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The response to the question below was authored by Marc Mitnick DPM

Pain between the 4th and 5th metarsals

by Deborah Godfrey
(Enterprise,AL 36330)

I am a walker. I usually walk 3 miles /day. 1 year ago, I developed a stress fracture in one of the small bones on top of my foot. I was in a cast for 3 months and non-weight bearing. The foot has been re-xrayed twice since then. I am now having excruciating pain between the 4th and 5th metarsals. The pain isn't in the same area that it was with the fracture. The doctor is stumped. He had me see a podiatrist who fitted me with an orthotic device for my shoe thinking that the extra support will ease the pain. The pain has gotten worse since I've been wearing the device. It puts more pressure on the top of my foot and causes much more pain. It even hurts to just touch a specific spot. I don't know where to turn from here. They seem to be stumped by my pain. I'm finding it very difficult to wear any shoe that puts any amount of pressure on the top of my foot. Any suggestions? There has never been any swelling or redness in the area at all. It is in an area about the size of a pea. Deborah Godfrey

Hi Deborah,
A couple of thoughts come to mind. The possibility that the stress fracture is not healed and an x-ray is not showing this. Secondly, the pain is between the fourth and fifth metatarsal bones so there is always the possibility of a neuroma, even though that is not the most common place for one, they can occur there. However, generally neuroma pain will be on the bottom of the foot and you state the pain appears to be on the top.
I would think the prudent move would be to have an MRI for two reasons. If the bone is still fractured, the MRI should reveal this and if not, the MRI should be able to reveal any soft tissue pathology that may be the source of your pain.
There is always the possibility that the MRI will show nothing and if that is the case I would recommend considering physical therapy as a way to reduce your pain.
Marc Mitnick DPM

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ADDITIONAL REFERENCES

Mayo Clinic

Johns Hopkins Medicine

MedlinePlus

Arthritis Foundation

University of Rochester Medical Center

Harvard Health

Drugs.com

American Academy of Pediatrics

Penn State Medical Center

National Institutes of Health

Columbia University Department of Rehabilitation

ScienceDirect

Stanford Health Care

Illinois Bone and Joint Institute

Mount Sinai Hospital

Institute for Chronic Pain

University of Florida Health

American Family Physician

Cedars-Sinai

University of Maryland Medical Center

MY PRODUCT RECOMMENDATIONS(items I prescribe in the office)

Orthotics for multiple types of foot pain best buy in a pre-made orthotic click link below

Orthotics for heel and arch pain for those who must wear dress shoes click link below

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(location unknown)

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(location unknown)

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(location unknown)

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(location unknown)

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Madison, Alabama

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Regards,

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South Africa

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Mansfield Ctr, CT

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Placentia, California

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Unknown

Unknown location

I received the orthotics Monday afternoon and began wearing them Tuesday. After two days I would say that I have noticed a huge improvement in the discomfort I have been experiencing. My foot feels better than it has in months.

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Unknown location

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Pacific Grove, CA

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Alameda, California

By the way, millions of websites could use yours as a guideline on how to organize information and make the site user-friendly. Kudos to you!

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New Zealand

Thank You for my answer! I have been schedule for a bone density scan, allingment, and I am in the process of getting orthotics made, and checking out the natural remedies. Thank again! What a great web site!

Sincerely

Josette

Yes I want both pair of orthotics. You don't have an option of ordering 2 at one time so I had to place the order twice. Thanks. My husband likes these and wants to put them in all of his shoes. (referring to Superstep orthotics)

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Arizona

I searched the internet everywhere for a clear description and illustration of my symptoms/problem. https://www.foot-pain-explained.com/ was where I ended my search with answers. If I lived in Jersey (left 30 years ago) and didn't live in Florida I would definetly make an appointment with Dr. Mitnick.

Thanks, Kathy

Florida

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Poland

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South Carolina

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unknown location

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Arlington, VA

Thank you so very much, that would be much appreciated. I love those insoles, by the way. (referring to Superstep orthotics)

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San Clemente, CA

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location unknown

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location unknown

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Bre

location unknown

Dr. Mitnick, Thank you so much for your reply. I did let my physician know and they took an x-ray - all is well! Also, thank you for providing this wonderful site, it is very helpful with lots of useful information! I appreciate your gift of time! God bless.

anonymous

Dr. Mitnick, Thank you, you were 100% correct. The pain finally brought me to the ER. I spent 8 days in the hospital. The Doppler you spoke of was able to show that there was no pulse in that foot. This was an arterial clot that split and traveled throughout my leg. My leg was almost amputated. I am in rough shape but have all my parts intact!! You certainly know what you are talking about. Thank you for taking the time to answer. Yours Truly!

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Poland

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Seattle, WA

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location unknown

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New Jersey

Thanks so much for answering my question. You've been more help to me than my own Dr. has been lately. Thanks again....I hope to be able to walk without pain someday.

Debbie

location unknown

Wow, that is exactly the information needed!!! thank you thank you thank you!!! I appreciate this help so very much from Marc Mitnick DPM. Excellent information and help to improve One's life.

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location unknown

Thanks so much for this website Dr. Marc! It is so nice that you have this ask the doctor feature..I'm sure I'ts been helpful for alot of people. I will try what you suggested and see if it helps...thanks again!

Tracy

Evansville, IA

Dear Marc

I just want to say thank you for the quick response and the good info. I find it amazing and a super nice thing that you do here by answering medical questions at no charge.

Russ W.

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-Sunny.

location unknown

Thank you very much for the information, I will consider it. Excellent web site.

Jackie

San Diego, CA

Dr. Mitnick, Just want to say thank you so very much for your quick response and very informative reply! After reading what you had to say, I called the doctor's office and was able to get in and see him the same day as my injury. Toe was x-rayed and luckily, it is not broken or fractured. Very badly bruised and will probably lose the toe nail. And although my toe and toe nail are still very black and blue and very sore, they ARE both starting to feel a little better. So again, thank you! I am so very happy that I came across your website. The service you provide is outstanding and immeasurable!

Rivi,

Albany, NY

Thank you so much for all of your advice. In searching the web for people dealing with this same issue i can tell you that you are a Knight In shining Armor! If I lived in Jersey I would gladly be your Spokesperson. Hopefully next time you hear from me it will be good news. God Bless,

Jill S.

location unknown

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Jackie

Whichita, KS

thanks again, this site is very helpful.

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Boston, MA

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....Keep up what your doing. Your a life saver.

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Colorado

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Colorado

Wonderful advice

by: Anonymous

This is the best site for foot problem info.

Thank you for this information. This description fits my pain and inflammation behind my 2nd toe perfectly.

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location unknown

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Canada

I just wanted to say that I am very greatful for this website!! I have had a fusion in my rt foot and am finally getting a little bit better......

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location unknown

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Wisconsin

Thank you for your response. You have provided some great insight (to my question)....

Julie

location unknown

Thank-you so very much for responding so quickly and in such detail to my question!! I will give my surgeon a call today!! This website is terrific!!!! Thank-you again!

Renae

North Carolina

Many Thanks Dr Marc!
Thank you for your response. It sounds like a good plan to me. He did not cut the wart out first ...

KG

location unknown

Thanks again doc for having this website and we STILL need qualified Podiatrists in beautiful sunny Tampa Bay (Bradenton) Florida.

Bessie Mae

Florida

Dear Dr. Mitnick, Thank you so very much for taking your time to answer my question. You have greatly relieved my anxiety related to the continual tingly I feel in my feet. I will share your response with my podiatrist next week. God bless you for having this question and answer page on your website! Most gratefully,

Lynne T.

location unknown

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Robert

New Jersey

Thank you. you were more detailed than what others have told me they finally called from the last xrays and my son is now in a cast for 2 weeks he did have a fracture that was not noticeable.

a mom

location unknown

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Lenoir, NC

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Bellevue, WA

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Jodi

location unknown

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