Chronic foot pain for 2 years

[threehappypenguins]

My husband has had chronic foot pain for 2 years. He is flat footed and has been so since he was a child. He wears orthotic inserts, but only since he began getting foot pain (he thought it might help). The pain began in Oct or Nov of 2007, and he doesn't remember ever injuring it. He said it began hurting (very slightly) as he was running down a stairwell, but doesn't remember twisting or rolling it. It began hurting severely a few days later, and hasn't stopped hurting since. He works 12 hour shifts doing security work which requires a lot of walking on hard tile on concrete. He is also 6'2 1/2" and weighs 290 pounds and is 30 yrs old.

He went to the doctor not long after it began hurting, and the doctor just said it was a sprain, and to ice and it and go to physiotherapy. He did this for quite some time, and there was no improvement whatsoever. He went back to the doctor after about a year or so, and the doctor again said it was a sprain. He also got an x-ray, and the results came back "normal." He also got a test for rheumatoid arthritis and it came back negative. However, there were some results that said that his swelling was fairly high. The rheumatologist also ordered a newer more advanced test for rheumatoid arthritis that is supposed to pick it up if the others come back negative (if he does have it). We are waiting for his knuckles or something to swell up again before he gets the test again (doctor said to).

He describes the pain as starting on the outside part of the top of his foot near his ankle. The pain goes across the top of his foot, and goes into the back of his ankle near the Achilles tendon area and up his calf. He said that it is a sharp stabbing pain that only subsides to a dull ache if he is off of it for quite a few days. The backside of his heel also hurts.

I began doing some research, and I came across something called "posterior tibial tendon dysfunction." Do you think it could have something to do with this?

[Yena H Do, DPM]

yes.  it sounds like posterior tibial tendonitis and dysfunction.
i would have him evaluated by an foot and ankle orthopedist or podiatrist who specializes in flat foot reconstruction.
there are bracing and surgical options that can help alleviate his pain.

[threehappypenguins]

I also forgot to add that when he moves his foot around, there is a grinding, crunching sound/feeling.