Foot Pain: Causes and Solutions for Neurological Issues

Foot problems

Pain on the outer side of the dorsum and sole of the foot (approximately below the ankle) has been noted.
Recent health check-ups indicate that I am slightly overweight and have a history of gout, but I have been managing my diet and have not had an attack for a year.
However, due to my weight, I recently started walking and then transitioning to jogging.
After the first day of walking, I felt something unusual, and by the second day, I experienced mild pain and swelling.
How should I manage this situation?
Additionally, there is a noticeable bump on the joint to the left of my big toe (unsure if it is bursitis), but I have heard it could also be caused by gout.
There is no noticeable asymmetry in my big toe when comparing both sides, and currently, walking does not cause pain.
Pressing on it seems to be painless, but it feels somewhat swollen and hard, with a slight purplish tint.
What could this be?

Lurén Jiǎ, 20~29 year old female. Ask Date: 2019/07/06

Dr. Zhang Junwei reply Neurosurgery

This is likely not a neurological issue; let's consult an orthopedic clinic!

Reply Date: 2019/07/06

More Info

Foot pain, particularly in the areas you described (the outer side of the foot and just below the ankle), can arise from various causes, including neurological issues, musculoskeletal problems, or even metabolic conditions like gout. Given your history of being slightly overweight and having a past diagnosis of gout, it’s essential to consider these factors when evaluating your symptoms.

Possible Causes
1. Gout: Gout is a form of inflammatory arthritis characterized by sudden and severe pain, redness, and swelling in the joints, often affecting the big toe. The fact that you have controlled your diet and have not had a flare-up for a year is promising, but it’s still possible for gout to cause discomfort, especially if there are changes in your weight or diet. The micro-bump you mentioned on the left side of your big toe joint could be indicative of tophi, which are deposits of uric acid crystals that can form in chronic gout cases.

2. Bursitis: The bump you feel could also be a sign of bursitis, which is inflammation of the bursa (a small fluid-filled sac that acts as a cushion between bones and soft tissues). This condition can occur in the big toe joint and may cause pain and swelling, especially after increased activity like walking or jogging.

3. Neuropathy: If you are experiencing a tingling sensation or numbness along with pain, it may suggest a neurological issue, such as peripheral neuropathy. This condition can be caused by various factors, including diabetes, alcohol use, or vitamin deficiencies.

4. Tendonitis or Ligament Strain: Increased physical activity, especially if you are not used to it, can lead to tendonitis or strain in the ligaments of the foot. This could explain the pain and slight swelling you are experiencing after starting a walking and jogging routine.

5. Stress Fractures: If you have recently increased your activity level, you may be at risk for stress fractures, which are tiny cracks in the bone that can occur from repetitive force or overuse.

Recommended Actions
1. Rest and Ice: Initially, it’s crucial to rest your foot and avoid activities that exacerbate the pain. Applying ice can help reduce swelling and alleviate discomfort.

2. Footwear: Ensure that you are wearing supportive footwear that provides adequate cushioning. Shoes that are too tight or lack support can contribute to foot pain.

3. Gradual Increase in Activity: If you are starting a new exercise regimen, increase your activity level gradually to allow your body to adjust. Consider alternating between walking and jogging to reduce stress on your feet.

4. Consult a Specialist: Given your symptoms and history, it would be wise to consult a healthcare professional, such as a podiatrist or orthopedic specialist. They can perform a physical examination and possibly imaging studies (like X-rays) to rule out conditions like gout, bursitis, or fractures.

5. Diagnostic Tests: If necessary, your doctor may recommend blood tests to check uric acid levels or other markers of inflammation. A nerve conduction study may also be warranted if neuropathy is suspected.

6. Physical Therapy: If your pain persists, physical therapy may be beneficial. A physical therapist can provide exercises to strengthen the foot and improve flexibility, which can help alleviate pain.

7. Medication: If gout is confirmed, medications to lower uric acid levels or anti-inflammatory drugs may be prescribed. For other conditions, over-the-counter pain relievers like ibuprofen or naproxen can help manage pain and inflammation.

Conclusion
In summary, the pain and swelling you are experiencing could be due to several factors, including gout, bursitis, or overuse injuries. It’s essential to take a comprehensive approach to your symptoms, starting with rest and proper footwear, and consulting a healthcare professional for a thorough evaluation. Early intervention can help prevent further complications and ensure a quicker return to your desired activity level.

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