[23F] With right foot pain and swelling post-injury

Patient Description

A 23-year-old female reports pain on the right side of her right foot, which began after she slid on it. The pain initially lessened but then worsened, especially when walking or standing, and is rated as 5 out of 10. The pain extends from the pinky toe to just in front of the heel. Swelling occurs, particularly if standing for longer than 30 minutes, but there is no numbness, tingling, redness, or warmth. The area is tender to touch. The patient has a history of three previous twisted ankles on the same foot. Tylenol was taken but did not alleviate the pain. Medical history includes anxiety, depression, seasonal allergies, acid reflux, chronic migraines, and occipital neuralgia. The patient is allergic to amoxicillin, causing hives. Current medications include Buspar (15 mg twice daily), Zoloft (150 mg daily), Zofran (4 mg as needed for nausea with migraines), an unspecified allergy medicine taken daily, birth control taken nightly, magnesium (400 mcg nightly for headaches), omeprazole (20 mg daily), and Emgality injection once a month for migraines. The patient occasionally takes Tylenol, ibuprofen, or Excedrin for headaches.

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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:

  • Stress Fracture: Given the pain, swelling, and tenderness in your foot, especially after a recent injury, a stress fracture is a possibility. Stress fractures are small cracks in a bone that often develop from overuse or repetitive activity. They can also occur from a sudden increase in physical activity or an acute injury.

    • Typical Treatment: Treatment usually involves rest, avoiding weight-bearing activities, and possibly wearing a brace or cast. In some cases, crutches may be recommended to keep weight off the foot. Healing typically takes 6-8 weeks.

  • Sprain or Strain: Since you have a history of twisted ankles, it's possible that you have a sprain or strain. These injuries involve the ligaments and muscles around the foot and ankle and can cause pain, swelling, and difficulty bearing weight.

    • Typical Treatment: Rest, ice, compression, and elevation (RICE) are commonly recommended. Over-the-counter pain relievers like ibuprofen can help manage pain and swelling. Physical therapy may also be beneficial.

  • Tendinitis: Inflammation of the tendons in your foot could also explain your symptoms. Tendinitis can cause pain and swelling, especially with activity.

    • Typical Treatment: Rest, ice, and anti-inflammatory medications are usually recommended. Stretching and strengthening exercises may also help.

What you can do

While it's important to consult a healthcare professional for a formal diagnosis and treatment plan, here are some steps you can take in the meantime:

  1. Rest: Avoid putting weight on your right foot as much as possible. Use crutches if necessary to keep weight off the injured foot.
  2. Ice: Apply ice to the affected area for 15-20 minutes every 2-3 hours to reduce swelling and pain.
  3. Compression: Use an elastic bandage to wrap your foot, but make sure it's not too tight. This can help reduce swelling.
  4. Elevation: Keep your foot elevated above the level of your heart whenever possible to help reduce swelling.
  5. Pain Relief: Over-the-counter pain relievers like ibuprofen or acetaminophen can help manage pain and reduce inflammation.
  6. Journal Your Symptoms: Use MDandMe to journal your symptoms, track your progress, and share your notes with your healthcare provider. This can help in monitoring your condition and making informed decisions about your care.

What you should look out for

Seek medical attention if you experience any of the following:

  • Increased Pain or Swelling: If your pain or swelling worsens despite rest and home treatment.
  • Inability to Bear Weight: If you are unable to put any weight on your foot.
  • Numbness or Tingling: If you develop numbness, tingling, or a loss of sensation in your foot.
  • Changes in Skin Color: If you notice any changes in the color of your skin, such as paleness or a bluish tint.
  • Fever: If you develop a fever, which could indicate an infection.

Remember, while these tips can help manage your symptoms, it's important to consult a healthcare professional for a formal diagnosis and appropriate treatment.

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4 mo ago

People Also Ask

What are the common symptoms of a stress fracture in the foot?

Common symptoms of a stress fracture in the foot include localized pain that worsens with activity and improves with rest, swelling, tenderness to touch, and sometimes bruising. The pain is often described as a dull ache that becomes more intense with weight-bearing activities.

How can I differentiate between a sprain and a stress fracture?

A sprain typically involves injury to the ligaments and may present with swelling, bruising, and instability of the joint, whereas a stress fracture involves a small crack in the bone and is characterized by localized pain and tenderness. An X-ray or MRI is often needed to confirm a stress fracture.

What are the best home remedies for managing foot pain and swelling?

Home remedies for managing foot pain and swelling include rest, ice application for 15-20 minutes every few hours, compression with an elastic bandage, and elevation of the foot above heart level. Over-the-counter pain relievers like ibuprofen can also help reduce pain and inflammation.

When should I seek medical attention for foot pain?

You should seek medical attention if you experience increased pain or swelling despite home treatment, inability to bear weight on the foot, numbness or tingling, changes in skin color, or if you develop a fever, which could indicate an infection.

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