Severe Ankle Discomfort and Swelling Each Morning
Recently, I've been experiencing a troubling issue with my ankles. For the past few weeks, each morning has started off with significant pain in both ankles. Initially, I assumed it was just a minor strain and took some Advil. However, as time passed, the discomfort escalated, accompanied by noticeable swelling in both ankles. This pain, which I would rate as a 6 or 7 out of 10, awakens me around 5 AM, and it feels like an intense, burning sensation. My ankles themselves feel unusually warm to the touch. The worst part occurs when I attempt to get out of bed and walk. This action ignites a severe flare-up of pain, prompting me to apply ice packs and take four Advil. After about an hour, the pain subsides enough that I can manage it without tears. When the symptoms first emerged, I visited urgent care, where the doctor prescribed a short course of prednisone, suggesting that it was unlikely to be a blood clot due to the bilateral nature of the pain. Thankfully, the prednisone seemed to provide relief—I felt almost back to normal by the second day, but my supply has since run out. The urgent care physician recommended that I follow up with my primary care doctor; however, I was surprised to find out they do not conduct blood tests there, contrary to what their website indicated. Fortunately, I had a scheduled routine blood test from my endocrinologist, as I manage type 1 diabetes. I went to the lab for that, and the results showed that my kidney function is normal, although my vitamin D level was slightly low. I then saw my primary care physician, who advised me to wait a bit after stopping the prednisone before getting another round of inflammation labs, for which she provided an order. I haven’t had the chance to undergo those tests yet, but I intend to ask her to include a white blood cell count check to rule out any infection. I'm feeling quite overwhelmed by this situation. The pain in the mornings is significantly affecting my daily life—I can hardly walk without ice, elevation, and pain relief. It’s unusual for me, considering I’ve always led an active lifestyle without issues like swelling in my feet and ankles. To provide some background, I’ve been living with type 1 diabetes for 25 years and maintain good control over it. I’m active, exercising four to five times a week, including activities like Peloton workouts and family bike rides. Although I experience occasional eczema-like rashes on my torso, I’m otherwise healthy and have recently entered perimenopause at the age of 50. I take insulin, a low dose of Wellbutrin, and Ozempic to manage insulin resistance. Over the last few years, I’ve noticed some joint pain in my fingers. I weigh 133 pounds at a height of 5'5" and try to eat healthily. Should I consider asking for a cardiovascular evaluation? Any insights would be greatly appreciated!
Answers (1)
7/28/2025, 1:02:12 PM
OpenHealth AI
It sounds like you're experiencing significant discomfort and challenges with your ankles, which is understandably overwhelming given your active lifestyle and long history with diabetes. Persistent pain, swelling, and burning sensations in the mornings can be signs of several underlying issues, including inflammatory conditions, arthritis, or even overuse injuries.
Explanation
Your symptoms, particularly the bilateral swelling and significant morning pain, indicate a process beyond simple strain. Since you found some relief with prednisone, this suggests an inflammatory component could be involved, possibly linked to conditions like gout, inflammatory arthritis, or other forms of arthritis. Your background with type 1 diabetes and the recent transition into perimenopause could also intersect with these joint issues.
Considering your healthy lifestyle and prior activity levels, the sudden onset of these symptoms is indeed concerning and warrants further investigation. Moreover, the slight vitamin D deficiency may contribute to joint pain and inflammation, as vitamin D plays a role in bone and immune system health.
Next Steps
Here are prioritized actions you can take to manage your symptoms and gather more information:
-
Follow Up on Blood Tests: Schedule the pending inflammation labs your primary care physician ordered, and ensure to include a white blood cell count to check for any signs of infection or inflammation. It's crucial to understand what's happening internally.
-
Monitor Your Symptoms: Keep a daily log of your symptoms, including pain intensity, swelling, and any other changes. Note the time of day these symptoms occur and any activities that seem to worsen or improve them. This information can be helpful for your doctor.
-
Vitamin D Supplementation: Since your vitamin D was slightly low, consider discussing supplementation with your healthcare provider. Proper levels may help reduce inflammation and support bone health.
-
Modify Activity Levels: While staying active is important, consider adjusting your workout routine to lower-impact exercises or incorporating more rest days to allow your body to recover. Activities like swimming or cycling with lower resistance could reduce strain on your ankles.
-
Ice and Elevation: Continue to use ice packs and elevate your ankles when resting, especially in the mornings. This can help reduce swelling and feel more comfortable before getting out of bed.
-
Re-evaluate Medication: Discuss with your physician about potentially using a longer-term anti-inflammatory medication if the prednisone provided relief and if inflammation remains a concern.
Additional Consideration
Based on the complexity of your symptoms and history, if your pain and swelling persist despite these measures and tests, you might want to consider asking for a referral to a rheumatologist for a specialized evaluation. This could help determine if an autoimmune process or another chronic inflammatory condition is at play.
It's understandable to feel overwhelmed, but by taking proactive steps, you will be better equipped to tackle the situation. Please keep track of your progress and don’t hesitate to reach out for more guidance or support as you navigate this.
Related Questions
Experiencing Clear Fluid from Ear with No Discomfort: Should I Wait for My Appointment?
I am a healthy 57-year-old female, weighing 120 pounds and standing 5 feet 5 inches tall. My daily medications include 100 mg of Losartan for effectively managed high blood pressure, 200 mg of Lyrica taken twice daily for post-herpetic neuralgia, 100 mg of Synthroid following treatment for thyroid cancer, and a combination hormone replacement therapy patch. Additionally, I take Zyrtec and Flonase every day to combat allergies. Since October, I have been dealing with persistent tinnitus in my right ear, accompanied by some pressure and a muffled sensation. Recently, I've noticed that when I speak, it feels akin to the sensation I experience when my ears clear during a flight after chewing gum—my voice sounds amplified in my head. I've scheduled an appointment with a physician's assistant in an ear, nose, and throat (ENT) office for the end of March due to my worries about the tinnitus and any potential hearing impairment. Yesterday, I noticed that my ear emitted a clear fluid. Thankfully, there was no associated pain. The fluid was somewhat thicker than water, completely odorless—unlike the unpleasant discharge I recall from my daughter's ear infections—and there was no sign of blood. Could this indicate a perforated eardrum? I suspect this might be the case, but can this occur without an underlying infection? Should I seek attention sooner than my appointment in March? I would prefer to avoid urgent care during flu season; however, if this situation is serious, I am prepared to take precautions and visit.
Understanding the Increased Pain in My Foot While Reclining
At 30 years old, I am nearing the five-week mark since undergoing surgery on my metatarsals. I've encountered a troubling issue: I can’t seem to find comfort when lying down, whether it’s with my foot raised or lying flat. My pain level escalates to a severe 10 out of 10, unless my foot is making contact with the floor or I dangle my leg off the side of the bed so that my toes touch the ground. Is this situation typical for someone in my circumstances? Are there any suggestions that might assist me in getting a better night's sleep?
Assessing My Health Concerns: How Anxious Should I Be?
I’m a 32-year-old woman, weighing 124 pounds and standing at 5 feet 6 inches tall. For over a year, I have been experiencing bright red rectal bleeding. Initially, I attributed this issue to hemorrhoids that developed during my pregnancy two years ago. The bleeding occurs with most of my bowel movements, sometimes happens without one, and on a few occasions, has been enough to stain the toilet bowl significantly. The color of the blood is typically darker than what I observe during a hemorrhoid flare-up. There is a notable family history of bowel cancer on both sides; one family member was diagnosed at age 45, and another at 60. In the past six months, I have encountered several episodes of severe abdominal pain—3 to 4 instances—intense enough to consider a trip to the emergency room. However, the pain usually subsides within about an hour. It’s unusual for me to experience such acute pain, given my high tolerance for discomfort; for example, I once played rugby shortly after dislocating and fracturing my finger. Recently, I mustered the courage to consult with my doctor, who recommended a FIT test, which returned a positive result (30.1). Additionally, I underwent a complete blood test, and aside from having low ferritin levels (7 µg/L), all other results were normal. I have since been referred for a colonoscopy on a two-week waiting list to rule out any possible bowel cancer. Given these circumstances, how concerned should I be? Thank you for your input.
Understanding Possible Seizure Triggers and Recurrence Risks
Health Background: I am a 21-year-old female, standing at 169 cm and weighing 65 kg. Over the past three years, I have been using oral contraceptives. As of this morning, I started taking 25 mcg of levothyroxine along with a weekly vitamin D supplement of 0.266 mg. Recently, I was diagnosed with hypothyroidism and found to have a vitamin D deficiency that I suspect has existed for the last three years. I do not consume alcohol or smoke, and I can confirm I am not pregnant. Two years ago, I experienced a mild concussion. I currently reside in Spain. A couple of months back, in mid-December, I blacked out twice. The second occurrence took place while I was at the doctor’s office after seeking urgent medical care for the initial incident. Following the second episode, I underwent a CT scan and an EKG, both of which returned normal results. Further tests, as directed by my physician, revealed a critical vitamin D deficiency and hypothyroidism; however, he expressed doubt that either of these conditions led to my loss of consciousness. I was then referred to a neurologist, and I am presently awaiting an appointment. Although the waiting period is lengthy, my doctor indicated that I should receive priority for scheduling, although the exact timeframe remains uncertain. The referral document summarized my events, labeling the second episode (which the physician witnessed) as a potential seizure devoid of tonic-clonic movements—a revelation that took me by surprise. After regaining consciousness, I felt extremely disoriented and terrified, struggling to process what was happening. I have no prior history of seizures, epilepsy, or any related conditions, and there is no known family history of these issues. If this indeed was a seizure, what might have triggered it? Additionally, what is the likelihood of experiencing another one? Since that time, I have not had any further incidents, but I have experienced moments where I felt a sense of impending doom, which I managed to overcome. I intend to wait for the neurologist's evaluation, but the uncertainty surrounding a possible neurological condition is quite distressing. Thank you for any insight you can provide!
Persistent Pain in Right Shoulder and Arm After Lifting
Hello, everyone! I’m a 23-year-old male and have been engaged in weightlifting for several years now. Recently, I’ve been struggling with ongoing discomfort in my right shoulder and arm, which I haven’t been able to accurately identify. The pain manifests during particular movements, especially with lateral raises or when my arm is raised to shoulder level while rotating my wrist. Certain pressing and pulling activities can also provoke this discomfort. Rather than feeling sharp, it’s a deep, nagging sensation that sometimes seems localized in the front area of the shoulder or at the biceps tendon, and at other times it feels more like it’s situated between the shoulder and upper arm. Fortunately, there’s no numbness or tingling involved. This issue began while I was working out. I decided to take a break for around two months, but when I returned, the pain persisted. After consulting a physician, I was diagnosed with bicipital tendinitis. Since then, I’ve reduced my upper-body workouts, completely steering clear of shoulder exercises and heavy lifting, and have begun a gentle rehabilitation regimen focusing on external rotations, pendulum movements, and scapular exercises. Despite adhering to this routine for about a week, I haven’t experienced any noticeable improvement. Is it typical for this type of tendon injury to require an extended period for recovery? At what point should I consider diagnostic imaging, such as an ultrasound or MRI? Additionally, are there frequent rehabilitation errors that might impede the healing process? I appreciate your insights in advance!