Sudden right ankle swelling and burning foot pain

[jbfickle]

I am new at this so please forgive me if this isn't in proper form.  First, I think you need a little background in order to understand what may be contributing to the sudden swelling and burning pain.  Born 2 months prematurely with club feet and pretty severe scoliosis, to military family.  Military drs. corrected club feet as best as they could in the 50's and did nothing about scoliosis [not so sure they could have].  In my 20's and until late 30's I became an avid runner, at that time without the benefit of great runing shoes for that purpose because correct shoes were not yet manufactured and recommended to runners.  The reason I quit running was back pain, sciatica, and migranes.  When that occured, I sought health care via my family dr. who recommended chiropractor for musculo-skeletal pain and a neurologist for migraines.  Chiropractor did fine for a while and I quit seeing him - his xrays proved the scoliosis had gotten worse but his manipulations and a masseus' treatment helped greatly.  Neuro confirmed migranes brought on by hormone changes, as attested by severe endometriosis and constant laproscopic removals of the endo.  Once I passed into the age of menopause I had no migranes until recently - within last two years.  

Another contributing factor to all these joint pains, sciatica and migranes is two auto accidents which had a very negative impact on my spine and other joints.  At about age 22, someone rear-ended me as I waited for a left hand turn on a two lane road, with the other driver failing to even tap the brakes before hitting my car - stopped completely as he went 40 miles per hour.  I know my knees hit the dash and my torso was forced forward and then snapped back at great force.  I knew nothing about whiplash or potential pain from hitting the dash with both knees.  Thus I claimed no injuries which ultimately showed up much later.   When I was in my mid 30's a driver ran a light as I was attempting another left turn with the green arrow on my side, t-boning me at about 30 mph. (I guess left turns ought to be eliminated from my driving habit, you think?)  That accident caused me to pursue an orthopedist who did arthro on both knees to remove cartiledge and repair acl in both.

At age 40, I slid on a wet tile floor, in a puddle of water I couldn't see.  That accident resulted in arthro on my left knee and I believe that dr. removed my acl entirely because the MRI prior to TKR reveal no acl in that knee.  OK, so given this background info.  I am wanting to know what could possibly be causing the sciatica to return and the sudden swelling in just one ankle along with bad burning sensation on both feet.  The pain in the swollen ankle is tender on the inside part of my ankle most of the time, but on the outside of that ankle is a nagging pain at the bottom of the bones.  I have tried ice, heat, elevation, staying off my feet and prescription pain meds.

Another part of this background is that I have been on long acting and immediate release morphine for about 8 years, initally because of chronic kidney stones and utimately to help with on-going chronic pain in both knees.  For some unknown reason, I really thought TKR would cure the arthritis in both knees -- but I was wrong and have not had one day in the last 10 years of painlessness in both knees.  I'm not a crybaby when it comes to pain and I hate being ill (after a total hysterectomy at age 35, I went home from the hospital one day following major surgery). and way layed from doing what I enjoy doing (golf, long walks, cardio benefitting exercises, chasing grand children).

So, because my hubby is retired after being declared disabled 3 months after our wedding (he was widowed twice and me never married until 42), due to a major heart attack following a triple by-pass in 85 and several angioplasy's to keep his ejection fraction reasonably high enough to give him a satisfactory life as long as possible, I have the obligation to work when I can.  Living with my parents to care for them as they deal with cancer make it impossible for me to hold down a job which precludes my having group health insurance and what I do have is pitiful as far as covering much.  Thus, going to find out what's going on is pretty much cost prohibitive.  When I took my mom to her ortho, he looked at my ankle (at no cost but also no diagnostics) and recommended trying shoe inserts to raise my fallen arches.  That has been six weeks ago with no improvement, and in fact the problem has worsened.

Do any of you out there know of any place in the Atlanta area where you can obtain care of an ortho or pain management clinic at no cost or at least on a sliding scale.  Also, do you have any idea, those of you with similar experiences, what may be going on and how to heal/treat this ankle swelling and severe pain?

I apologize for the length of this question, but I don't think it is a good idea to leave out background info that may help with diagnostics.  

Thanks I look forward to some responses - if you finish this lengthy diatribe.  I promise not to be so verbose in the future.

[jbfickle]

Thanks again for the info.  I do the same with acronyms from the computer world and legal system.  I will talk to my new pain dr.  & find out what we need to do to see if I may have SIJ dysfunction.  

I notice you do a lot of responding and helping with advice on this forum and I think we are fortunate to have people who care enough to help.  So my hat's off to you.

Thank you again.

Julie

[Tuckamore]

Sorry I used acronyms and please don't apologize. I have a medical background and education in the field and I didn't know what SIJ was until I was diagnosed with SIJ Dysfunction.  

Not many ppl even know we have a SIJ (sacroiliac joint). It is the joint between the sacrum, at the base of the spine and the ilium of the pelvis, which are joined by ligaments. It is a strong, weight bearing synovial joint with irregular elevations and depressions that produce interlocking of the two bones. We have two sacroiliac joints: a left and a right joint that often match individually but are highly variable from person to person. It can become inflamed during pregnancy, arthritic or from improper shifting of your weight, an injury or an unusual gait or for no apparent reason.

It can become "stuck" or in some cases one half of the pelvis can glide forwards or backwards.  Mine goes out of place often and the pain is excruciating. There is a lot of good information on the internet about this often misunderstood joint and the often under diagnosed condition of SIJ Dysfunction.

However if you are suffering form SIJ pain it is probably secondary to the pain in your ankles. It will most likely respond once you are ambulating normally again.

I will look forward to your updates.

Peace,
Tuck

[jbfickle]

Thanks for the quick response.  I must apologize for not knowing some of the medical acronyms - but what is SIJ?  Thanks also for the suggestions relative to low cost medical assistance and elder care help.  I will seek to find out what our state offers.  

I will keep you posted as soon as I have more to report.

Again, thank you and take care.

[Tuckamore]

Welcome to the Pain Mangement Community. You certainly have been through much in your life and I am sorry that once again you are faced with a painful issue.

I am not sure that you sciatica and painful ankles are related, other than you may be walking in an protective guarded manner which will aggravate your SIJ and which can cause sciatic pain. Have you had gout in the past or been diagnosed with arthritis?

The edema (swelling) could be related to a medical issue and because they are swollen they are painful. If possibly try to see a MD or DO ( A DO would be my preference) for at least a consult to rule out medical related edema.

I am sorry but I do not know that Atlanta health care delivery system at all. Hopefully a member can assist you with that question.

Have you applied for state health insurance? Have you considered applying for SSDI? Either option may be helpful to your financial situation.

You are caring for your parents. It is amazing to me that there is no financial remuneration to those that care for loved ones at home. Nursing homes cost thousands of dollars a month and the state does pay for that. What is wrong with our system? Don't misunderstand me I am sure your love your parents and are not looking for payment. However their care elsewhere would be very costly it seems shameful to me that our government does not do more to help families maintain loved ones in their homes. Check with your state and see if possibility GA is different than WI.

Best of luck to you. I hoe you will become an active member of our community. Please let us know how you are doing. I will be interested in your next update.

Take Care,
Tuck