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Suggest Treatment For Foot Pain

Posted on Thu, 15 Oct 2015

Question: In the past 3- 4 months I have been having severe pain at the top of my L foot Starts at the base of the foot where it connects to the toes up to the ankle. The pain is in the center of the foot (direct line from the 2nd and 3rd toes) up to the ankle No pain at the sides of the foot (bridge of the foot) It is starting to cause me issues walking any distances and length of time. I wear arch supportive shoes in and out of the house now. At times it throbs and it is warm to touch No redness thou I am a very active person high pain tolerance and rarely do I take any medications I have had to take Tylenol to ease the pain (I do have a bunion on that foot)

Answered by Dr. Naval Mendiratta (2 hours later)

Brief Answer:
Foot pain

Detailed Answer:
Good evening

Thank you for writing on health care magic

Well, foot pain is a very mysterious issue as it is always difficult to pin point where the pain is coming from. There are so many points which can cause pain from any site, so an examination is a must.

But as for the middle part of the pain, I would like to ask you a few more questions to help me narrow down if it is inflammatory or is it age related:

1. Did you have any similar episodes before?

2. Is the pain more only on walking or while you are resting or sleeping as well?

3. How do you feel in the mornings when you wake up? Is the pain more or less?

4. Any swelling noticed?

5. Any associated back ache or neck pain??

6. When did your menses cease? ( As bones are prone to fracture if menopause happened early)

Well, for now I would suggest you dip your feet in hot water( 10 minutes) morning and evening. Secondly you can try with tablet Celecoxib 200 mg twice daily for 3 days to see how the response is. Incase it doesnt improve it will be worth while to get a X ray and an Ultrasound done.

Do let me know these queries

Regards
DR Naval

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Naval Mendiratta (18 minutes later)

The pain continues at rest as well as walking. It is not continuous some days I have no pain then I will have it for several days in a row not associated with any increase in activity level. NO swelling noted No injury tot htat foot that I can remember either
This whole thing started a few months ago out of the blue I am not over weight and actually I am doing less exercise now due to the pain as it limits how much I can walk
I have neck pain but that is due to a whiplash accident 2 yrs ago NO real back pain

Could it be arthritis but wouldn't that be bilateral?

Answered by Dr. Naval Mendiratta (19 hours later)

Brief Answer:
Foot pain

Detailed Answer:
Good evening

Sorry for the delayed reply. Was stuck in home duties

Well, it doesnt look like arthritis as it will be more of a continous pain and would have involved other joints by now. If it is an early start for the disease, it can involve only one joint but after 4 months it can involve the rest of the joints too.

never the less, we should evaluate you for it to rule out if it a start of inflammatory arthritis or it is some other form of arthritis( age related)

Firstly, I would advise you to get certain blood tests done: ESR, CRP, Rheumatoid Factor and Anti CCP antibody

Secondly, A X ray of the foot and ultrasound would be helpful to see what exactly is going on in the foot

Thirdly, give a trial of anti inflammatory to see the response. If you can get your hands on Celecoxib, it would give us a fair clue on the inflammatory arthritis or some other factor causing the pain

Last resort we would keep it as MRI if nothing else comes conclusive

I hope the information was useful

Do let me know for more queries

Regards
Dr Naval

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Naval Mendiratta (5 hours later)

Unfortunately because of my ITP I cannot take any aspirin based meds. Is Celecoxib aspirin based? I will try and get into to see my GP and see if we can proceed with the x-ray.

Answered by Dr. Naval Mendiratta (9 hours later)

Brief Answer:
Celecoxib

Detailed Answer:
Good evening

oh dont worry about, it is not an aspirin type medicine. It is selective COX 2 blocker and inhibits the inflammatory cycle. It does not harm the platelets as such

X Ray would be little helpful to see if any process going on. Ultrasound would be more conclusive though

Do let me know for more queries. would be happy to help out

Regards
Dr Naval

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar