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Suggest Treatment For Arthritic Pain After Injury To Leg

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Posted on Thu, 12 Mar 2015
Question: I sustained an injury to my right foot some years ago. Particularly within my right big toe. I had been carrying a series of heavy objects at arm's length in which I was unable to maintain a normal gait as I would, say, utilizing a wheel barrow. My steps forward were abbreviated, pressing weight upon the front of my foot, walking upon uneven terrain. Unbeknownst to me, my right big toe contained significant bone loss: arthritis, and I had a high arch. The following day I awoke to debilitating pain within this right big toe, unable to press any weight upon it. I did not seek medical attention, thinking it would go away. However, the pain persisted. I was, in effect, hobbling. I sought consultation with a podiatrist to whom I insisted he take an x-ray, certain that I had fractured this big toe which was intractable and numb besides the sole of my foot. The x-ray, so I was informed, contained no fracture nor pathology to justify the pain I was enduring. My diagnosis, in effect, was fallen arches. My high arches dropping significantly upon standing. I might question here, could the carrying of these heavy objects, in effect, be responsible for collapsing my arches? None the less, I was assigned orthotics which, without reference, I believed would cure this pain to my right toe. It did not. The wearing of these orthotics only increased the pain to my right big toe and surrounding area despite my being careful to slowly adjust to them. I found myself walking on the outside of my foot! I had five readjustments during the course of a year. No success. during the course of this year, I experienced symptoms of wearing a 'cold wet sock' and the sensation of walking upon corrugated cardboard within my right foot. I was referred to a neurologist who confirmed I had an idiopathic neuropathy, cause unknown. I could not comprehend. Pixels upon the EMG depicted 'hot spots', colours of red and yellow emanating from my right big toe, the source of my pain. I believed and argued this injury to be the cause of this neuropathy, but was informed that data disproved this. Also, I had informed the neurologist that there was no pathology, nor fracture within the x-ray to justify my pain. For fact, years later, the x-ray HAD contained evidence of a pathology: arthritis, which was misread, overlooked. A digital scan, three years later confirmed this. I was only informed at the time that the pain I was subject to the following day after carrying these heavy objects, was the initial onset of the idiopathic neuropathy which further made no sense to me. How could an idiopathic neuropathy, in effect, 'fuse' the joints within my big toe? I was informed that it was a 'fluke' that I had been carrying these heavy objects the previous day, otherwise the injury would have been more immediate. And symptoms of neuropathy take various guises, much like the sensation of wearing 'cold wet socks'. The fusing of my big toe was neuropathic in origin and, it being a mild neuropathy that I was diagnosed with, the pain shouldn't be debilitating as I described it, despite there being every physical evidence that I was bearing weight to the left hand side of my body to forego placing weight upon standing and stepping forward upon my right foot. The inside of my right calf was starting to atrophy, comparable to the left. My question. I have read of foot trauma causing neuropathy. Could bearing excess weight upon an arthritic big toe of the right foot, in effect, become traumatized IN itself of arthritic pain, and, neglected of proper diagnosis and treatment, been the consequent cause of this neuropathy, or had both injuries occurred simultaneously. I am a male who was 55 years old at the time of this injury.

Kind regards: XXXX
doctor
Answered by Dr. Prof. Kunal Saha (2 hours later)
Brief Answer:
Rhematoid disease activity or trauma -both probable simultaneously

Detailed Answer:
Thanks for asking on HealthcareMagic.

I have gone carefully through the issues mentioned. For the degree of bone damage that you have suffered in your big toe of the right foot there are two broad possibilities. While trauma is a possible cause, rheumatoid arthritis could have given rise to a condition called Charcot's joint where such an injury could have occurred without any apparent injury. Both the causes could have played a role. But one precedes the other. The rheumatoid process should have preceded the injury/trauma.

Since you have a neuropathy, it is possible that you did not feel the injury that you originally suffered. It cannot get traumatized in itself or due to arthritic pain. But it is possible that the bone degeneration has been caused due to Rheumatoid disease activity and the neglect would have played a definite role in this regard. The fusing of the joint as mentioned, is indicative of rheumatoid disease activity.

Hope that helps.

If you found my answer to be helpful, please close the thread with a positive review and a 5 star rating.

Regards
Dr. Kunal Saha
Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.

Above answer was peer-reviewed by : Dr. Yogesh D
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Answered by
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Dr. Prof. Kunal Saha

General & Family Physician

Practicing since :1954

Answered : 4467 Questions

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Suggest Treatment For Arthritic Pain After Injury To Leg

Brief Answer: Rhematoid disease activity or trauma -both probable simultaneously Detailed Answer: Thanks for asking on HealthcareMagic. I have gone carefully through the issues mentioned. For the degree of bone damage that you have suffered in your big toe of the right foot there are two broad possibilities. While trauma is a possible cause, rheumatoid arthritis could have given rise to a condition called Charcot's joint where such an injury could have occurred without any apparent injury. Both the causes could have played a role. But one precedes the other. The rheumatoid process should have preceded the injury/trauma. Since you have a neuropathy, it is possible that you did not feel the injury that you originally suffered. It cannot get traumatized in itself or due to arthritic pain. But it is possible that the bone degeneration has been caused due to Rheumatoid disease activity and the neglect would have played a definite role in this regard. The fusing of the joint as mentioned, is indicative of rheumatoid disease activity. Hope that helps. If you found my answer to be helpful, please close the thread with a positive review and a 5 star rating. Regards Dr. Kunal Saha