I can hazard a guess based on your picture. If you are an older individual, that too may explain why your pain appears to be worsening. Older individuals, especially women are more prone to osteoporosis and both men and women will have some degree of arthritis in their feet, both of which could cause pain if subject to trauma.

Now, if you fall into any of the above categories, you will probably find that by using moist heat on the foot and perhaps wrapping the foot in either an Ace bandage or other form of immobilization, the foot will begin to feel better in a short period of time. If you can tolerate them, you may also consider a short term round of anti-inflammatory medication, but check with you doctor since you also take Aspirin daily.

As a more remote, but possible scenario, I have to ask you if you are having any pain in the calf of the affected foot? If you had come into my office with the history you just described, one of the things I would have done would have been ordering a venous ultrasound to rule out a blood clot in your leg or even your foot.

I only mention it because I am concerned about your timeline; the pain and swelling began much after the actual trauma and in looking for a reason for that I would have to rule out a blood clot.

If by the time you read this response, your foot is still swollen and painful, you might want to run that possibility by your doctor and see if he or she concurs.

Marc Mitnick DPM
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