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The response to the question below was authored by Marc Mitnick DPM
Running leads to stress fracture?
Hello Marc,
In Nov/08 I overdid it while getting back into my running routine at the gym. I felt a pain in my right foot while on the treadmill and had to stop. Later that day, while trying to go for a walk, I noticed the pain again and the only thing that made it possible to continue was by walking without putting my heal of my right foot down. Since then I have done some ultrasound treatments at physio and some laser treatments. Slowly it improved so that I could walk with my heel touching the ground though I am still not able to run and if I go for a walk I still have pain.
The doctor I have seen suspects a stress fracture. X-rays have been negative so he has ordered a bone scan. I have heard differing opinions about a) how necessary it is and b) the negatives in terms of radiation I am hesitant to expose myself to the radioactive isotope without being clear about it's necessity.
Couple last points:
-I am a 30 year old woman with a fairly healthy lifestyle. I do have trouble staying off my foot altogether.
-I don't think it's relevant but I will mention just in case that I am on a daily dose of Mezavant (5-aminosalicylic acid or mesalamine - essentially an anti inflammatory) for ulcerative colitis.
-The pain in my foot was originally in the cuboid area. Now the most tender spot is in my 4th metatarsal.
Questions:
-Does it make sense that I am still in pain over 5 months later?
-Is the radioactive isotope that is injected during a bone scan potentially harmful? -What are my best treatment options at this point?
-Can I expect that this will ever heal altogether?
Any help you can give is very much appreciated. I cannot express how eager I am to get back to my former quality of life (able to exercise; no pain)! Thank you for your time!
Best,
Leigh
Hi Leigh,
If you are concerned about the isotopes then an MRI would be a better option as there is nothing taken internally for that test, plus an MRI will also demonstrate any soft tissue damage that may be causing your pain while a bone scan will not.
Your problem has been going on way to long for you to assume it will heal on its own.
I would be concerned about stress fracture, I also would be concerned about cuboid syndrome (you may read about it on my site).
If no pathology is found, then I would suggest you consider physical therapy in an effort to move this problem along.
Marc Mitnick DPM
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Columbia University Department of Rehabilitation
ScienceDirect
Stanford Health Care
Illinois Bone and Joint Institute
Mount Sinai Hospital
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American Family Physician
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