Ask the Doctor

Guidance will be appreciated
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hiker
Guidance will be appreciated

First Emily, thank you for this service. I sure appreciate it as I have an issue I'd very much like you to consider if you have the time. I'll try to be as explicit as possible.

A little background may help here: I've had chronic fatigue syndrome (CFS) for eight years and I was recently recovering. I started walking around the house. Around the garden, Around the park, the block, the suburb, around mountains, up mountains, built up to 30km, and all was awesome. I found a love of hiking. I went the gym, and all was great!

With no indication of a foot problem, one evening after dinner (24 Dec) I went to stand up and I had this tremendous pain throughout my foot. It was so severe the slightest movement would lance an agonizing pain through my foot and ankle. It was so bad I splinted it so it wouldn't move. I couldn't put any pressure on it. The foot looked normal other than a very slight fleshy swelling under the ankle.

I went to hospital, was examined, x-rays taken because it felt broken, but nothing showed up. It was suggested I had damaged a tendon and to take it easy for a few days.

About a week passed and I visited my doctor and explained the situation. He gave me some anti-inflammatories and said rest, ice, and it'll be fine in a few days. He also said it could persist for more than 3 months and if it does to come back. I thought this a bid odd, but he's the doc. Not me.

A couple of weeks later I saw another doctor for a third opinion. She said it's probably exercise related and to rest it a few more days. I advised I had rested it for about a month and although much of the pain has subsided it's difficult to walk on. I said when I walk anywhere I have to wear my hiking shoes for support.

Since the injury I alternate with four ice packs throughout the day. Unfortunately my health took a turn for the worst (CFS again) and the foot pain remains.

About the pain: when it first happened, however it happened, there was significant pain throughout my right foot, especially the top and outer blade, with a little pain, but not much, under the foot. The pain was 8 out of 10. Very significant. I first thought it was broken and had nerve damage.

After removing the splint (was on for about 24 hours because the hospital was full and I wasn't a priority), the pain was about 4/10 in the same locations.

Now, four weeks later, there's no change. I've tried many things from exercising the foot (which makes it worse), constant ice and self-massage, running a golf ball under foot, Voltarin gel, rest, but nothing works. I'd love to go to a podiatrist. The swelling remains and most of the pain is at the top of the foot about an inch below the middle toe. I also get pain in the blade and occasionally a little pain at the bottom of the foot.

Unfortunately with my illness I haven't worked in many months and money is very tight. I appreciate you don't give medical advice and any anecdotes, things to look into, suggestions, anything drawing on your experience will be awesome until I can somehow afford to get some help. I also miss my hiking, sick all the time, and this foot aggrevation is getting stressful.

Hope that's enough information. Thanks again Emily. I will very much appreciate your time. Take care.

ESplichal

Hello and thank you for your question.

Without examining you it is difficult for me to say exactly what may be causing your pain but will give general recommendations. Based off of your descriptions and symptom presentation I would want to rule out a stress fracture. Were any x-rays done at the ER or by any of the Doctors? Stress fractures typically do not show up on x-rays until several weeks into them - so if nothing showed up on an x-ray 4 weeks ago I'd recommend a repeat x-ray.

If it is a stress fracture then you'd want to stay off of your foot as much as possible and ideally be in a surgical shoe. If it is not a stress fracture then you'd want to rule out tendonitis-type diagnosis. So I'd recommend getting an x-ray as your next step and seeing a Podiatrist as opposed to an Internist or Primary Doctor.

I hope this helps!

==============
Dr. Emily Splichal
Please be advised: we do not provide medical advice, diagnosis or treatment.
By law, we cannot give specific medical advice over the Internet.

hiker

You're wonderful, Emily.

I had x-rays done and they advised me nothing is broken. I'll do exactly what you suggest and will keep off the foot as much as possible until I can afford to see a Podiatrist. Will let you know how I go.

Thanks again, all the best.


- Guidance will be appreciated -

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