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What causes pain and swelling on foot after an injury?

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General & Family Physician
Practicing since : 1980
Answered : 1 Question
Question
I have a couple of issues going on and I'm not sure if they are related or not. Back at Easter I tripped and fell...since then I've had tremendous pain in my left foot (top) and swelling...(but better with rest) now over the past week I've got swelling in my left knee and pain is extreme and rest doesn't seem to help but very little...to make the even more discomforting...last few days I've been experiencing pain/tingling in both arms and hands. Lying down intensifies this sensation. I am a "home therapy" kind of person, but symptoms are just gradually intensifying.
Posted Fri, 22 Aug 2014 in Bones, Muscles and Joints
 
 
Answered by Dr. Rahul Tawde 2 hours later
Brief Answer:
Urgent clinical evaluation and treatment needed

Detailed Answer:
Hi, thanks for posting your concern in the HCM.
Progressively increasing swelling and pain in lower extremity after any trauma need urgent clinical examination to rule out any bony pathology or soft tissue infection. If left untreated, this may lead to more complicated and life threatening conditions, including cellulitis, osteomyelitis and even sepsis and its complications.
Furthermore, consumption of analgesic or pain killer may lead to analgesic nephropathy and renal failure. Sepsis and muscle injury also adds to renal complications.
My recommendations are-
1. Urgent clinical evaluation by an orthopedic consultant
2. Xray of the injured foot and blood examinations including complete blood count, CRP, urea, creatinine and electrolytes, fasting plasma glucose should be done
3. Tab Paracetamol 500 mg may be taken, whenever required for pain management and in case of fever and 6hr interval should be there between two doses.
4. Plenty of oral fluid (3-4l/day) should be taken.
5. Rest and elevation of the affected limb, while lying down is necessary.
6. Xray and MRI of spine may also be needed to rule out any spinal pathology depending upon findings in clinical evaluation.
7. Any discolouration of the affected limb should be evaluated in detail, to rule out chances of gangrene formation.
8. Colour doppler study of lower extremity may be needed to rule out DVT
9. You may need oral/intravenous antibiotic treatment for any infectious etiology.
Finally, I don't think "home therapy" is a prudent choice at all in this condition. You should consult your doctor as early as possible to save your limb and your life.
Hope I have successfully answered your question. For any further information, feel free to write back to me.
If you are satisfied with my answer, please mark it as helpful.
Regards,
Dr. Kaushik
Above answer was peer-reviewed by
 
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