What might my mom's unexplained but severe foot pain be?

Bev1120 asked...

My mom's right foot started swelling 3 weeks ago...she says the pain is almost unbearable. We took her to hospital, and at first they thought it was broken, but the x-rays said it wasn't. The hospital said it was neuropathy. Last week I took her to a foot specialist, but he said he did not think it was what the hospital thought. They wrapped it thinking it would make swelling go down, but the pain was so bad we took it off 2 hours after it was on her foot. It hurts to even touch it, but now it is starting the same thing in her other foot. What do you think is wrong? What doctor can I take her to that will help her? Please help; I hate seeing her in so much pain.

Expert Answer

Jane Andersen, DPM, is a board-certified podiatrist in private practice in Chapel Hill, North Carolina. She provides surgical and nonsurgical foot and ankle care to all types of patients, including the geriatric population in her area. With the American Podiatric Medical Association, she has worked to educate the public on foot and ankle health.

There are so many different things that could be causing pain and swelling in your mom's foot. Sometimes, unfortunately, the true diagnosis isn't always obvious to even the best of doctors right away.
If I were seeing your mom, there are several steps I might consider taking. Sometimes fractures, especially stress fractures, are not obvious on the first or even subsequent x-rays. I would consider repeating the x-ray or consider other types of imaging if needed. I would consider blood work to rule out infection or any other systemic cause (like arthritis). A thorough follow up history and physical exam is important to see if anything has changed. Here are some questions that may be considered: "¢ Has the redness or swelling worsened? "¢ Are there any wounds? "¢ Does the swelling decrease with elevation?
"¢ Are there varicose veins present that could cause skin inflammation? "¢ Has there been any fever?
"¢ What kind of pain is it?
"¢ What makes it worse/better?
"¢ Is there a rash? The possibility of a blood clot in the leg may need to be considered as well. This can be screened for with a simple ultrasound after a physical exam.
I would recommend seeing a podiatrist in this case. Be prepared: you and your mom should be ready to answer all of the questions listed above and more. A follow up appointment with the prior doctor may be helpful for the sake of comparison. If he/she cannot help you, ask for to be referred to someone that can, or for further testing. Good luck. Remember that feedback, whether it be negative or positive, is critical in helping your doctor figure out the best treatment for your mom.