5th (little) toe pain

by Jan
(Seattle)

I have intermittent pain in my right foot in 5th toe, tip of big toe, ball of foot, outside edge of foot below 5th toe, sometimes 4th toe.

Little toe by far most problematic. Pain (felt like burning) was severe and constant 3 months ago. FYI, I have no pain when area pressed on top of foot between 3rd and forth. My foot clicks when walking, especially without pad. There is no pain associated in area where clicking is (between 4th and 5th). Entire foot sometimes becomes red and sometimes even lower leg. Separating 5th and 4th toes very painful.

Podiatrist #1 said it is neuroma and said stay off. Gave me toe separator and metatarsal pad. Had me purchase wide toe box shoes. My lower back then went out (which of course also kept me off feet. Lower back went out second time after a few days in bed just from coughing. (My lower back does go out every year or two from bending over wrong etc). Pain did diminish over a few weeks but still intermittent. 800 ml Advil several times a day takes away almost all pain even walking but try not to take it all the time. Left foot on occasion will mimic conditions of right.

Went to Podiatrist #2 for second opinion. He diagnosed Morton's neuroma in left and right foot AND tailor's bunion in right. As of now, pain in 5th toe when walking and intermittent redness of foot. Pain is now almost gone when separating 4th and 5th toes. One dose of 800 ml Advil per day will keep almost all symptoms at bay. However, as soon as I stop taking Advil there is some 5th toe pain when walking, slight redness in foot, sometimes ball of foot pain. Can you advise on how to proceed from here.

Thanks so much,

Jan

RESPONSE

Hi Jan,

This all comes down to your degree of comfort. I am going to make the assumption that you are in reasonably good health. If you are an older individual, suffer from diabetes, have blood pressure issues or circulation problems,then all this changes.

In any event, if taking only one Advil per day suffices in alleviating the pain, then you could leave it at that with the hope that in some point in time your right foot might just stop hurting. If you have read much on this site you will know that I am not big on long term anti-inflammatory medication, but having said that, if you are healthy and are limiting the Advil to once a day, I do not see much harm in trying it for a couple months to see if the pain will subside.

If that is not acceptable to you and you do not feel like stuffing pads between your toes then you are a candidate for more aggressive treatment.

My favorite treatment for Morton's neuroma is multiple injections of 4% denatured alcohol. These injections tend to be highly successful. They work by sclerosing the nerve, or deadening it in an effort to stop the pain. Since I started using them 7-8 years ago, I have had to surgically remove very few neuromas, as that is how successful the injections tend to be.

Speak to whichever podiatrist you liked better about your more permanent options; they are obviously more familiar with the total picture.

Marc Mitnick DPM
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