[44F] Experiencing foot pain and swelling

Patient Description

A 44-year-old female presents with a 2-day history of foot pain and swelling, particularly affecting the bottom of the feet and the pinky toe, which is notably more swollen. The pain is described as an aching sensation that worsens with walking. The patient works on her feet for 40 hours a week, which may be contributing to her symptoms. Despite rest and sleep, the symptoms have not improved. The affected areas are red, painful, and slightly warm, suggesting inflammation. The patient has a history of psoriasis and has been taking ibuprofen for arthritis-related inflammation. No recent injuries, fever, chills, or skin changes other than redness have been reported. The patient has allergies to Bactrim and clindamycin but is not currently on any other medications except for the ibuprofen, which has been taken for the past two days.

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Arora's Assessment

What might be happening

Based on the information you've provided, possible explanations for your symptoms include:

  • Plantar Fasciitis: This is a common cause of heel pain that occurs when the band of tissue (the plantar fascia) that supports the arch of your foot becomes inflamed or irritated. This condition is often associated with long periods of weight bearing or sudden changes in weight bearing or activity.

    • Treatment typically involves rest, ice, over-the-counter pain relievers, and physical therapy.

  • Gout: This is a type of arthritis that is often characterized by sudden, severe attacks of pain, swelling, redness and tenderness, often in the joint at the base of the big toe.

    • Treatment usually involves medications to control pain and inflammation, as well as lifestyle modifications to manage triggers.

  • Psoriatic Arthritis: Given your history of psoriasis, it's possible that you could be experiencing psoriatic arthritis, which can cause pain, swelling, and stiffness in and around your joints.

    • Treatment typically involves medications to control inflammation and prevent joint damage.

What you can do

While waiting to see a healthcare professional, you may find the following tips helpful:

  1. Rest and elevate your feet as much as possible. This can help to reduce swelling and pain.
  2. Apply a cold compress to the swollen area for 15 minutes at a time, several times a day.
  3. Over-the-counter pain relievers such as ibuprofen can help to reduce pain and inflammation. However, it's important to use these medications as directed and not exceed the recommended dose.
  4. Gentle stretching exercises may help to relieve tension and improve flexibility in your feet.

What you should look out for

You should seek immediate medical attention if:

  • The swelling and pain in your feet becomes severe or unbearable.
  • You develop a fever, chills, or other signs of infection such as pus or severe redness.
  • You notice a sudden increase in the size of the swelling or if the skin over the swelling becomes hot, red, or shiny.
  • You experience sudden or severe pain in your feet or legs, especially if it's accompanied by shortness of breath, chest pain, or other symptoms of a serious condition.

Remember, this advice is intended to be general in nature, and specific causes may not apply to your situation. Always consult with a healthcare provider for appropriate examination, testing, and care recommendations.

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9 mo ago

People Also Ask

What are the common symptoms of plantar fasciitis?

Common symptoms of plantar fasciitis include sharp pain in the heel or bottom of the foot, especially noticeable with the first steps in the morning or after long periods of rest. The pain may decrease with movement but can return after prolonged standing or activity.

How can I differentiate between gout and psoriatic arthritis?

Gout typically presents with sudden, severe attacks of pain, swelling, redness, and tenderness in the joints, often starting with the big toe. Psoriatic arthritis, on the other hand, may cause joint pain, swelling, and stiffness, often accompanied by skin symptoms of psoriasis. A healthcare provider can perform tests to help differentiate between the two.

What lifestyle changes can help manage foot pain related to arthritis?

Lifestyle changes that can help manage foot pain related to arthritis include maintaining a healthy weight to reduce stress on the feet, wearing supportive footwear, engaging in low-impact exercises like swimming or cycling, and avoiding activities that exacerbate the pain.

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

You should seek medical attention if the foot pain and swelling become severe or unbearable, if you develop a fever or other signs of infection, if the swelling increases suddenly, or if you experience sudden or severe pain accompanied by other serious symptoms like shortness of breath or chest pain.

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