Q: I suffered a fracture of the left calcaneum last year due to fall from a height. The foot was cast under sedation. There appeared to be a slight dislocation in the fracture. After six weeks the plaster was removed, and I was asked to take physiotherapy. At that time I could not even place my left foot on the ground due to pain. Slowly I started walking with the help of crutches. But because of my own lethargy, I stopped taking physiotherapy, as I thought that the pain would go away in a few days. A year has passed by but there is still excruciating pain and the foot has very poor weight bearing. Recently I again took physiotherapy for 45 days with the physiotherapist giving me ultrasonic therapy, exercises in a well equipped gym, and foot aids like heel pads and knee caps but the problem still remains. What should I do?

A:The fracture may have been malunited. It is possible in calcaneal fractures to impinge on the nerves and tendons, which may cause pain. The diagnostic test would be to inject the painful site with local anesthetic and then if that is the true site of pain - address it surgically. You may have to see an orthopedic surgeon for this. Before this - the conservative modalities should have been exhausted. Contrast bath - immersing foot in alternate cold and hot water, anti inflammatory, local analgesics, ultrasound and physiotherapy. I do not know what kind of fracture you had sustained - but calcaneal fractures are prone to long term pain.