[34F] Experiencing severe foot pain with history of toe fracture

Patient Description

A 34-year-old female reports severe pain in her foot, described as a sensation of twisting with the pain radiating up her leg. The pain began one day ago and is rated 9 out of 10 in severity. She has a history of fracturing the fourth toe bone approximately a year prior due to a slip and slide kickball accident. Post-fracture, she was treated and informed that the toe had healed. This is the first occurrence of pain since the injury, although she notes persistent swelling in the foot. There is no reported redness, temperature change, new deformity, or decreased range of motion. She can bear weight on the foot. The patient has a history of asthma diagnosed in childhood. She is currently taking Fluoxetine 20 mg and Valacyclovir 500 mg, both for about 2 years, with the latter taken less frequently. She is allergic to cats and some dogs but has no known medication allergies.

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Arora's Assessment

What might be happening

Based on the information you've provided, the following conditions could be causing your symptoms:

  • Post-traumatic arthritis: This can occur after an injury like a fracture. Even if the fracture has healed, the injury can lead to changes in the joint that cause pain and swelling.

    • Treatment typically involves pain management with over-the-counter or prescription medications. In severe cases, surgery may be necessary.
  • Complex regional pain syndrome (CRPS): This is a chronic pain condition that can occur after an injury, and is characterized by severe, persistent pain that is worse than expected for the injury.

    • Treatment often involves a combination of physical therapy, medications, and sometimes procedures like nerve blocks.
  • Bone infection (osteomyelitis): Although less likely, an infection in the bone can cause pain and swelling. This would typically also cause redness and warmth, which you did not report.

    • Treatment involves antibiotics and sometimes surgery.

What you can do

While waiting for a formal medical evaluation, you can try the following to manage your symptoms:

  1. Rest and elevate your foot to help reduce swelling.
  2. Apply a cold pack to your foot for 15 minutes at a time to help with pain and swelling.
  3. Over-the-counter pain relievers like ibuprofen or acetaminophen can help with pain.

What you should look out for

Please seek immediate medical attention if you experience any of the following:

  • Increased pain or swelling
  • Redness or warmth over the area
  • Fever or chills
  • Any new or worsening symptoms

Remember, this advice is not a substitute for professional medical advice. You should consult with a healthcare provider for a formal diagnosis and treatment.

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11 mo ago

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People Also Ask


What is post-traumatic arthritis and how is it treated?

Post-traumatic arthritis is a form of arthritis that develops after an injury to a joint, such as a fracture. It can cause pain, swelling, and stiffness. Treatment typically involves pain management with medications, physical therapy, and in severe cases, surgery.


What are the symptoms and treatment options for complex regional pain syndrome (CRPS)?

Complex regional pain syndrome (CRPS) is a chronic pain condition that can occur after an injury. Symptoms include severe, persistent pain, swelling, and changes in skin color or temperature. Treatment often involves physical therapy, medications, and sometimes procedures like nerve blocks.


How can I differentiate between normal post-injury pain and a bone infection like osteomyelitis?

A bone infection, or osteomyelitis, typically causes pain, swelling, redness, and warmth over the affected area, along with possible fever or chills. If you experience these symptoms, it's important to seek medical attention for a proper diagnosis and treatment, which usually involves antibiotics and sometimes surgery.


What immediate steps can I take at home to manage severe foot pain and swelling?

To manage severe foot pain and swelling at home, you can rest and elevate your foot, apply a cold pack for 15 minutes at a time, and take over-the-counter pain relievers like ibuprofen or acetaminophen. However, it's important to consult a healthcare provider for a formal evaluation.


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