Persistent Left Foot Pain: Seeking Solutions for Chronic Discomfort

I experience pain in my left leg when squatting down or standing up straight, and my legs feel a bit weak when going down the stairs?

Hello, doctor.
My issue is similar to the topic above.
Whenever I move my left foot too far to the left or right, I feel pain.
This problem has been bothering me since June of last year.
I have visited many clinics, received treatments from traditional Chinese medicine practitioners, acupuncture, and even the orthopedic department at Taipei Hospital, but none have provided effective treatment.
Since June, I have experienced intermittent flare-ups.
(After seeing a traditional Chinese medicine practitioner, the same issue tends to start again after about two weeks to a month.) The acupuncturist has targeted the painful areas, including Yinlingquan, Ashi points, Dubi, and Weizhong.
I work as a baker, which often involves lifting heavy objects, going up and down stairs, and standing for long periods with breaks of about one hour every eight hours.
Recently, my condition has worsened.
I requested an X-ray at Taipei Hospital, but I was declined because I appeared to have no external injuries, swelling, and being young, they deemed it unnecessary.
They only prescribed pain relievers and muscle relaxants (Acetaminophen/Orphenadrine 450mg/35mg).
After taking them for a few days, I still felt pain, but it was reduced by about half.
A few days later, the pain returned, making it difficult to squat.
I hope the doctor can provide some answers, as each clinic has given different opinions.
I am looking for a definitive solution for this chronic issue.

Niming, 10~19 year old female. Ask Date: 2018/02/24

Dr. Li Yongheng reply Orthopedics

Hello, based on your symptoms, there is a higher likelihood of plantar fasciitis, which is related to prolonged standing and heavy lifting.
Abnormalities in the arch of the foot (such as flat feet or high arches) may also contribute to this condition.
I recommend that you return to the orthopedic clinic and ask the physician to perform an X-ray examination.
If it is indeed just plantar fasciitis, you may consider out-of-pocket extracorporeal shock wave therapy.
Wishing you a speedy recovery.

Reply Date: 2018/02/24

More Info

It sounds like you are experiencing a complex and persistent issue with your left foot that has not responded well to various treatments. Given your symptoms, work environment, and the history of your pain, it is essential to consider several potential underlying causes and treatment options.

From your description, the pain in your left foot, particularly when moving laterally or when standing for prolonged periods, could be related to several conditions, including plantar fasciitis, tendonitis, or even issues related to the foot's biomechanics such as flat feet or high arches. Your occupation as a baker, which involves frequent lifting and standing, can exacerbate these conditions, leading to chronic pain.

Potential Causes:
1. Plantar Fasciitis: This is a common cause of heel pain and can result from overuse, especially in individuals who stand for long periods. The plantar fascia, a thick band of tissue that runs across the bottom of your foot, can become inflamed, leading to pain, particularly with movement.

2. Tendonitis: The tendons in the foot can become inflamed due to repetitive strain, especially if you are frequently lifting heavy objects or standing for long hours.

3. Biomechanical Issues: Conditions like flat feet or high arches can lead to improper weight distribution across the foot, resulting in pain when performing certain movements.

4. Nerve Compression: Sometimes, nerve entrapment can cause pain that radiates through the foot, particularly if there is swelling or inflammation in the surrounding tissues.

Recommended Actions:
1. Diagnostic Imaging: Although you were previously denied an X-ray, it may be beneficial to seek a second opinion or request an MRI. An MRI can provide more detailed images of soft tissues, including tendons and ligaments, which may help identify any underlying issues that X-rays might miss.

2. Physical Therapy: Engaging in a structured physical therapy program can help strengthen the muscles around your foot and improve flexibility. A physical therapist can also provide you with exercises tailored to your specific needs and help correct any biomechanical issues.

3. Orthotics: Custom orthotic inserts can help correct foot alignment and provide additional support, which may alleviate pain during activities.

4. Activity Modification: While it may not be feasible to stop working, consider modifying your activities. Taking more frequent breaks, using proper lifting techniques, and alternating tasks can help reduce strain on your foot.

5. Pain Management: Continue using anti-inflammatory medications as prescribed, but also consider adjunct therapies such as ice therapy, heat application, or even over-the-counter topical analgesics.
6. Alternative Therapies: Since you have tried acupuncture and other traditional methods, you might also explore options like chiropractic care or massage therapy, which can sometimes provide relief for chronic pain.

7. Surgical Consultation: If conservative treatments fail, discussing surgical options with an orthopedic surgeon specializing in foot and ankle issues may be warranted.

Conclusion:
Chronic foot pain can be frustrating and debilitating, especially when it interferes with daily activities and work. It is crucial to approach this issue holistically, considering both physical and lifestyle factors. Persistent pain often requires a multi-faceted treatment approach, and it may take time to find the right combination of therapies that work for you. Keep advocating for your health, and don’t hesitate to seek further evaluations until you find a solution that alleviates your discomfort.

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