trauma to left side foot

by KATHLEEN
(KURE BEACH, N.C. 28449)

I have had no foot pain until I fell from a ladder taking something down from a shelf. as soon as it happened I could walk on the foot, but it was hurting all over. next day, still hurting and when I put any weight on foot to walk it hurt. there was a pooling of blood in my toes, however, my toes did not hurt. this all happened just after xmas 2013. went to family doctor, he said he felt nothing was broken, but to take an x-ray to make sure. the x-rayed showed no break, fracture, or soft tissue damage, whatever that means. I rested and elevated foot, along with icing it. areas of the foot was very swollen, but at this point could not pin point exact location of injury. I let a week go by, and called my doctor to say, I was not getting any better,and putting weight on foot caused pain. basically walking. swelling went down, blood pooled in toes are being absorbed from body. I now have an appointment with podiatrist 2/3/2014. could not get an earlier appointment. I feel I did some tendon damage, but will not get any answers until appointment which again is not until 2/3/2014. I hope I will. I now can pinpoint origin of pain which is left side of my left foot, and some pain on the top of foot. how should I treat this until appointment. I did some research, and it sounds like cuboid syndrome. if I am off the foot, I have no pain, but if I flex the foot, I will feel pain especially if I flex my foot to the right. read your last answer to person with foot pain. you suggested that he ask his doctor for a cortisone injection, which was something I was going to ask when I go for this appointment. what is your take on what I explained?

RESPONSE

Hi Kathleen,

Since there is a history of trauma, until you know exactly what is causing your pain, I would not recommend a cortisone injection. If you have a fracture, and you may even though the original x-rays were negative, a cortisone injection would be counter-productive. Sometimes small fractures do not show up on x-ray until ten days or more after trauma. (BTW, "no soft tissue damage" refers to every thing in your foot but bone. X-rays are not very good at detecting soft tissue damage.)

Obviously, without examining you, I have no idea what is causing your pain, so I am not going to guess, but I did answer your post because I think you need better advice than what you have received so far.

Your appointment with the podiatrist is way too far off in the future. You sustained trauma to your foot and trauma is best treated as soon as possible. Delaying treatment may make matters worse.

So, as I see it you have a couple of options. Call the podiatrist's office and tell them you sustained trauma to your foot and you cannot wait three more weeks for an appointment. Most offices will accommodate patients who are in pain.

If that does not work, you always have the option of going to the Emergency Room of your local hospital. You can even call the hospital and ask them for names of other podiatrists or even orthopedists on staff who may be able to see you sooner. You may have to travel a bit further for an appointment, but I personally think it is worth it.

If you find that there is no doctor in the area that can see you immediately, the best thing to do would be to go non-weightbearing on your left foot with the use of crutches. Quite simply, every time you walk on the foot, you are essentially aggravating the injury and of course that is counter productive.

Lastly, if your pain is essentially as bad today as it was three weeks ago AND your new x-rays are still negative for fracture, then you may require an MRI or CT scan which will give a better picture of a small fracture, or a displaced bone, or soft tissue damage.

Good luck.

Marc Mitnick DPM
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