Puffy Foot

September 21, 2008 1:27 PM

Foot Filter: I know y'all are not my doctor, etc, but I'm looking to the hive mind for some opinions. What are some possible causes of non-painful swelling on the top of one foot? (The usual looong story inside.)

Three days ago I happened to notice that my left foot was swollen on the top, between the part over the arch and just short of the base of the toes. It wasn't painful nor discolored nor warm to the touch. I wouldn't have even noticed it had I not had trouble scooching that foot into my slipper. It is only on the left foot, it doesn't affect the ankle, the toes, or any other part of the foot that I can see, and it doesn't affect my walking or range of motion. After the first time I discovered it, I noticed that when I woke up the next morning, that foot was back to normal. But then later in the day, the swelling had returned. (I work from home as a writer, a sedentary job.)

When I Google "swollen foot" I get all sorts of dire diagnoses like liver and/or kidney failure. I have an appointment coming up with my rheumatologist in three weeks, so if at all possible I'd like to wait and ask her what the heck is going on. (Actually, in a perfect world, I'd prefer that my foot stop doing this long before my appointment.)

Additional info that might apply: I have Lupus and circulation issues (Reynaud's syndrome, anti-phospholipid syndrome) and have always had very cold feet, but never any swelling. Even when traveling on overseas flights my feet never swelled. However, about a month ago I did slip and fall in the bathroom and took the brunt of it on the left knee. Within the hour, the knee had puffed up, so Mr. Adams took me to the ER. X-rays determined no breaks or serious damage, but I did get serious bruising after the fact that not only covered the kneecap but aslo extended down the front of my leg to just above the ankle. (I'm on a daily baby aspirin regime, so I've always presumed that's what causes my extreme bruising.) I'm wondering if this previous trauma could have anything to do with this foot swelling? Some sort of tiny blood clot or something?

Again, it's not painful or discolored in any way, so for the moment I don't think a visit to the ER is in order. (Unless the hive mind medicos tell me that this is in fact a sign of liver failure or blood clot or some other dire condition.) The swelling goes away after I nap (that is, when I have that foot parallel to the rest of my body.) Any ideas as to what the problem is?

posted by Oriole Adams to health & fitness (6 comments total)

Sounds like edema.
posted by watercarrier at 1:57 PM on September 21, 2008

after a recent knee surgery, when i worked at the computer for more than half an hour that foot would get puffy like you are describing (same place, not painful, etc). my physical therapist was unconcerned and said to get up and walk aroud every 20 mins and do ankle pumps (flex and point the foot, make circles with my toes, write the alphabet). i imagine it's possible that this is related to your knee injury. you didn't have any soft-tissue imaging done? perhaps something is swollen in the knee and restricting the flow of fluids. i would focus on the knee, if it were my body. as an anecdotal data point, a friend of mine has permanently puffy feet and has gone to several doctors and had imaging done and has never gotten more of an answer than "yep, there is fluid there." so you might not want to get your hopes up for an answer, any more than you want to worry about a dire dx yet.
posted by nevers at 2:05 PM on September 21, 2008

Do you sit crosslegged in your office chair? If I do that too long the instep of my left foot swells up, and goes a bit numb sometimes.
posted by bink at 3:06 PM on September 21, 2008

I get swelling like that if I sit motionless in front of the computer for longer than an hour or so. It happens at home but not at work, so I'm pretty sure it has to do with my chair at home (it's a bit too tall, so I tend to "dangle" my feet a bit there, or sit crosslegged). I've gotten used to moving my feet a lot in my chair at home, which has reduced the severity and frequency of swelling. My doctor didn't think it was anything to worry about, and just encouraged me to get up and move about at least once an hour.
posted by gemmy at 6:09 PM on September 21, 2008

I agree with watercarrier, sounds like the swelling is edema, though that's the kind of thing only a doc can tell you. As for blood clots- usually you have painful swelling with discoloration (like bruising) that does not go away. If you're concerned you can have an ultrasound done. Better safe than sorry!
posted by starfyr at 11:22 PM on September 21, 2008

Thanks for the responses. They didn't do anything at the ER for my knee other than take X-rays. You've got me wondering about soft tissue damage now, though, because I can still "feel" my knee when going up or down stairs and it regularly will make snapping and popping noises when I walk (it never used to). I'll have my rheumy check it all out at my next appointment. (And here's a word of warning for y'all: a glossy magazine on the bathroom floor can act like a patch of ice if you step on it just the right way.)
posted by Oriole Adams at 1:38 AM on September 22, 2008