Hi, Thanks for your question. I'm Dr. Hasan and I'll try to help you.
Is there any actual swelling there?
Any change in skin color?
Are you able to feel a lump there actually?
Do you feel pain primarily on top of foot or under surface?
Pain under the foot when walking, but otherwise only aware that if feels as if there is a bump there; severe pain on top of the foot when the tender area is pressed. As stated, both X-ray and MRI scan showed nothing, and the appearance of the foot is normal.
Thank you for your input.
Which specialist you have seen and what treatment has been given so far?
I have seen a specialist at the Royal National Hospital for Rheumatic Diseases in Bath (primarily because my GP thought it was rheumatism. He doesn't know what it is but my next appointment is for six months which seems a long time when it hurts to walk. My chiropractor, Peter Dixon, who is President of their association, is trying to solve it with very painful manipulation. My GP gave me the Gabopentin when I went to him and stressed that I couldn't go on as I was.
Last question, have you ever tried simple anti inflammatory medicines like ibuprofen, naproxen etc?
Yes, both in tablet and in gel form.
and you haven't got physical therapy so far?
Not specifically for that, but have been seeing a physiotherapist for a few months and he is aware of the problem but has suggested nothing specifically for that.
Thanks a lot for your input . I am sorry to hear about your problem. I am going to address your primary concern but later you can ask anything you want.
As per symptoms and tests done so far, your doctors have ruled out most of the possibilities.
In my opinion it can be tendonitis.
It means inflammation of tendon which is attached to our foot.
They are both on top of the foot and at under surface as well and they are supposed to move the foot.
I am not suspecting anything bony because your X rays were clear.
MRI can show tendonitis but not always.
The point is what you should do now.
First of all you should request your doctor to ask for earlier appointment from a rheumatologist.
Would this not show on the MRI scan?
and see your physical therapist as well. He can help you as well.
It can but it is not necessary.
It is possible to miss it on MRI.
It depends on the degree of inflammation as well.
Arthritis is less likely but possible.
Gabapentin is not the best thing in your case.
It works well for nerve related pain which is not your case.
In nerve related pain, there is no pain on pressing the area.
I suggest you to talk to your GP to change your pain medications.
massage of capsicum creams (available over the counter) can provide some relief.
Irrespective of the cause, local injection of cortisone in the involved area can help you a lot.
That has to be done by your rheumatologist.
Till you get all this done, you can add over the counter available tablet naproxen 500 mg twice daily to gabapentin and they both can provide a better pain control together.
Any question please?
So what do I do about it, go back to my GP or what?
There are things that you can do yourself;
1. Over the counter tab naproxen 500 mg twice daily can be added to gabapentin and both can provide better pain control
2. Massage of the area with over the counter bengay cream twice daily.
Sorry, I didn't see all your answer. Please ignore my last question and thank you for your help and advice.
You are most welcome.
Don't worry you are going to be fine.
Anything else I can help you with?
Massage is too painful but will try the naproxen.
Just apply the cream and left it there.
My best wishes and prayers are for you.
I wish you good luck and that you get well soon. My goal is to provide you with excellent service – if you feel you have received anything less, please reply back as I am happy to address follow-up questions. Kindly rate me when you are done. You can come back here to ask anything even after you have rated the answer. I will be glad to help you always.