Ask a doctor on the topic of General medicine

Foot becomes inflamed sporadically - every 1-3 years.

August 23, 2014 | 30,00 EUR | answered by Dr. med. Frauke Gehring

Subject: Foot inflammation just below the toes

Description: For many years now, I have been experiencing inflammation in my foot, causing severe pain and difficulty in walking. This happens every 1-3 years without any specific trigger. The inflammation starts below the middle toes, sometimes on the right foot, and for the past 3 days, it has been on the left foot.

I have seen various doctors, had a comprehensive blood test, no Lyme disease, no stress fracture (confirmed by MRI). None of them have come up with a convincing idea. An orthopedic surgeon recommended insoles, which seemed to help for a while, but I didn't wear them in sandals during the summer.

When the inflammation occurs, I take Ibuprofen. If I take it early enough, the pain subsides in 2-3 days. However, when I didn't take it once, the inflammation spread up to my knee. The swelling caused by the inflammation makes it impossible for me to fit into my shoes.

I can also send pictures for a better diagnosis.

I am at a loss because I don't know where to turn, which is why I am reaching out for help for the first time now.

Dr. med. Frauke Gehring

Good day,

The image is very meaningful, and the first thought I had when I saw it was: gout! I hadn't even read your contribution yet.

It is essential to determine the uric acid level (which is not necessarily included in the "complete blood count"). The redness, severe pain, and relief through ibuprofen lead to this suspected diagnosis.

Obviously, it is not just a matter of overuse, for example due to a foot misalignment (that would go away without redness), and it is also not a chronic inflammation like osteomyelitis (which would have been seen in the MRI).

Please have your primary care physician determine the uric acid level now and again during the next attack. It increases with consumption of alcohol, meat, and legumes in larger quantities, which can then lead to a gout attack.

Warm regards,
Dr. Höllering, Specialist in Internal and General Medicine