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Daniel Nelson, MD
Daniel Nelson, MD, Doctor (MD)
Category: Health
Satisfied Customers: 258
Experience:  Licensed MD. Mayo Clinic Rochester trained physician in Internal Medicine - Critical Care Medicine.
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Woke up this morning with extreme foot pain

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I woke up this morning with extreme pain in my left foot. It feels like it is broken or at least badly sprained. I cannot walk on it and I have NOT injured it in any way.

What could cause this? Should I have it xrayed? What could cause this sort of thing? 

What part of the foot hurts?
Is there any redness, swelling, or warmth in that area that is different than the rest of the foot?
Can you list any medications and doses you are taking currently, including supplements?
May I ask your age?

Kindest Regards,

Customer: replied 9 years ago.

The pain is in my entire foot with the exception of my big toe. The pain seems to radiate from my ankle down to the bottom of my foot. It is not so much my toes that hurt as it is the rest of my foot. The arch of my foot and the instep of my foot is what hurts the worst. My ankle does not actually hurt but when I move my ankle it makes the rest of my foot hurt!. On a scale of one to ten I would put the pain at a 6 or 7. Also, the bottom of my foot is what hurts the most.

With the pain so diffuse, severe, and with such sudden onset while asleep I am afraid that I would prefer to have you examined to rule out a traumatic sleep injury, and x-rayed. While the pain in the arch or instep area sounds like plantar fasciitis plus/minus a bone spur (an inflammation of the connective tissue on the bottom of the foot). The more extensive pain in the foot is concerning to me for trauma, infection, diffuse tenosynovitis (inflammation of the tendons and the synovial fluid and membranes that surround them), or sprain. At a minimum, you could benefit from a decent pain reliever with a 7/10 pain. Gout and pseudogout can come on suddenly like this, and their treatment is usually prescription based in order to gain control of the acute inflammation they cause.

I recommend that you be seen to rule out the bad things first and foremost. If it's plantar fasciitis it will be treated with anti-inflammatories, stretching exercises, and sometimes custom orthotic inserts. If it's infection, gout, pseudogout, tenosynovitis, sleep trauma, then we will both be glad to have had it examined, x-rayed, and treated appropriately. The diffuseness is what throws this away from being a simple diagnosis of plantar fasciitis. Also, the suddenness is concerning. It's not typical of gout or pseudogout either, but their treatments are unique and most often by prescription, as is the case for infection, trauma, and tenosynovitis / synovitis.

The severe pain on the bottom of the foot is more consistent with the plantar fasciitis I mentioned above. However, I am still concerned that we need to rule out those other serious conditions such as an infection and synovitis, or infectious synovitis. I will rest more easily knowing a physician has seen you and examined for these other serious conditions.

I recommend that you be seen. I wish I could examine you over the Internet, but I can't. I want you to be safe and have the bad stuff ruled out first and foremost. Keep me posted for my own knowledge and for my colleagues as well.

Kindest Regards,

Daniel Nelson, MD and 4 other Health Specialists are ready to help you

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