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Pain, Cold, numbness on bottom of foot that started from mild trauma (?)

Mid to late June, long day of gardening in a stooped position without supportive shoes caused this same basic thing. There was more bruising on ball of foot, it was only really bad for 1 day, and it subsided quickly; within a week or 2. (capsulitus??)


10 Days ago, running around at work on concrete floor wearing flat, unsupportive sandals I could feel the stress/pressure injury coming on. By afternoon had excrutiating pain on sole of foot (front, middle and outer side). Left Foot. Pain extended to left, outer calf, throbbing/achy. Any weight on foot caused color of sole to turn funny white/yellow.
That evening, cold and elevation made it worse. Heat helped a bit, Advil helped a bit. Pain was somewhat improved over the next few days, but still present and only in the foot. Foot was turning white after weight bearing, very poor initial capillary reaction. Was also continually going numb and cold. Taking all weight off foot allowed feeling and color to come back.
Saw my Primary DR on Day 6, diagnosed a pressure injury, he thought that blood flow was consistent with my uninjured foot, therefore probably not clot related. No instructions, meds or followup.
Over the last 4 days pain is still present. Occasional shooting pain from very center of sole, this while no weight on foot (happened while driving). Cold, numbness and whitening still present but slightly improved. Coloring of foot seeing some purple on tops and bottoms of some toes (big toe and 1st in from pinky toe). Very painful to walk on barefoot.
Last 2 days a good deal of pain on backside of calf about halfway between heel and largest part of calf. Feels almost like a pulled muscle. Have also had same pain on back and side of thigh just over the back and left side of the knee. This too feels like a muscle pull/residual pain from muscle cramp. Also now have slight pain to touch on top of big toe, right side where it meets the foot. Still hurts to be on barefoot, also hurts to have foot simply dangle off a chair; Almost feels like under pressure from weight of leg even when it's not. Standing/walking for any length of time does cause pain, whiting and numbness to get much worse. What the heck is wrong with me? Help. Thanks.

ANSWER
Hi,
I will keep this short. You need to have a venous doppler to rule out a venous thrombosis (blood clot), as the pain in the back of your calf and the discoloration in your feet sounds very suggestive of this. This is potentially a very serious problem. Have the test to rule this out.
If the doppler shows you do not have a blood clot, then you will need an xray of your foot to rule out stress fracture. In lieu of a blood clot, the pain in the calf may be due to a strain of the muscle brought on by your activity and the pain in your foot, however, as I just stated, you should have your doctor rule out a blood clot first.

Marc Mitnick DPM
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Aug 18, 2011
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I got my answer
by: The Patient in Question

Dr. Mitnick,
Thank you, you were 100% correct. The pain finally brought me to the ER. I spent 8 days in the hospital. The Doppler you spoke of was able to show that there was no pulse in that foot. This was an arterial clot that split and traveled throughout my leg. My leg was almost amputated. I am in rough shape but have all my parts intact!! You certainly know what you are talking about. Thank you for taking the time to answer. Yours Truly!

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