The patient presents today for his first follow-up visit since I initially consulted with him on April 18, 2013. The pain in his right foot did abate for a while with the use of Voltaren gel, but then he stopped using it and the pain did return. He continues to use the Ecco shoes that may have been the culprit for starting this pain. He did obtain the x-ray that I wrote for his last visit.
Right foot pain of unknown etiology; clearly ligamentous strain plus or minus compression neuropathy plus or minus tarsometatarsal joint irritation.
I told him to change shoes and go barefoot as much as possible. I also would like to start him on a course of physical therapy one to two times a week for four to six weeks with the use of ultrasound and electric stimulation. If he is not improved with these changes, we will consider injection into the area depending on his response. He is in agreement with this plan and I will see him back next month for follow-up.