Question
Hi I was wondering if u could help me. I am a 21 yr old female with ankle and foot pain. I have been to 2 different podiatrists. I had this pain since Jan.  I was taken by a snowboarder when I only had one foot in the board so I fall back and had shooting pain in my foot/ankle I felt something was wrong. The first Dr I went to had told me it was a Jones fracture according to the x-ray and then ankle sprain. Few weeks?later same pain so I had an mri of both ankle of foot was told it was normal then came a bone scan and the same it was normal. So by the next few weeks I had 3 cortisone shots into the areas. It did help but only for the max 2 weeks. Slowly pain started and then got intense. I get a painful cramp in the last 2 toes, I have a painful popping feeling in my ankle. I have pain both ankle and foot. The 2nd dr had taken another x ray and was normal as well. But with palpation and walking it would kill. I work in a medical office and im on my foot all day. Walking=pain, running=pain, standing=pain. He had said that he has seen this before and concluded that it was a osseous contusion to the talus and cuboid I was in the boot for the 2nd time and crutches and off of my foot for 6 weeks (haven抰 been at work unlike the 1st time I wore boot I was working full time and in it all day 朾ig mistake pain just got worse) till I had a procedure called intra osseous cortisone injection under fluoroscopic guidance for cuboid and talus. 10 days later I only had 1 day with no pain and its back but not as intense as before the procedure just the beginning   of how it started. As you can see I have done everything I was told do and now im desperate and need some relief plz help. Thank you for ur time. I don抰 wanna go back to work and have to stop again bec of the intense pain. I can抰 walk for more then a few minutes till it starts I want my life back. I cant run, walk, work, exercise etc Even when Im resting my foot I feel a heavy (painful) feeling.

Answer
Hi Stella,

Just a note.  I know that you are anxious to get an answer to your question but my submitting your question every day, you have caused others to lose a chance at getting their questions answered.  Please be patient and I can answer your question.  Submit your question once and wait for an answer.  That is the fair way to do this.


First, if you did have an osseous contusion to the bone it would show on MRI and bone scan, so that diagnosis is not likely.  I would not recommend cortisone injections into the bone itself.  I also would avoid excess cortisone injections generally.   With the injury to your foot/ankle, you likely have torn multiple ligaments although this should be obvious on MRI.  When the structures are torn there is a very long recovery.  During that recovery you should be having physical therapy to help you return to activities.    In addition, you likely have injured nerves in the foot and ankle.  I treat this with a procedure known as CryoMax or ultrasound-guided cryosurgery.  This is an excellent method of getting foot and ankle pain relief while you recover.  The pain between the toes is most likely nerve related.  See my site below.  

I would seek another opinion and consider repeating the MRI and certainly start physical therapy.

Marc Katz DPM
Tampa, FL
Advanced Podiatry
www.tampacryosurgery.com
www.thetampapodiatrist.com
www.cryosurgerypodiatrist.com