Hello, I am a recent physio grad from Uk and like most am struggling for any experience, this was until my dad constantly complained of foot and lower limb pain so I thought bonus Ill keep up my assessment and management skills here! However not having much knowledge of disorders of the lower limb/feet, I am struggling to diagnose the cause of the pain much to my embarrassment and I therefore need some help if possible from you more experienced physios!!

PC - 50 year old, no history of any trauma. Right foot ‘burning’ pain very localised on plantar surface around head of 1st metatarsal (sesamoids?) and more recently anteromedial pain up to about ¾ the way up the lower leg. C/o ‘burning’ sensation especially on head of R 1st metatarsal and planages. No numbness or altered sensation. He’s recently changed job (approx 3 months ago) which is around the time of onset, job is predominantly office based but he has to drive 2 hours each way. Aggravating factors include pressing accelerator while driving for more than ½ hour and easing factors include wearing new boots with higher instep inside. No difference between morning/night.

Observation – fair loss of longitudinal arches/pes planus foot pattern
?Poor circulation – dry skin and ‘cold’ to palpate

No pain/stiffness on AROM or PROM and these were all full with no restricted movements in any direction. Muscle strength Gd 5 and L=R. Performed quick assessment of knees, hips and lumbar spine but indicated nothing.

Hypothesis – Wikipedia reference-linkPlantar Fasciitis – due to possibly overuse injury

However, this does not explain the anteromedial pain ¾ of the way up the lower limb and also the pain on the foot is very localised and Im at odds to explain this.

So far, I have suggested seeing the doctor for anti-inflammatories and purchasing insoles for every pair of shoes. However I am reluctant to manually treat (i.e frictions etc) until im sure what the diagnosis is so sorry for the long winded patient assessment but hope someone out there may offer some explainations especially concerning the anteromedial lower limb pain.

Thanks!!

Similar Threads: