Foot Swelling: When to See a Doctor for Pain Relief

My foot is swollen!

Hello! I am a 39-year-old female, married, with no children.
I am 165 cm tall and weigh 52 kg, working full-time as a secretary.
I usually exercise 2 to 3 times a week at the gym with "non-strenuous" activities.
About three weeks ago, I started experiencing pain in my left foot below the ankle, along with slight swelling, resembling a sprain.
The condition fluctuates; it usually eases slightly in the morning but worsens in the afternoon and evening.
When it is severe, I cannot place my foot flat, and it is particularly painful when going up and down stairs.
When the swelling is significant, the veins on the sole of my foot are completely invisible, making it impossible to wear shoes.
I consulted a traditional Chinese medicine doctor, and although I felt slightly better after his manipulation and applying a black ointment, the symptoms recurred the next afternoon.
I am unable to press the top of my foot downwards.

I would like to ask the doctor whether it is better to see a Western medicine specialist or a traditional Chinese medicine practitioner for this type of pain.
If I should see a Western doctor, which specialty should I consult? I hope to receive your professional advice soon.
Thank you!
P.S.
Here is a brief summary of my medical history:
Allergies: Medications - none; Food - seafood (slight), monosodium glutamate (severe).

Medical history: I have congenital bronchitis, and in my twenties, I had severe sinusitis and neurogenic gastric dyspepsia.
I was involved in a car accident that injured my spine, leading to frequent lower back pain.
My platelet count is slightly low, making me prone to subcutaneous bleeding, bruising, and erythema.
In May 1993, I underwent an appendectomy in Vancouver, Canada, due to a severe infection of peritonitis.
My menstrual cycle has been irregular for many years, with varying flow.
In the past year, it has become increasingly sparse, sometimes occurring only once every two months.
I have regular Pap smears, all of which are normal, but there is evidence of uterine atrophy.
My diet consists of regular meals, with a preference for vegetables, rice, and bread; I do not eat snacks, consume little meat, and drink water and eat fruit regularly.

Miss Zhang, 30~39 year old female. Ask Date: 2001/01/31

Dr. Pan Yingda reply Rehabilitation

I just saw your question; I hope your issue has been resolved.
Let's clarify a few things: 1.
Are you injured? 2.
Is the swelling severe or is the pain more intense? Based on your description, it seems that "swelling" is the primary concern, which could be approached from the perspective of venous and lymphatic circulation, suggesting a consultation with a vascular surgeon.
If pain is the main issue and there is warmth, it may indicate an inflammatory response, which would require evaluation by an allergist, immunologist, or rheumatologist.
In addition to seeking medical attention promptly, my recommendations are: 1.
Avoid excessive salt intake, 2.
When resting, lie flat with your legs elevated and move your toes and ankles, 3.
When getting out of bed, engage in gentle movement and consider using compression wraps.

Reply Date: 2001/01/31

More Info

Foot swelling and pain can be concerning symptoms, especially when they persist over time. Based on your description, it seems that you are experiencing discomfort in your left foot, particularly around the ankle area, with swelling that fluctuates throughout the day. This type of symptomatology can arise from various underlying conditions, and understanding the potential causes is crucial for determining the appropriate course of action.

Possible Causes of Foot Swelling and Pain
1. Injury or Sprain: Given that you mentioned a sensation akin to a sprain, it is possible that you may have sustained a minor injury that has not fully healed. Sprains can lead to inflammation and swelling, particularly if the affected area is not given adequate rest.

2. Tendonitis: Inflammation of the tendons around the ankle can cause pain and swelling. This condition is often exacerbated by physical activity, especially if the movements are repetitive or involve sudden changes in direction.

3. Venous Insufficiency: If the swelling worsens as the day progresses, it could indicate issues with venous return. Conditions like chronic venous insufficiency can lead to fluid accumulation in the lower extremities.

4. Lymphedema: This condition involves swelling due to lymph fluid buildup, which can occur after injury or surgery, particularly if lymph nodes were affected.

5. Arthritis: Conditions such as osteoarthritis or rheumatoid arthritis can cause joint pain and swelling, particularly if there is a history of joint issues.

6. Gout: This is a type of inflammatory arthritis that can cause sudden and severe pain, often in the big toe, but it can affect other joints as well.

When to See a Doctor
Given the persistence and severity of your symptoms, it is advisable to consult a healthcare professional. Here are some indicators that you should seek medical attention:
- Persistent Pain: If the pain does not improve with rest or over-the-counter pain relief.

- Severe Swelling: If the swelling is significant and does not subside with elevation or rest.

- Difficulty Walking: If you find it increasingly difficult to bear weight on the affected foot.

- Changes in Skin Color or Temperature: If you notice any changes in the color of your foot or if it feels unusually warm or cold.

- Associated Symptoms: If you experience fever, chills, or any other systemic symptoms.

Which Specialist to See?
If you decide to seek medical attention, starting with a primary care physician is a good option. They can perform an initial evaluation and may refer you to a specialist based on their findings. Depending on the suspected underlying cause, you might be referred to:
- Orthopedic Surgeon: For issues related to bones, joints, and soft tissues.

- Rheumatologist: If an inflammatory or autoimmune condition is suspected.

- Vascular Specialist: If there are concerns regarding blood flow or venous issues.

- Podiatrist: A foot specialist who can provide targeted care for foot-related problems.

Conclusion
In summary, your symptoms warrant further investigation to determine the underlying cause of your foot pain and swelling. While alternative therapies such as traditional Chinese medicine may provide temporary relief, a comprehensive evaluation by a medical professional is essential for a proper diagnosis and treatment plan. Early intervention can help prevent further complications and improve your quality of life. Please consider scheduling an appointment with a healthcare provider to discuss your symptoms in detail and explore appropriate diagnostic tests and treatment options.

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