About 3 months ago I opened a door with a metal edge over the top of my bare right foot over the 4th tarsal about 1" distil to the toes. As expected, the foot swelled within 30 minutes and a deep bruise appeared which took about 2 weeks to resolve. Swelling resolved in about 2 weeks as well but general tenderness remained but was acute if I pressed directly on the site of the injury. 3 weeks after the injury I finally had the foot X-rayed which showed no injury to the bone. About 2-3 weeks ago the swelling suddenly returned for no explicable reason and has resulted in a foot and ankle swollen to about 2 - 3 X normal. There's no redness but the point of original injury is slightly tender to touch.

The extent of the swelling depends on what type of shoes I wear. I do not wear heels because of knee problems: if I wear loafers the swelling begins at the point of constriction of the loafer on the top of the foot and extends up my ankle. If I wear a closed top shoe swelling begins at the ankle openning and encompasses only the ankle and only slightly the top of the foot. In both cases the ankle is stiff but I have fairly complete mobility if I "force" it and no pain. Swelling is not alleviated by cold compresses and I have been on anti-inflammatories for about 3 weeks (started originally because of slight sprain in my left knee). I took Voltaren for 2 weeks and my doctor switched me to Naprosyn last week, which does not seem to be helping--in fact, swelling seems to be slightly worsening. Removing my shoe and elevating the foot while sitting does not alleviate the swelling either: the only time my foot and ankle return to normal is after a night's sleep but then swell again within 30 minutes of putting on my shoe. I am not having any problems walking.

To give a more complete picture of my general health, I have an idiopathic autoimmune disorder (sudden appearance of angioedema in the lips, eyelid and esophagus which is kept in check by long-term use of an OTC antihistimine (loratidine) and H1 inhibitor (cimetidine). I also have asthma for which I take singulair, atrovent and flovent, GERD for which I take Prevacid, hypertension I for which I take Toprol XL and moderate sleep apnea. I currently seem to be having problems with other inflammatory processes as well: my doctor recently diagnosed chondrochondritis (thus the switch to Naprosyn) and I just had to have a root canal because of intractable inflammation in the back right lower molar and extending into the jaw. Interestingly, all of the swelling I experience is on the right side of my body. I am ashamedly about 60 lbs overweight (technically obese) and am frustrated by an inability to lose weight even on a low-fat, low-carb diet and excercise (30 min or more/day on a stationary bike). I am 46 years old, female and have a sedentary job although I keep a stair climber under my desk and "pedal" on it from my chair while reading and researching a couple of times a day. Swelling is unilateral so I'm not concerned about early stage heart failure.

Any thoughts on the foot problem? Although it's localized, should I be concerned about a more systemic problem? My doctor thinks it is soft tissue damage but, as I mentioned above, I have not sustained a second injury to the foot. Is it time to demand a referral to a podiatrist or should I give the Naprosyn more time?

have you tried support hose?

Do you mean anti-embolism stockings? If so, no. There's no indication of a clot -- no redness or pain.

The stocking are good for edema as well. You have stated that your foot swells up just proximal to the type of shoe you are wearing. The socks would extend that coverage to your knee. Their available at most pharmacies.

Thanks. I didn't realize you could get knee high stockings -- I've only seen the thigh-high variety. I'll give it a try. How important is it to determine the etiology of this? I'm starting to wonder if it's related to the Toprol I'm taking, which has a reported side effect of peripheral edema in approximately 1% of those using it. I'm wondering if it's possible that the blood vessels surrounding the original injury are weakened and more likely to leak, and that this new tendency is exacerbated by the vasodilatory function of the Toprol.

All in all I recomend controling the edema because that can cause pain and more if left uncontroled. As far as medications see your doctor or get a second opinion.

Hope the socks help.