[21O] With persistent foot pain post-ankle twist

Patient Description

A 21-year-old individual, sex assigned at birth as other, reports experiencing sharp and throbbing pain in the right foot for the past two months following a twisted ankle. The pain is exacerbated by walking, standing, and even sitting, and occasionally feels like acid being poured on the foot. The pain is localized to the bottom of the foot. There is no swelling or bruising, but the patient experiences tingling without numbness and sometimes has difficulty walking due to the pain, which has affected their gait. There have been no changes in the color or temperature of the foot. The patient has a history of previous ankle injuries, including a sprain in the left ankle and an injury to the right one. No imaging studies have been conducted for the current pain. The patient takes painkillers as needed. Medical history includes epilepsy, autism, ADHD, PTSD, and OCD, with diagnoses made at various stages of life. The patient is allergic to latex and currently takes oxycarbazine, folic acid, over-the-counter allergy medication, albuterol, and Flintstone gummies. The medications have been taken consistently since elementary school.

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Arora's Assessment

What might be happening

Based on the information you have provided, here are some possible explanations for your symptoms:

  • Chronic Ankle Sprain: Given your history of twisting your ankle and previous injuries, it's possible that you have a chronic ankle sprain. This can lead to persistent pain, especially if the ligaments have not fully healed.

    • Treatment: Rest, ice, compression, and elevation (RICE) are initial treatments. Physical therapy may be recommended to strengthen the ankle. In some cases, a brace or orthotic device may be needed.

  • Tendonitis: Inflammation of the tendons around the ankle can cause pain, especially with movement.

    • Treatment: Rest, ice, anti-inflammatory medications, and physical therapy can help. In severe cases, a doctor may recommend corticosteroid injections.

  • Nerve Pain: The tingling sensation you described could be related to nerve irritation or damage, possibly from the initial injury.

    • Treatment: Rest, physical therapy, and medications to manage nerve pain. In some cases, further evaluation by a specialist may be needed.

  • Plantar Fasciitis: Pain at the bottom of the foot can sometimes be due to plantar fasciitis, especially if the pain is worse in the morning or after periods of inactivity.

    • Treatment: Stretching exercises, proper footwear, orthotics, and anti-inflammatory medications. Physical therapy may also be beneficial.

What you can do

  1. Rest and Elevate: Continue to rest your ankle and keep it elevated to reduce swelling and pain.
  2. Ice and Compression: Apply ice packs to the affected area for 15-20 minutes several times a day and use a compression bandage to help with swelling.
  3. Pain Management: Over-the-counter pain relievers like ibuprofen or acetaminophen can help manage pain and inflammation.
  4. Physical Therapy: Consider seeing a physical therapist who can provide exercises to strengthen your ankle and improve your gait.
  5. Footwear: Wear supportive shoes that provide good arch support and cushioning.
  6. Journal Your Symptoms: Use MDandMe to journal your symptoms, track your progress, and share your notes with your healthcare provider.

What you should look out for

  • Increased Pain or Swelling: If your pain or swelling worsens, it may indicate a more serious issue that needs medical attention.
  • Numbness or Weakness: If you develop numbness, significant weakness, or difficulty moving your foot, seek medical care promptly.
  • Changes in Color or Temperature: If you notice any changes in the color or temperature of your foot, it could indicate a circulation issue that requires immediate attention.
  • Inability to Bear Weight: If you are unable to bear weight on your foot, see a healthcare provider as soon as possible.

Remember, while these suggestions can help manage your symptoms, it's important to consult a healthcare professional for a formal diagnosis and appropriate treatment plan. If you have any further questions or need more information, feel free to ask!

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4 mo ago

People Also Ask

What are the common causes of sharp and throbbing foot pain after an ankle injury?

Common causes of sharp and throbbing foot pain after an ankle injury include chronic ankle sprain, tendonitis, nerve pain, and plantar fasciitis. These conditions can result from incomplete healing of ligaments, inflammation of tendons, nerve irritation, or strain on the plantar fascia.

How can I differentiate between nerve pain and other types of foot pain?

Nerve pain often presents as tingling, burning, or shooting sensations, and may be accompanied by sensitivity to touch. Other types of foot pain, such as from tendonitis or plantar fasciitis, are usually more localized and related to movement or pressure.

What are the recommended treatments for chronic ankle sprain?

Recommended treatments for chronic ankle sprain include rest, ice, compression, and elevation (RICE), physical therapy to strengthen the ankle, and possibly the use of a brace or orthotic device. Pain management with over-the-counter medications and supportive footwear can also be beneficial.

When should I seek medical attention for foot pain?

You should seek medical attention for foot pain if you experience increased pain or swelling, numbness or weakness, changes in color or temperature of the foot, or if you are unable to bear weight on the foot. These symptoms may indicate a more serious condition that requires prompt evaluation.

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