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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Severe Pain In Instep?

Hi I have developed a severe pain in my instep and can only walk on the side of my foot. The pain feels like it is now travelling up the inside of my leg and the pain is also now felt just above the inside of my knee. I have had this before and it seems to get better in about a week or so. Is this gout or dvt?
Wed, 4 Feb 2015
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General & Family Physician 's  Response
hi there

It is possible that you may have something called PTTD (Posterior Tibial Tendon Dysfunction). It is commonly seen in patients with flat feet or in patients who over pronate the foot whilst walking. This eventually leads to pain in other areas of the limb due to compensation. If you are suspecting gout then you should consider the risk factors. High content of red meat in your diet(High protein) as well as alcohol consumption , or a lack of ability of the kidney to adequately excrete uric acid.

I would suggest you buy yourself a medial arch support insert to wear with your shoe and take a short course of NSAIDs for a week.

It would be a good idea to have your bloods done if you find bo relief after a week. A full blood count , liver function test and a Uric acid level.

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What Causes Severe Pain In Instep?

hi there It is possible that you may have something called PTTD (Posterior Tibial Tendon Dysfunction). It is commonly seen in patients with flat feet or in patients who over pronate the foot whilst walking. This eventually leads to pain in other areas of the limb due to compensation. If you are suspecting gout then you should consider the risk factors. High content of red meat in your diet(High protein) as well as alcohol consumption , or a lack of ability of the kidney to adequately excrete uric acid. I would suggest you buy yourself a medial arch support insert to wear with your shoe and take a short course of NSAIDs for a week. It would be a good idea to have your bloods done if you find bo relief after a week. A full blood count , liver function test and a Uric acid level.