Arthritis in foot feeling like a railroad spike driven in

After eight months of intense PT for sever sciatica, I am once again BARELY ambulatory. I was clumsy with crutches for a day. I use my walking stick now, but getting around is painful and limited.
.
My right foot hurt one day. And the next day it felt like someone had driven a railroad spike through the middle of it. Now and then a second spike would be driven in. And there were intermittent ZINGS up my leg to just past my ankle mixed with the numbing type of pain like when you've smashed your hand with a hammer, or had slammed it in a door.
.
I was on the phone with Medicare finding out my options and let out a whoop of pain, and the agent said, 'If you are in that much pain, go to an ER, NOT an Urgent Care.
.
She gave us the closest that took my coverage
.
Eight hours at the emergency room, and I left in no better shape than when I went in, save for digesting a Motrin. My GPs have discouraged ibuprofen as I've a history of some renal issues.
.
The x-rays show arthritis. I am attaching the radiology report.
.
I was not been able to bear ANY weight on my right leg for two full days. Oh, and they gave me a 'boot' that looks more like my sandals, with a wide, flat sole.
.
I've an oddity in that foot that it ALWAYS feels like there is something about midway between my toe, and just down into to sole in my shoe. Or on the ground if I am shoeless. Whenever that foot contacts a flat, it feels like there is a pea or a small pebble under it.
.
Even when I DO attempt to rest it, if I've a shoe on, I am forever fidgeting my toes to try to get them flat.
.
Now I don't know what in my leg is foot oriented and what is sciatica originated.
.

@kaptainkat, this sounds absolutely unbearable. Thanks for providing the extra details. Please note that I removed the x-ray report since it contained personal identifying information. Since this is a public forum for patients to connect, we recommend posting without personal identifying info for your security.

It sounds like you are looking for medical help. If you would like to consult with a Mayo expert, here's information about how to request an appointment: http://mayocl.in/1mtmR63

What did the emergency room doctor suggest as next steps?

Colleen...
.
Thankmew for your reply and for protecting my privacy. I should have remembered about that!
.
My departure instructions are:
'...elevate when possible. Alternate warm and cool compresses. Avoid prolonged weight bearing. Follow up...'
.
I've an appt with my GP on the 21st at which time we will add this to my list of issues.
.
I have JUST gotten to walking following eight months of intense PT for sever sciatica! And now my FOOT stops me! I saw where at the bottom of one list of suggestions was PT, and I will certainly ask my GP if PT would help. I had a GREAT therapist leading a team of GREAT technicians.
.
So i endeavor to stay off it as much as possible while still not being a burden to the Mrs.
.
It is getting to 'What's Next?' Already can't eat. Now can't walk - again.
.
(=^..^=)

The description of your pain sounds quite like a neuroma - a cyst or knot on a nerve. Google Morton's Neuroma and see what you think. These are not generally identified by imaging - requires a nerve conduction test called an EMG.
Sue

I shall be sure to inquire. I have only the radiologist's report to go by, and that is saying arthritis.

As I said, a neuroma won't appear on an x-ray like arthritis does. You can have both, but the "railroad spike" description is more descriptive of neuroma pain...
Sue

@kaptainkat

I agree with Sue that it could be neuromas and arthritis.

I had only a MRI to confirm two neuromas and had surgery to remove them in 2012. In 2017 I went to a different podiatrist in another town and a MRI found a small neuroma and the neuroma stumps were inflamed. Podiatrist did an injection and referred me to physical therapy.

Not a lot of physical therapist know much about foot therapy in my town. I found from the first therapist I saw that one therapist that had helped me many times knew how to treat feet. He used massage, torture tools but mostly dry needling. Dry needling is basically acupuncture with a TENS unit attached. I think I had 8 to 10 sessions and could walk again with little pain.

Then back to podiatrist in 2021 .. now bone on bone arthritis. The worst pain is when low pressure weather fronts come through. The base of my big toe on the bottom hurts the most and across the top of the rest of my toes. Most of the swelling is on top. I get my moist (microwavable) heating pad and place on my foot when it hurts the worst. .. beats filling a pan with water to soak it. Ice makes it hurt worse for me.

No injection into area will help bone on bone arthritis. If there is a space in the joint it will help arthritis. I did have torodol and depro medrol injections in my buttock a few months later for on general all over arthritis. They helped my foot too. I was told by the podiatrist he does do a surgery to help the arthritis, but he would not recommend it for me. I have osteoporosis.

I do think you should see a good podiatrist. I asked a nurse friend about podiatrist in her town .. she had only seen him a couple of times, but her friends thought he was a good podiatrist. I figured she was the person to ask being nurses are on their feet so much.

You have your insurance company and hopefully there will be a good podiatrist that is in your network.

ZeeGee

ZeeGee...
.
Thankmew for the info. As mentioned I will discuss the neuroma possibilities with my GP. I saw a podiatrist a while ago for a pair of ingrown toenails, one of which needs to be redone.
.
I saw a 'pod' once who with barely looking at my feet said 'You need inserts, and they run $600.' But I didn't get them at the time. I hope that Medicare will cover it.
.
My mother had 'bad feet'. One was from birth never quite attached right to the bottom of her leg. In her latter years, she did in fact trip over her own foot.
.
Mine just hurts.
.

Oh, and ditto on the low pressure systems and my sciatica. I don't think it is the cold nor wet so much as the change in barometer.