My foot looks like a non-hairy paw.
June 14, 2005 2:49 AM   Subscribe

What the hell is wrong with my foot? I sprained it very mildly last July, and its still swollen!

Last september (three months after the mild sprain) I had my foot both x-rayed and ultrasounded, and neither showed anything wrong. But almost a year later, it is still subtantially swollen (I can't wear my strappy sandals). It doesn't hurt, but when I 'flex' my big toe (ie make a fist with my toes) I do feel a sensation of 'tightness' across the top of my foot.

What the heck is wrong and is this swelling going to be permanent?
posted by Kololo to Health & Fitness (12 answers total)
Have you tried taking aspirin or some other anti-inflamatory?

I've had swelling from a sprained foot that didn't go away until I did.

My theory is that the swelling prevents the circulation needed to clear the swelling away.
posted by Nancy Lebovitz at 3:05 AM on June 14, 2005

If the pain's gone and you haven't been reinjuring it to your knowledge then presumably you ripped through a lot of blood vessels/tissues at the time and the residual swelling is scar tissue which would need to be resected surgically.
Otherwise, you had an occult fracture that was missed and bone remodelling has contributed to the swelling in which case it's probably permanent without surgical intervention.
Or there's some sort of tendinous nodule that's sprung up as a consequence of the original injury - surgery again.
All a little bit difficult to tell without a dozen more questions and a look of course. IANAD
As long as the circulation hasn't been impaired (temp. differences between feet or increased swelling when the affected foot has been on the ground for a while) then I think you'll want first a GP to have a look and then probably a referral to an Orthopedic Surgeon.
I can't think what, if any, physical therapy might help but others may want to weigh in - it's a mighty long time after to start exercises to reduce swelling, I would have thought, even if feet do take a fair while to heal sans pun.
posted by peacay at 4:01 AM on June 14, 2005

You mean it's been swollen for a whole year constantly, or that the swelling came and went?

In any case I don't think there is necessarily anything wrong apart from the swelling itself. Once I sprained my knee and the swelling came and went for months, but that was because I wasn't using any drugs and protecting it properly when walking or cycling, so it ended up being continously subjected to tension before it'd had had a chance to heal completely.

You usually need both anti-inflammatory drugs and local anti-inflammatory creams that you apply once or twice a day. But do check with your doctor.
posted by funambulist at 4:10 AM on June 14, 2005

X-rays don't detect small stress fractures - they need to inject you with radioactive isotope to see those. Stress fractures can not heal for months/years (I think because you constantly re-break them, not sure), but I would have thought you'd feel some pain when you used your feet in some ways. So it's probably something else :-)
posted by -harlequin- at 4:41 AM on June 14, 2005

Response by poster: funambulist, its been swollen the whole time, although to varying degrees (ie sometimes i can wear the sandals but they look gross what with the foot puffing through the straps, sometimes i can't even get the sandal on. Somehow i find that the most illustrative example!)
posted by Kololo at 4:55 AM on June 14, 2005

Kololo, if the swelling is changing then maybe you're reinjuring it regularly and perhaps you either damaged nerves or else the swelling itself is masking pain. Have you been very active? I take it that the swelling is on the top of the foot?
If this is the case, maybe a physical therapist plus anti-inflammatories will help. But it still might be worthwhile getting it re-xrayed: the healed fracture (if it was one) might show up now. Otherwise it would need a bone scan as -harlequin- mentioned.
If it was me, I'd try anti-inflammatory drugs first. And the sandal not fitting is very illustrative.
posted by peacay at 5:41 AM on June 14, 2005

I'll give the same answer everyone gave me when I asked a medical question.

Go see a doctor.
posted by jackofsaxons at 6:01 AM on June 14, 2005

All good advice here. Another suggestion is to see a chiropodist (foot doctor) to see if your feet mechanics are ok. If you're a runner, it may be indicative of more fundamental issues with your feet and/or legs, such as over-pronation, uneven leg length, etc. I had something similar that went away after I got orthotics.
posted by RibaldOne at 6:17 AM on June 14, 2005

Just wanted to note that I would recommend Advil over aspirin for anti-inflammatory properties. Also : ice packs. Bags of frozen peas do wonders for swelling.

If it's not painful, then it's probably not fracture related. What would probably be more helpful than a bone scan would be an MRI to show if there's any soft tissue damage.

I had a really bad ankle injury a few years ago that wasn't diagnosed until surgery (three years after the initial injury!) due to the fact that it was a soft tissue and not a bone injury and thus never showed up on x-rays or bone scans. (An MRI was scheduled but cancelled in favor of immediate surgery due to my unbearable level of pain.)

Anyway, your swelling sounds to me like fluid build up rather than bone buildup as it comes and goes. I would recommend seeing your GP about it as you might not be in pain now, but I imagine that constant swelling could lead to circulation issues further down the line. (I'm assuming you have insurance.) Orthopedic surgeons are able to do minimally invasive procedures to remove scar tissue which do wonders. I had this type of surgery and was fully recovered after three weeks and haven't had a significant relapse since.
posted by grapefruitmoon at 6:26 AM on June 14, 2005

I've had similar stuff on an ankle that I sprained. It was still "swollen" a year later (really just non-painful scar tissue). I thought I would have it forever, but eventually it went away.
posted by Doohickie at 8:25 AM on June 14, 2005

Go see a doctor.
posted by docpops at 11:08 AM on June 14, 2005

Also have a puffy fluid retentive foot due to soft tissue damage above my ankle (fell down some stairs in a drunken state) - for 5 years :( My Doc is useless and now I've heard about the surgery side I think I might start pestering him again to see if I would be a suitable candidate.

Kololo - I know about the dainty shoe dilemma too (who am I kidding it's pretty much every shoe for me) so keep pestering your doc as well!
posted by floanna at 3:57 PM on June 14, 2005

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