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foot hurts for no reason

For 2 months I have had severe pain in my left foot. It started with my entire foot and ankle swollen and pain on top and bottom. Then the pain went away on the top right side after the swelling when down and now I have severe pain on the left side of my foot around the ankle, down the side and on the top when stepping down on it or rotating it. Also,touching it can cause pain.


I had an MRI a couple of weeks ago on the top front of my foot that showed extensive edema, but no break.

I have had no trauma to my foot to cause this. I have been on crutches for 4 weeks and the swelling has gone down, but not the pain. No one seems to know what is going on. I am also being treated for a vitamin "d" deficiancy.

RESPONSE
Hi,
This is very difficult to answer without knowing any thing about you including your age, medical history, weight, occupation, etc.
What concerns me is that at one point the whole foot was swollen and you apparently had pain in more than one area. All this with no history of trauma. Now, after being on crutches for four weeks the swelling has reduced but you still have pain. One would think that being non-weightbearing would have also reduced some of the pain and it has not. So, at this point I am thinking that this might not be a musculo-skeletal issue. You then have an MRI which shows nothing which further reduces the argument that this is a musculo-skeletal issue.
So, where does that leave us?
Has any one examined your vascular status? Again, I know nothing about you, but over the years I have had a couple of patients who presented with pain and swelling in the foot and ankle with no history of trauma. As it turned out they actually had a deep vein thrombosis or what is commonly known as a blood clot in the lower leg.
Most cases of phlebitis do not present this way but that does not mean it cannot happen.
If you happen to be overweight or have an occupation where you are standing all day or a multitude of other potential situations, you could develop a dvt.
Now, keep in mind I do not know if this is the actual source of your pain, but I think at this point your doctor needs to look elsewhere and this is one area I would investigate if you were under my care.

Marc Mitnick DPM
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