Advice for patient with toe pain

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Need some help with a problem patient.Patient suffers with pain in toes after taking shoes off and in bed at night.We have changed shoes, elevated feet and Ultra Sounds and every other test I can think of all to no avail, also has the doctor scratching her head as well.
Any ideas would be helpfull, Kath McC

 

Re: Toe Pain

Hi Kath,

What sort of pain is it ie burning, pins and needles ,any loss of feeling . does it occur when standing moving or when feel are elevated, when is it worse in bed or straight after taking shoes off ?

 

Re: Toe Pain

Hi Kath,

If you could provide a full overview of the patient and her management history you are likely to get a better and more appropriate responses.

- Age
- Medical History
- Diabetes?
- Medications?
- Family History?
......

Good Luck,

Sally Belcher

 

Re: Toe Pain

It would also help if you can give us:

nature, location, duration, onset, course, aggravating factors and effects of any treatment thus far, plus sex and social history.

All the best

Bill Liggins

 

Re: Toe Pain

Sorry got interupted when doing first lot of info,I'm sure you all know how it is !!!

Patient is 45 year old woman with no medical history of note, no medication and no chronic disease.Numbness occures in all toes when she takes her shoes off. All tests show no problems and new wider shoes didn't help.
Lifting the met heads gave some relief but only a little.Elevation didn't relieve the pain or numbness.Ultra sounds confirmed good blood supply.Doctor has also no idea.

 

Re: Toe Pain

Kath sounds a bit neurologic does the patient have any history of lower back problems ? Do they sit alot at work old seat etc ?


Also does the patient have any pain when pallpating the head of the fibular.

Is the problem more or less if the patient wears heels for a day ?

Have you tried support socks to see if that changes the symptoms ?

 

Re: Toe Pain

Hi Michael
Patient lives and works on a farm and wears good supportive lace ups.
No history of back pain and no pain on palpatation, wnet down this avenue with the physios.
Haven't tried support socks I guess there could be some swelling that I wouldn't see due to appointments in the am.
Thanks
Kath