Foot pain that won’t go away (From Bradford Telegraph and Argus)

Foot pain that won’t go away

7:34am Tuesday 2nd December 2008 in Questions & Answers By Dr Tom Smith

Q: I have been jogging regularly for the last few years, taking part in 10k and half marathon runs. Recently I’ve had a pain in the middle of my left foot that is worse when running, but never really goes away completely even when I’m resting. Could this be a muscle or ligament strain, and what can I do to ease it? I don’t want to stop my running unless I really have to.

A: You must see your doctor. It’s possible that it is a strained ligament, but it could also be a stress fracture of a metatarsal, one of the bones in the centre of the foot. If that’s the case (an X-ray may help) you will need to rest the foot. You may even have to have a walking cast for four-to-six weeks to let the fracture heal. After the cast is removed, you may still have to return to exercise slowly, say over four weeks, only starting to run again after that time, and then only if the foot is pain free.

Q: My 12-year old daughter has developed arthritis in her knees and ankles, and has been put on methotrexate. It seems to be helping her a lot, but she has blood tests every week while on it. Must she really have so many tests? She hates the needles, and it’s always a struggle to get her to go to the doctor.

A: I’m afraid she must. One of the side-effects of methotrexate is a lowering of the white blood cell count, and that can cause her to be very susceptible to infections. The weekly test will catch any drop in the white cell count early enough to reverse it in time to keep her healthy. Her doctor may give you some anaesthetic cream to rub on the needle site before the sample is taken, to make it easier for her.

Q: I’ve lost 2st recently, and my doctor has found I’m anaemic. I’ve been sent for a bowel endoscopy. Why is that? I’ve always had normal bowel movements, and have never passed blood.

A: I’m afraid I must be blunt. Your doctor is following the guidelines for early diagnosis of bowel cancer. Seventeen per cent of men and women who are found to have what is called iron deficiency anaemia on routine testing turn out to have bowel cancer, even though they have not had any symptoms (like diarrhoea or bleeding) or signs (like lumps in the abdomen). So your doctor is trying to rule out cancer as a cause for the anaemia. Anaemia isn’t an illness in itself – it is a sign that there is an underlying problem that has to be found and cured. You may have been leaking tiny amounts of blood every day in your motions – enough to make you anaemic, but not enough to show.