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Date of last update: 8/21/2017.

Forum Name: Rheumatology Topics

Question: Foot Pain & Swelling

 Anni - Fri Nov 07, 2003 4:52 am

Everytime I wear shoes, other than tennis shoes, my feet become extremely red, swollen and painful wherever the shoes have put pressure. The soles of my feet, the tops of my feet, etc. I can wear most tennis shoes, but anything else is out of the question, including clogs because they make the soles of my feet extremely sore. The redness, swelling and pain usually last for several days. The swelling is significant and sometimes I can't wear shoes at all for several days and the soles of my feet get so sore that I limp for days. I have seen my regular doctor for it, but he is mystified. Can you help? Thanks!
 Dr. Tamer Fouad - Fri Nov 07, 2003 12:05 pm

User avatar Dear Anni,
I have reviewed your case extensively. Having been diagnosed with Acute intermittent porphyria probably has nothing to do with it. AIP may lead to weak skin which is slow to heal in addition to the photosensitivity but this has nothing to do what your describing, and is not present in all cases.

Inderal is associated with contact dermatitis. But if this is the case then wearing tennis shoes should be no exception. Does it happen when you wear socks only? How long has this condition been this way?
 Anni - Fri Nov 07, 2003 10:28 pm

Dear Dr. Fouad,

I can wear socks with no problem, and I have one pair of sandals which just have a very thin strip of leather that touches my feet and I can wear them for up to an hour without any serious side effects. This has been going on for about three years. I really appreciate your efforts on my behalf. My great grandmother had really terrible rheumatoid arthritis and I have often wondered if this could be the beginnings of that. She was quite old when I was born and so I don't know any specifics about her condition beyond that. I hope that helps you to help me.

 Dr. Tamer Fouad - Sat Nov 08, 2003 5:48 am

User avatar When it happens with the sandals does it affect the area corresponding to the thin leather strip or does the whole foot get swollen and inflammed? Does it get inflammed as a result of pressure or does it happen when the shoes are comfortable as well?
 Anni - Sun Nov 09, 2003 10:30 pm

Comfortable shoes or uncomfortable does not seem to make a difference. The area touched by the thin strip does not seem to be affected, but everything near the area is affected. For instance when I wear high heals, the area around the top of the shoe on top of the foot will swell and become inflamed, so will my big toe and the two toes next to it on either foot. The soles become extremely painful with some swelling and redness. As far as we can tell, it's not a contact dermatitis.

 Dr. Tamer Fouad - Mon Nov 10, 2003 3:52 am

User avatar Anni,
Its not easy judging here from the internet. At the same time your condition is very atypical. Believe me I have gone through a whole podiatrics reference in search for an answer. I don't get quite the picture: So it's not related to the tightness of the shoes or the fabric?

Anyways I could go on asking questions here forever. Here's my two cents:

There are many causes of foot swelling. If one leg is swollen, it may be caused by vein problems, blood clots in vein, infection, injuries, surgery, blockage of deep veins due to tumors, disease of the lymphatic channel, etc. Swelling of both legs may mean heart conditions, kidney problems, liver cirrhosis, malignancies, vein problems, or sitting in a wheelchair for a long period of time.

General podiatric care:

    Every time you buy shoes, measure your feet standing. Remember your feet change in shape and size during full weight bearing.
    Let your podiatrist examine your new shoes for an approval before you wear them. You may not be able to feel the fit of the shoes as neuropathies get worse.
    The shoe should be ½ inch longer than your longest toe. A shoe larger than this makes your foot slide back and forth causing blisters.
    If you have feet of different sizes, get both pairs of shoes even if it costs you more.
    Do not wear shoes with more than an inch heel height. With high heel shoes, there is increased pressure at the ball of the foot where foot ulcers develop most frequently.
    Inner lining of the shoes should be free of in-seam lines which can be abrasive on the sensitive skin.
    Do not wear shoes made of nylon or plastic. Leather shoes breath better and absorb moisture from perspiration. Deerskin and calfskin leather are recommended.
    A toe box should be high and wide especially if you have bunions or hammertoe deformities. Your toes should not be squeezed from the sides nor pressed down from the roof of the shoes.

Go through the list of causes above and if you wish to discuss any points further go ahead. If you can send me a pic of the swelling, that may also be helpful.

 Anni - Tue Nov 11, 2003 1:01 pm

Dr. Fouad,

I appreciate the time you took to help. I know that what I describe is very atypical and I suspect that with time the answer will reveal itself, as is so often the case.

I'm not going to worry about it anymore, just keep wearing tennis shoes.

Thanks again for the time and the trouble.


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