Question to general practitioner Maarten: Pain under left foot
Maarten Vasbinder lives in Isaan. His profession is general practitioner, a profession that he mainly practiced in Spain. On Thailandblog he answers questions from readers who live in Thailand and writes about medical facts.
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Dear Martin,
How are you doing? I see you still giving useful advice to compatriots with ailments. About the skin rash I had on my lower legs at the time….I stopped using all remedies 2 years ago, but have washed and covered it many times.
Since I live near the beach at Ban Phe (Rayong), I walk many km through the salt water and almost get rid of the rash. Unfortunately, due to serious pain in my left foot, I can no longer do that beach walk through the water.
See attached writing and photos. I feel the pain in the foot cushion and indicate the places with an X on the photo.
I look forward to your response.
Greeting.
R.
ps I have more pictures if you want.
*****
Dear R,
Nice to hear from you again. Glad the results are almost gone.
The pain under your foot is called metatarsalgia and is common as you get older. The cause is usually relaxation of connective tissue and/or incorrect footwear. Being overweight doesn't help either.
We can't do much about that connective tissue. Sometimes shockwave therapy by the physiotherapist helps. However, good footwear is a much better treatment. A good podiatrist will be able to help and also a specialist shoemaker. Birkenstock shoes seem to help. They ensure that the pressure on the painful area decreases. Further stretch the foot and move well without strain. So just in your chair. Cooling sometimes brings temporary relief. An elastic sock sometimes also does something. Not too tight.
What also strikes me about your feet are fungal nails and very dry skin, which also seems to have fungus. If those nails don't bother you, don't do anything. The treatment is quite rigorous. Medications plus in this case nail extraction, something they are not very handy at here.
In Spain, surgeons came to see how I did it. Anesthesia and the right tools work wonders. The extraction took 1 to 2 seconds. You use the same kind of technique when pulling teeth.
Many doctors cut the nails into strips and then pull those strips out. After a few days you can walk without bandages again. The growth of the new nail sometimes takes up to a year. The drugs are needed to kill the fungus.
The danger of fungal nails and fungus between the toes, especially with diabetes and poor circulation, is that there is an opening for bacteria, which can lead to serious infections. Therefore, keep your feet very clean, also between the toes. If they are dry use miconazole powder between the toes.
Here's another article about pain under the forefoot. For example, you can also take Naproxen 300 mg (max. 3 / day) to combat the worst pain. However, that has side effects, such as stomach upset, for which you can also take pills. So that's a way to become medicalized, something you should avoid if you can.
Under metatarsalgia and forefoot pain you can find hundreds of articles on Google. However, beware of quacks, such as acupuncturists
Sincerely,
Dr. Maarten