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What causes pain and swelling with warm sensation on foot?

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Posted on Mon, 27 Jan 2014
Question: Having pain in one foot - continuous, even when not walking on it (keeps me up at night), came on suddenly, is swollen and warm to the touch on the ball of right foot, near outside of big toe. Hurts more when touched and when walked on. I had no injury prior to this (I have been relaxing at home all week - watching TV), etc. Of course I am not covered with Health Insurance (unemployed) so want to be sure before I go in that it's needed. Temperature is 97.3 degrees.
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Answered by Dr. Rakesh Karanwal (36 minutes later)
Brief Answer: You probably have an Acute attack of Gout Detailed Answer: Hi there, Thanks for your query. Your symptoms are suggestive of an Acute attack of Gout. Gout occurs due to high Uric Acid level in the blood. It is however, not necessarily raised during an attack of gout. You need to get blood workup, along with an X-ray/CT scan of the foot done. A short course of an Anti-inflammatory drug, such as, Indomethacin; or, Colchicine will relieve pain and swelling. Thereafter, a regular intake of a Uric acid-lowering drug to maintain blood uric acid level to within normal range, will prevent further attacks of Gout. Preventive measures include weight reduction; avoidance of alcohol, smoking and foods rich in high uric acid. Consult your doctor and apprise him of my opinion. I am certain that he will agree with my opinion; order required tests, and- based on the reports- will arrive at a certain diagnosis and prescribe suitable treatment as advised. Hope I have addressed to your concerns to your complete satisfaction and you find my response helpful and informative. I will be happy to answer further queries, if any. Fond regards and have a nice day, Col (Dr.) Rakesh Karanwal
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Rakesh Karanwal (1 hour later)
Thank you for your quick response. I appreciate it. As a follow-up - I considered gout and have been researching it online, but besides being a bit overweight and lazy, I don't have the "classic" risk factors. I do not drink alcohol, etc. I'm under 40 and female. I tend to have cold extremities, is this a factor? Is circulation a factor? What about having some relief after a bowel movement? Not completely, but some "tingling" left the foot (right foot only). Nerve damage? I'm not a hypochondriac, but I try to pay attention to body signals. I prefer a more homeopathic route to treatment and I do realize that lifestyle is a factor. My grandmother had diabetes that led to amputation so I'm hyper aware of these circulation/diabetic issues. I have not been diagnosed with diabetes but I do not frequent the doctor, either. Thank you again for your response.
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Answered by Dr. Rakesh Karanwal (11 hours later)
Brief Answer: Consult your doctor at the earliest Detailed Answer: Firstly, I had taken all factors into active consideration, before giving my opinion based SOLELY on the information provided by you. Acute attack of gout occurs spontaneously and NOT by any injury or any other activity. Most of the diseases do NOT manifest with "Classic" presentation. The information provided by you is not suggestive of cold extremities, circulation disorders or nerve injury as the possible causes of your problem. You will appreciate that physical examination is mandatory for arriving at a definitive conclusion. Online doctors do not enjoy this privilege. The most rational approach would be to consult a doctor (or Homeopathic doctor as preferred by you) for evaluation and prompt treatment. Lastly, in view of a family history of diabetes, you should get your Blood sugar checked up at least every six months. Take care, Dr. Rakesh Karanwal
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Rakesh Karanwal (9 hours later)
Thank you again. I want to clarify that I am not disputing your diagnosis as I have come to terms that it IS definitely an acute gout attack. No doubt in my mind now. However, I am trying to understand better an underlying CAUSE rather than just treat the pain or take drugs to minimize/reduce, etc. I seek the root cause and source (is it auto-immune? is it circulatory? nerve?) so I may treat the system as a whole. Gout was never in my radar at this stage in my life so I am very unfamiliar with it. Ultimately, what it comes down to is better lifestyle choices and being more diligent with an aging body. Thank you, again, for your quick and spot-on diagnosis. I do not require a response as I believe I have all the information to proceed from here. I appreciate your time and expertise greatly.
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Answered by Dr. Rakesh Karanwal (2 hours later)
Brief Answer: Gout is a metabolic disease Detailed Answer: You are most welcome. Just wanted to inform you that it is a metabolic disease. Uric acid is produced from degradation, by the liver, of a protein called Purine. Uric acid is thrown out of the body by the kidneys. Remaining uric acid remains in the blood in the soluble form. However, when uric acid concentration exceeds a certain level, it gets precipitated into very small solid crystals, called monosodium urate crystals. Deposition of these crystals in the joints causes gout. Take care
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Rakesh Karanwal

Internal Medicine Specialist

Practicing since :1980

Answered : 1357 Questions

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What causes pain and swelling with warm sensation on foot?

Brief Answer: You probably have an Acute attack of Gout Detailed Answer: Hi there, Thanks for your query. Your symptoms are suggestive of an Acute attack of Gout. Gout occurs due to high Uric Acid level in the blood. It is however, not necessarily raised during an attack of gout. You need to get blood workup, along with an X-ray/CT scan of the foot done. A short course of an Anti-inflammatory drug, such as, Indomethacin; or, Colchicine will relieve pain and swelling. Thereafter, a regular intake of a Uric acid-lowering drug to maintain blood uric acid level to within normal range, will prevent further attacks of Gout. Preventive measures include weight reduction; avoidance of alcohol, smoking and foods rich in high uric acid. Consult your doctor and apprise him of my opinion. I am certain that he will agree with my opinion; order required tests, and- based on the reports- will arrive at a certain diagnosis and prescribe suitable treatment as advised. Hope I have addressed to your concerns to your complete satisfaction and you find my response helpful and informative. I will be happy to answer further queries, if any. Fond regards and have a nice day, Col (Dr.) Rakesh Karanwal