Nerve shocks on the heel

by Al
(Oxen)

Hi

Over the last 3 months I have been experiencing shocks coming from my inner heel after landing heavily on it.

The best description of it would be as if a nerve is made to tingling or tickle the moment weight goes onto it.

I can walk on the balls of my feet fine, and I get no soreness from my plantar fascia and it only happens when pressure is applied to the top inner corner of the heel.

http://www.podiatrytoday.com/files/photos/pt1105cover1.jpg

Looking at the above picture it appears like it is one of those nerves at the back that branch onto the heel.

It is not painful, just unpleasant more like being pricked with a needle. However I have been walking on the front of my foot to avoid triggering it off. Every week or so I try a day walking on it to see if it is better but it seems to not change.

My doctor said there appeared to be nothing wrong with my foot and that it is perhaps swelling putting pressure on my nerve and that it should be gone within 4 weeks. However this was 2 months ago and I am now getting concerned. I have been thinking of not walking on it at all for 6 weeks in the hope that it goes away, whilst using Ice and anti inflamatories. Is this a good idea or does walking on it help?

Hi Al,
Read my article on
heel neuroma. This is a treatable condition and after two months of no relief it would seem to me that it is not going to go away by itself.
If you try and walk differently to avoid pressure on the heel , eventually you will develop pain elsewhere on the foot or even your leg.
You will need to see a footspecialist who can first confirm the diagnosis and then you may want to try anti-inflammatory medication.
Marc Mitnick DPM




Thanks, Al

never ending pain in foot

by Karen
(Kingman,Arizona)

I have had xrays,and they dont show anything wrong.But for the last year I have had constant aching in my foot,and its at the point now ,where I rarely can sleep because it is SO much worse at night.The best way to describe the non stop aching is,that its a dull ache and it feels like its my whole foot.It doesnt hurt half as much when I have shoes on or as long as I am moving.I find it very difficult to walk on that foot without shoes.And it hurts more when I am just standing in place,or sitting,but definetly the very worse at night in bed.And no matter what I do,I cannot get comfortable enough to sleep.PLEASE help! I only got 1 hr. of sleep all night last night.Thank you!!!

Hi Karen,
I am probably stating the obvious when I say your foot needs further investigation. An x-ray alone is sometimes not enough to rule out pathology. Your next step would be an MRI. I do not know your age, or occupation, or anything else about your medical history but a constant aching in the foot, going on for a year, you need to rule out other sources of the pain such as neurological and vascular.
Be proactive about your problem, see a foot specialist and let he or she work you up covering all aspects of the potential source of your pain. Pain for over a year is not normal.
Marc Mitnick DPM

hammertoe surgery recovery..

I am 19 years old and ive decided to have toe surgery as well as the doctors decision. I have my surgery in november 2010. The problem is, i am a volleyball athlete in college. My question is since i jump alot in volleyball as a hitter, by having my surgery in november, will i be good enough to workout again by end of february 2011? Estimated guess? I know it dependson my body too. But i really need the surgery. They said they are just removibg the littke piece that cobnects my joints which will flatten n straighten my toe . It will only be my first two toes after my big toe on both feet.

Hi,
I do not think any one can give you any guarantee as to when you will be able to return to volleyball.
Assuming you are a quick healer, you might be able to return to play, but do not be surprised if you have some tenderness in the toes during and after the game and do not be surprised if your toes swell up somewhat.
Possibly splinting the toes during games may go a long way in reducing your discomfort.
I would recommend you speak to your surgeon regarding specifics of your recovery.
Marc Mitnick DPM

morton's neuroma post surgery

I had surgery for morton's neuroma 10 1/2 months ago. Surgery was done from the top. I'm still experiencing stinging pain (it feels like tiny electric shocks or pins & needles)in my foot. Even though I'm still feeling this my Dr. told me to resume to all normal activities. He said I'm healing normal & everything is fine. Can't feel any scar tissue everything is soft. I'm having a hard time beleiving this. Is this normal for me to still have this type of pain after all this time?

Hi,
At ten months this surgery should be a distant memory. The pins and needles feeling suggests that there is still neuroma tissue that was not totally removed. This is known as a stump neuroma. (read my section on Morton's neuroma).
I would suggest you see another doctor; do not be quick to consent to additional surgery as there are less invasive treatments available that should be tried first, such as denatured alcohol injections or perhaps even orthotics.
Marc Mitnick DPM

i am 8 months pregnant and my right heel of my foot is very painful when i put pressure on it

by Kris
(SD)

recently the pain has been getting worse and worse, hard to walk on or even put pressure on it. the further along I get hte worse the pain and it is sometimes effecting my ankle

Hi Kris,
Two things happen in pregnancy that adversely affect the feet. One is weight gain. The more weight you put on , the more stress to the feet.
Secondly, hormonal changes associated with pregnancy also can cause foot problems.
The best advice I can give you, is if the pain is getting worse, may an appointment with a local podiatrist and get an accurate evaluation and some treatment.
Marc Mitnick DPM

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Numbness

by AEC
(UK)

Hiya,
I have total numbness in left big toe, which tends to feel like it is spreading over the whole foot sometimes. It is the same sensation as when you sleep on your arm in a funny way and wake up and cant feel it at all - thats exactly what its like excpet its in my toe! It is also a slightly cold sensation but my feet are not cold to the touch.
I have great circulation - i have had no trauma recently - I only have it in one foot!
GP checked my reflexes etc and says there is no need to worry - guesses at a trapped nerve but there is NO PAIN! Just numbness....

The past couple of days my entire leg has been feeling tingly too from time to time.

I also have a sensation in certain patches of skin across my back of sever sunburn, but no marks or patches?!
I wonder if it is related?
Any ideas???!?!?!?

Hi,
Based on all your complaints I might be inclined to either look at your lower back as the source of this nerve pain, or local irritation of the nerve around the toe. The most important thing to look at is your circulation. Besides having good pulses, check the color of the toe; does it ever turn pale, or get very blue in color? A circulatory problem with the toe would be my biggest concern. I would recommend you get another opinion from a doctor who specializes in foot problems.
Marc Mitnick DPM

ligament or nerve pain on top of ankle

by Greg
(Seattle, WA)

I've had a herniated disc in my L4/L5 for a while now. I've received steroid injections and been doing stretches for a few years now. I have had radiating nerve pain down my leg, however I've never had this pain on the top of my foot/ankle. just recently I started feeling a pain (about 8 on 1-10 scale) on the top of my foot/ankle. I feel it's related to my nerve pain due to herniated disc but can't say for sure. I'm worried the herniated disc is starting to cause permanent damage to my nerves. I've avoided surgery because of the horror stories I've heard about seemingly simple procedures putting people out for 6 months and not even fixing the issues or creating more issues. Can you give me an educated guess as to what the issue may be(arthritis?)...I completely understand that without a hands on diagnosis this would be difficult.

Hi Greg,
The most common cause of pain in the area you describe would be tendonitis of the tendons that allow the toes to bend upwards. This may be due to nothing more than a change in your gait because of your herniated disc. An exam by a doctor should be able to rule out any other source of pain.
Marc Mitnick DPM

I'm 35, not overweight and try to stretch daily

Lump under ankle...

by andreasmom
(VA.)

Hi, I'm a 29 year old female. About a month ago, I noticed a small cyst or lump on the side of my right foot below my ankle. It feels a little bigger than a pea. I have twisted the ankle a couple of times in a certain pair of flip flops I have. When I push in on the lump, it is kind of firm and feels "boney." I seen a dermatologist about it, but she said it felt "boney" and not of the skin. She felt it was a little small to be a ganglion cyst, but really didn't know what it was. She suggested seeing a PCP or orthopedic doctor. I really don't know what kind of doctor I should start with. I'm hoping it is something benign, but if not, I don't wanna have something biopsied that could be malignant. Any ideas as to what kind of lump this probably is? Where should I start first as far as doctors go? Thanks....

Hi,
Before you start writing your own obituary go see an orthopedist or a podiatrist. Bony prominences are very common in the foot and ankle. Soft tissue growths such as ganglion cysts are also very common.
Some need to be treated, others are best left alone, but you need to see someone who understands the anatomy, I do not think that someone is a dermatologist.
Marc Mitnick DPM

I dropped weight on my big toe

by Ivan
(Europe)

Hello,

About 1 month ago I dropped 2kg weight on my right big toe.
I didn't go to doctor right away but it got swollen and bruised.
The bruised disappeared for about 3-4 days but swollen after 1-2 weeks.
But now my right big toe is little bigger than the other and has little bump on top of it.
Infront the joint of my big toe and when I try bending it it with force it hurts but If I only bend it myself without force it doesn't hurt.

Should I go take a X-RAY?

Thanks,
Ivan

RESPONSE
Hi Ivan,
You probably do not need me to actually answer that question, but yes you need to have an x-ray. In most cases of trauma the affected area will gradually get better as time goes on, eventually it will stop hurting.
Foot trauma and foot pain in general take longer to heal than injuries on other parts of the bottom for the simple reason that every time you walk you are basically re-injuring an injured area. This is compounded by the fact that gravity causes the foot to stay swollen longer than say a hand injury.
In your particular case it sounds like the injury may actually be worsening, so this is a cause for concern.
I cannot tell you if you fractured a bone in your toe or not, only an x-ray will tell you that. If there is a break in the bone, it needs to be treated. Contrary to popular myth, there is treatment for broken toe bones.
If the toe is broken and not properly treated, you run the risk of having chronic pain in that toe.
So, get yourself an x-ray to see what is actually going on with your toe and then get some treatment to make it better.

Marc Mitnick DPM
DISCLAIMER

Hammertoe? Claw foot?

by Susan
(Milwauklee)

Approximately 8 months ago I started to develop a callus on the ball of my right foot. I had no previous foot pain ever. Orthotics were tried as well as cortisone injections. As time went by, my 2nd toe started to claw under and it also started veering to the left. My knuckle of the toe was enlarged. This all happened in a 8 month period of time. My diagnosis was hammertoe but isn't hammertoe supposed take along time to develop? If so, why didn't I ever have any problems?

Hi Susan,
In most cases hammertoes take years to develop. I do not know your age, but the older you are the quicker they may develop (since they are an arthritic condition, they occur more frequently the older we are).
The other possibility is a certain pair of shoes that may have been too short forcing your toe to "bend".
Lastly, if there is severe inflammation on the bottom of your foot, the increased level of swelling at the metatarsal-phalangeal joint (ball of the foot) may have caused an abnormal position of the toe at that point which is then further exacerbated by shoes thus causing the mallet toes.
Marc Mitnick DPM

missing toenail

by brian doyle
(Kincardine ontario canada)

Hi: I had a toenail torn off on middle toe of left foot - is there a splint available to cover the toe to protect it against possible contact? What is the best method of treatment for this type of injury? Thx.

Hi Brian,
The best treatment is to wash the toe with soap and water, apply an antiseptic like bacitracin and a bandaid for 7-10 days. At that point the skin underneath will have hardened up and will be no more sensitive that your other toes.
If you should start to notice oozing, or increased redness or swelling, you will have to see a doctor as those are signs of infection.
Marc Mitnick DPM

Hard, painful lump to top of foot.

by Kristi K
(Ohio)

I am a runner and for several months have noticed a hard, fixed, painful lump on the center of the top of my foot (around the "N" point). It appears brused as it is slightly discolored and about the size of a peach pit. There has been no trauma that I can recall. It is painful with ROM (more with plantar flexion)and palpation. At first, I thought it was just time for a new pair of running shoes but it continuse to get worse despite changing shoes. I have been unable to find anything that accuratly describes my symptoms on line. Please help as I have a half marathon comming up.
Kristi K.

Hi Kristi,
The most common problem that I can think of that would occur in a runner would be a ganglion cyst, however, if you do not think it is ganglion, then you need to see a local podiatrist; since it hurts when you run I think your only option is to see a doctor if you want to run your half marathon.
Marc Mitnick DPM

I am scheduled for surgery for Morton's Neuroma

by Melissa
(Midlothian, Va, USA)

I'm not sure I have a neuroma, please help. I explained to the doctor I have terrible pain on the bottom of the foot down the middle when the widest part of my foot is sqeezed. I have no burning, tingling, or pain at any of the toes. That being said I also have terrible pain on the top of my foot. If I hold my foot up and twist my big toe (or the wide part of my foot behind the big toe)OR put pressure on the wide part of the foot behind the small toe there is sharp stabbing pain at the top of the foot towrd the ankle. The top of the foot pain is almost worse then the bottom. The doctor said the neuroma has nothing to do with the pain on the top of the foot and it may be my gait from the neuroma making the top of the foot hurt. After researching on your site I'm not sure I even have a neuroma and surgery is next Wednesday-what do I do? I don't want to have surgery and still have the horrible pain on the top of my foot.
Please help.
Melissa

Hi Melissa,
Not all neuromas will give symptoms "exactly" as they appear in the literature. Having said that, has your doctor tried any other forms of treatment, particularly injections of either cortisone or denatured alcohol?
Before I would consent to surgery I would insist that other forms of therapy be tried.
I find in my practice, even if the particular injection does not rid the patient of the problem, the injections can go a long way in helping my confirm my diagnosis of neuroma based on how the patient responds to the treatment.
Marc Mitnick DPM

Leg and foot pain after AIF

by Sondra
(Gulfport, Ms)

I had an anterior intrabody fusion L5-S1 3 weeks ago. About 1 week after surgery I started having pain going down my left buttock, leg and foot. My foot is extremely painful. It is very sensitive to touch. My toes are tingling and very painful. It feels like some one is taking a needle and stabbing it in my foot. My lower part of my leg is throbbing. I can't sleep. It hurts to walk. I have to keep a sock on my foot to keep things from rubbing it. What would cause this?

ANSWER

Hi Sondra,

This sounds like it is from an irritation of one of the nerves that comes out of the spinal column at the level of your spinal fusion.
This is a problem that needs to be brought to the attention of your surgeon immediately. The longer you wait, the greater the chance that you will have permanent pain.
The problem may be due to an issue with the surgery itself or may be just a result of inflammation as the result of surgery. Only your surgeon will be able to determine that.
Once the cause of the paresthesia (your sensations) is determined than appropriate care can be instituted.
I do not treat backs but depending on what your surgeon determines the source of the pain is coming from, he or she may elect to have you do nothing for the time being, to giving you oral anti-inflammatory medication, to possibly an injection in the area, to sending you for physical therapy.
The message to take away from this response is please call your surgeon immediately and be examined. The sooner this condition is address, the less likely of it becoming a chronic issue.

Marc Mitnick DPM
DISCLAIMER

mortons nuroma

by Scott
(Dillon CO)

Growing up in Minnesota and playing hockey from 1st grade to college along with skiing my entire life in tight skates and ski boots.....many times in below zero weather with some instances of frostbite at age 45 I'm now experiencing "sore feet" The pain is infrequent but typically spurred by wearing mtn. bike shoes, dirt bike boots or ski boots. The pain under my foot between the big toe and next toe is most common and hits the morning after activities mentioned above. Sometimes I get the pain on the side of my outside foot and rarely in my heels. I've been to a foot specialist who diagnosed Morton Nuroma. That makes sense when the pain is under my big toe and second toe but can't figure out the heel and side foot pain? Could it be a mixture of Plantars Flacia and Mortons Nuroma? I've recently purchased a couple pairs of orthodics which really seem to help but wondering what next steps I should take? Could I out grow this even at age 45???

Hi Scott,
I do not think these are conditions you "grow" out of particularly if you are still athletic. I am not so sure about the neuroma under your big toe because typically that is not where one will get a neuroma; there are other conditions that will cause pain under the big toe.
Your other problems are probably not related to the neuroma and sometimes when I see patients with multiple problems, each problem has to be dealt with individually.
If the orthotics are helping and you feel reasonably comfortable then you may not need further treatment, but if they are not giving you the type of relief you need to function athletically, then a trip back to the podiatrist would be indicated.
Marc Mitnick DPM

numbness & pain in back, legs, and feet

by Lynnette
(Alabama)

If I sit or stand a few minutes later my legs and feet start to get weak and painful to the point it hurts to walk. Mostly on my left side. It gets worse when I lay down. I will wake up in the night my bladder if full and my leg is crampings after I go to the bathroom the cramping in my leg lessons. If I lay on my left side my arm also starts to hurt and go weak. I've seen doctors and all they say is "that" strange I've never heard of that" and they do nothing.
Can you tell me what might be wrong and what type of doctor to see?
Hi Lynette,
Your problem is not coming from your feet but is highly suggestive of a herniated disk. I would advise you to have your back examined by a back specialist to rule that out.
Marc Mitnick DPM

lump or growth

by nazneen
(dhaka,bangladesh)

i have growth/lump on the top of my right foot about one and a half inches from the middle toe. i have had this for the past 6-7 years.it was a soft and palpable and caused no pain when pressed.it's about one inch in diameter.but there is a pain under my foot just off the ball of the foot towards the arch.this growth did not cause any problem except when wearing tight fitting shoes, the shoe just felt tight on the right foot due to the growth.but suddenly today the growth/lump has become hard and is movable when pressed from the sides and it's very painful too. in fact there's a dull pain around the area even when not touched.please help.

Hi
Based on your description and you picture the most probable diagnosis would be a ganglion cyst. I am not so sure it is related to the pain on the bottom of your foot, but if it is very painful you should seek medical attention.
Marc Mitnick DPM