[28M] Experiencing foot pain and swelling in line with big toe

Patient Description

A 28-year-old male reports pain on the top of the foot in line with the big toe, particularly when lifting the toes. The pain is described as an achy sensation accompanied by a feeling of creaking or rubbing. The symptoms have been present for a few days, and the patient has noticed some swelling in the mid-foot area, which has been present for a day. The swelling is painful but not discolored, and the patient is currently applying ice, making it difficult to ascertain if the area is warm. The pain increases with walking and physical activities, but there is no severe pain or inability to walk. There is no history of recent injury, redness, severe swelling, or inability to bear weight on the foot.

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Arora's Assessment

What might be happening

Based on the information you've provided, possible diagnoses include:

  • Extensor Tendinitis: This condition occurs when the tendons that run along the top of the foot become inflamed, causing pain and swelling. This can occur due to overuse, particularly from activities that involve repetitive motion of the foot and ankle.

    • Treatment typically involves rest, ice, compression, and elevation (RICE). Over-the-counter pain relievers may also be helpful. In some cases, physical therapy may be recommended.
  • Stress Fracture: This is a small crack in a bone that occurs over time due to repetitive force, often from overuse — such as repeatedly jumping up and down or running long distances. Stress fractures are most common in the weight-bearing bones of the lower leg and foot.

    • Treatment usually involves rest and refraining from the activity that caused the stress fracture. In some cases, surgery may be necessary.
  • Gout: This is a type of arthritis that occurs when uric acid crystals accumulate in the joints, causing inflammation and intense pain. Gout attacks can occur suddenly and are often severe.

    • Treatment typically involves medications to control pain and inflammation, as well as lifestyle modifications to manage uric acid levels.

What you can do

You should consult a healthcare provider for a formal assessment. They may order imaging tests, such as an X-ray or MRI, to help determine the cause of your symptoms. In the meantime, you can:

  1. Rest your foot and avoid activities that cause pain.
  2. Apply ice to the affected area for 15-20 minutes at a time, several times a day.
  3. Elevate your foot to help reduce swelling.
  4. Take over-the-counter pain relievers, such as ibuprofen or acetaminophen, to help manage pain.

What you should look out for

Seek immediate medical attention if:

  • Your pain or swelling significantly worsens.
  • You are unable to walk or bear weight on your foot.
  • You develop a fever or the swollen area becomes red or warm to the touch, as these could be signs of an infection.

Please remember that while I strive to provide accurate information, I am not a doctor. Always consult with a healthcare provider for a formal diagnosis and treatment.

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1 yr ago

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People Also Ask


What are the common causes of pain on the top of the foot?

Common causes of pain on the top of the foot include extensor tendinitis, stress fractures, and conditions like gout. These can result from overuse, repetitive motion, or the accumulation of uric acid crystals in the joints.


How can I differentiate between extensor tendinitis and a stress fracture?

Extensor tendinitis typically presents with pain and swelling due to inflammation of the tendons on the top of the foot, often related to overuse. A stress fracture, on the other hand, is a small crack in the bone that develops over time due to repetitive force. Imaging tests like X-rays or MRIs are often needed to differentiate between the two.


What are the initial steps I can take at home to manage foot pain and swelling?

Initial steps to manage foot pain and swelling include resting the foot, applying ice for 15-20 minutes several times a day, elevating the foot to reduce swelling, and taking over-the-counter pain relievers like ibuprofen or acetaminophen.


When should I seek medical attention for foot pain and swelling?

You should seek medical attention if the pain or swelling significantly worsens, if you are unable to walk or bear weight on the foot, or if you develop a fever or notice redness and warmth in the swollen area, as these could indicate an infection.


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