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Laceration injury in the foot.

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Two years ago I lacerated my left heel on a broken door. I already had degenerative disc disease but in staying off my foot as much as possible my back became worse and an MRI several months later showed a new problem which appeared to have happened at the time of the injury. Additionally, my right foot, more specifically the large toe and ball directly underneath became almost impossible to walk on. My GP agrees that it is all inter related but I can't get the foot doctor to understand nor does he feel it's related. Because this has gone into a lawsuit I am being treated like a liar that any of this has happened based on my cutting the opposing foot.

Category: Family Physician-GP

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Dr. Deepu Sebin Sebastian is online now

Expert:  Dr. Deepu Sebin Sebastian replied 4 Days.

Hello and thankyou for approaching DoctorSpring with your query.
I have gone through your case and understand your concern.
Pain can occur in the big toe due to degenerative disc, but in that case usually there will also be pain in the other toe joints or calf muscles or thighs. However I will require you to give me additional information so that I can give you an informed opinion.

1) Are you having any burning, tingling and numbness in the big toe and any symptoms elsewhere in your leg or foot?
2) Is there any redness, warmth or swelling in the area?
3) Would you wear shoes with heels through out the day at work? If you have stopped, since when did you stop?
4) Please can you tell me what was the MRI result.

Please reply as a follow up and I will guide you accordingly.

Patient replied :

Laceration on left foot healed nicely with nerve damage as expected at affected site. Left big toe burns,catches and becomes numb if walked on for too long or pressure put on it, same with the joint immediately below on ball of foot. It is localized. I can wear only flip flops or soft slippers. To walk or drive car (that part of foot is used to press on gas peddle) I wrap it as if it is broken. The toe has started to curl upwards and have noticed I am walking on the side to prevent pressure. XRays shows hallux limitus with broken dorsal spur with assessment 'Possible traumatic arthritis first right toe and abnormal gaiting.

Expert:  Dr. Deepu Sebin Sebastian replied 3 Days.

Hello and thankyou for your reply.
From what I understand from your previous question and from your XRay findings, it is your right toe that is giving you trouble?
From your XRay your are having 'hallux limitus' which is a progressive arthritic condition of your big toe. It could have resulted either from trauma of your big toe, excessive weight bearing on that toe, genetic, could be due a long big toe or elevated big toe . In your case it is likely to be due to trauma or increased pressure on the right big toe.
In some cases bone spurs (bony growth) develops causing more pain.
It is a possibility that as a result of trauma to your left leg, you have been putting more weight on your right foot, resulting in overuse of your right big toe.

I would advise you to get yourself examined as it is necessary to asses the severity of your condition and get appropriate treatment.
For now you can use orthotics like dancer's foot pad or later you can use morton's extension carbon foot plate if your symptoms are severe.
You can use OTC Ibuprofen to control the pain.
You can continue using protection, rest your big toe, you can apply ice for symptomatic relief, and when you are resting keep your right foot elevated.
Depending on the severity you may require surgical repair in severe cases.

I hope this has helped.
Wishing you good health.

Patient replied :

Thank you very much for your input. It validates what I and my gp have been saying. Just arranged for an MRI of the right foot to conclude findings. Your answers where very helpful.

Expert:  Dr. Deepu Sebin Sebastian replied 2 Days.

Thank you.
Let me know if you have any followup questions.

Dr. Deepu Sebin Sebastian
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MD, Internal Medicine - Stanley Medical School
Medical School - MBBS - Govt. Medical College, Kottyaam

Diagnostic Prediction - Stanford School of Medicine
Received Specialty training in Critical Care, Cardiology, Neurology, Gastroenterology, Nephrology from Stanley Medical College and in Endocrinology, Rheumatology.

Hematology and Geriatrics from Madras Medical College.
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