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What Causes Chronic Foot Pain?

Posted on Wed, 9 Apr 2014

Question: I have 13 year old daughter who has chronic foot pain for the last 2 years. We have seen seen a foot doctor many times. Tried orthotics. It started out as ankle pain and progressed to her entire foot. Both feet are effected. She does turn her left foot in a bit when she walks. She describes it as a stabbing pain sometimes. Activities make it worse. We also tried Phyisical Therapy. It helped with balance but not pain. What should our next step be? There has to be a cause. Foot doctor is stumped also.

Answered by Dr. Mukesh Chugh (46 minutes later)

Brief Answer: Growing pain but other cause need to be ruled out Detailed Answer: Hi Thanks for your query After going through your query, this type of pain which increases on activity are quite common in her age group with most likely cause being growing pain. I would treat her with calcium and vitamin D, hot fomentation along with pain killer on SOS basis. Having said that , one should rule out the other causes by investigation like blood test for calcium, phosphorus, vitamin D , alkaline phosphates and serum RA factor. If not done, get it done and please share along with X ray picture in follow up query. Is there any swelling in feet along with warm to touch? What about other joints status? Looking forward to your reply to above asked queries. Take care Regards

Above answer was peer-reviewed by : Dr. Shanthi.E

Follow up: Dr. Mukesh Chugh (32 hours later)

She has had X-rays before nothing showed up. One X-Ray showed inflammation between joints in her toes treated with a steroid. She says her feet are stiff when she gets up and that gets better as the day goes but the pain increases throughout day. She was in tears after walking around an amusement park for a day and has misses many activities due to pain. She does have pain in her right knee also. Her feet look puffy but not obvisiously swollen per say. They are not red or hot. I have made another appointment with her foot doctor.

Answered by Dr. Mukesh Chugh (4 hours later)

Brief Answer: She needs blood test to have diagnosis Detailed Answer: Hi It’s good to see you again. After going through your reply and whole discussion it seems her suffering may be because of juvenile rheumatoid arthritis as she has pain in multiple joint. I advice following test to confirm like-Serum RA factor, ANA factor,HLAB27 ,haemoglobin, complete blood count, erythrocyte sedimentation rate(ESR) and C reactive protein(CRP).ASO titter. Most common is pauciarticular juvenile arthritis .My advice would be getting her eyes checked for any signs of inflammation secondary to her arthritis. Rheumatologist is the right person to treat her. Meanwhile, continue with the tab. Ibuprofen, vitamin D and calcium as discussed earlier. Please share the blood reports. Take care and I shall be glad to answer any further query. Regards Dr XXXXXXX chugh (http://bit.ly/drmchugh)

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