Two Years of Left Foot Pain
Greetings, I am a 37-year-old woman facing a persistent issue. For the past two years, I have experienced discomfort in my left foot resulting from a work-related injury where it was crushed. Previously, I maintained an active lifestyle, engaging in bouldering and hitting the gym twice weekly. Despite undergoing X-rays which revealed no fractures, my foot remained swollen for over a month, and subsequent MRI scans also returned with unremarkable results. I have been under the care of a podiatrist, during which I received two steroid injections that provided temporary relief. My podiatrist is as perplexed as I am about the underlying cause of my pain. While he identified a small bone spur on my big toe, he does not believe that it contributes significantly to the discomfort I experience. An additional observation is the skin surrounding that area has turned completely white, contrasting starkly with my normally tanned complexion. The sensation I feel is akin to a constricting ring around the joint of my left big toe, often transitioning into acute pain. The discomfort intensifies with prolonged activities such as walking, running, bending the toe, or pushing off with my foot. There are also unpredictable instances where the pain escalates without any apparent trigger, and I occasionally experience numbness in the toe. Tests for gout have been ruled out. Although I refrain from consuming alcohol, I do utilize cannabis to alleviate arthritic pain related to my shoulder prosthesis. I am primarily seeking suggestions regarding additional tests or diagnostic avenues for my doctors to explore in order to gain insight into my condition. My podiatrist has proposed the option of exploratory surgery, though he mentioned that there’s only a fifty percent chance of actually discovering a definitive issue during the procedure.
Answers (1)
9/15/2025, 1:10:39 AM
OpenHealth AI
It sounds like you've been through a lot with your foot pain, and it's understandable to feel frustrated not having clear answers. Based on your description, it seems like your pain is complex and may involve multiple factors, especially following an injury. It’s good that you’ve pursued various tests and treatments, and while some preliminary options have been exhausted, there are still routes to explore that might shed light on your condition.
Key Points:
- Pain and swelling after an injury can sometimes point to underlying issues that are not easily identifiable on standard imaging, like inflammation, nerve damage, or issues with blood supply.
- It's important to investigate potential reasons for the skin changes and the sensation of tightness and pain you're experiencing.
Explanation:
The swelling and white skin around your toe could suggest a few possible issues, such as complex regional pain syndrome (CRPS), nerve irritation, or circulation problems, especially since you're experiencing numbness and intermittent pain spikes. Since gout has been ruled out, other inflammatory or systemic conditions might need to be considered.
Next Steps:
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Request a Referral for a Specialist: Consider asking your podiatrist for a referral to a rheumatologist to evaluate for any systemic conditions like arthritis, autoimmune issues, or fibromyalgia that could be contributing to your symptoms.
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Consider Advanced Imaging: Discuss the possibility of a more comprehensive imaging study, such as a CT scan or an ultrasound, to better visualize soft tissue damage or inflammation that might not show up on an MRI.
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Evaluate Vascular Health: Since you mentioned changes in skin color, it could be worth working with a vascular specialist to rule out any circulation issues in your foot. A Doppler ultrasound can help assess blood flow.
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Explore Pain Management Options: Given the chronic nature of your pain, you might benefit from a multidisciplinary pain management clinic. This could offer a combination of physical therapy, medication adjustments, and alternative therapies that focus on improving function and managing pain.
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Keep a Symptom Journal: Documenting your symptoms, triggers, and pain levels can provide useful information for you and your healthcare team, helping to identify patterns that may guide further testing or treatment.
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Consider Surgery Wisely: If exploratory surgery is on the table, weigh the risks and benefits thoroughly. It might be beneficial to have additional tests done first to solidify the need for surgery.
I hope this helps you feel more empowered in addressing your health concerns. Each step forward, whether through testing or symptomatic management, brings you closer to clarity and relief. Please let me know if you need further assistance!
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