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Why does the foot toe pain when suffering from diabetes and thyroid?

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Orthopaedic Surgeon
Practicing since : 1998
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Hello Dr., I am a 50 year old lady and i have pain in my left foot toe mould (in the toe next to big toe). There is no swelling or red burn. Normally the pain is low, but suddenly it becomes unbearable. I take pain relief for 2-3 days then it become normal for 2-3 month and the cycle repeats. Medical Background: I have diabetes and thyroid for couple of years but it i take proper control of it. This pain started 1.5 year back. I consulted about this pain with my doctor and he said that it is not because of diabetes and thyroid. He asked me to visit orthopedic doctor. I visited an orthopedic doctor, he asked for an X ray. But he found everything okay. I was given anti-inflammatory and asked to dip my foot in hot water 2 times a day. But no relief. Then i consulted another orthopedic, he also gave pain relief - Cipzen D. This helped in short term but the pain persists. We have got the MRI done, it was fine. No problem was reported in MRI. We have also been to physio-therapist and under gone a 15 days course but no relief. We have undergone a 15 days course of massage but again no relief. Is it possible that the blood circulation is getting restricted and leading to this pain - but again their is no physical remark on the feet. Kindly advice what could be the cause of pain and how it be permanently treated.
Posted Sat, 21 Dec 2013 in Bones, Muscles and Joints
 
 
Answered by Dr. Vaibhav Gandhi 20 minutes later
Brief Answer: I would like to keep possibility of gout Detailed Answer: Hello I have studied your case, I would like to keep possibility of gout first as per your history and symptoms. In gout there is accumulation of uric acid crystals in joint mainly foot. This leads to swelling and redness in foot. Another differential can be nerve compression leading to tingling and swelling. There is also possibility of Morton’s neuralgia. You may need neurotropic medication with analgesic . Yes diabetes can lead to poor circulation and pain you can do foot perfusion scan for it. I will advise to do blood inv like complete blood count ,uric acid level, if required EMG –NCV[ nerve study] Till time take analgesic and neurotropic like methylcobalamine. If gout is confirmed you may need medicine accordingly and diet restriction. Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health. Take care
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Follow-up: Why does the foot toe pain when suffering from diabetes and thyroid? 27 minutes later
We have not seen any redness in the foot. We have under gone uric acid test and the values were within the defined limits. Please advice test for nerve compression or Morton’s neuralgia. We have also gone and MRI, but it was found okay. Please advice.
 
 
Answered by Dr. Vaibhav Gandhi 17 hours later
Brief Answer: EMG will help Detailed Answer: Hello again Thats good that your uric acid levels are normal and MRI shows no significant pathology. You can do Electromyography[EMG] for nerve compression. Mortons neuroma is a clinical diagnosis, MRI foot may help if needed. Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health. Take care
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