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The response to the question below was authored by Marc Mitnick DPM
pain in ball of foot and tips of toes
It started as pain in the ball of my right foot, felt like I had stepped on a stone. The next morning I had burning pain that felt like it was moving from the middle of my toes down to the ends, and then a burning, pulsing sensation. The next day, the toes felt okay, but the ball of my foot still hurt, and there was burning pain on the outside edge of the foot. There is no discoloration or swelling. Over the past 2 weeks the pain has come and gone every day, and now affects both feet, although not nearly as much in my left foot. Some days the pain starts when I first wake up, some days it is several hours into the workday before it starts, and a few times it started while I was asleep at night. Most days the pain lasts for a few hours at a time.
ANSWER
Hi,
The first thing I would like to note is that it is taking place in both feet although it is worse on the right. What this suggests to me is that it is being caused by a common denominator, either a certain pair of shoes that you are wearing, either high heels or perhaps very thin soled shoes. It could also be caused by some kind of activity that you are doing, like perhaps climbing a ladder, climbing a lot of stairs daily or bending down such as gardening where you force the toes to bend excessively.
The actual cause of your pain sounds most suggestive of a Morton's neuroma which is a pinched nerve that originates in the ball of the foot, but can send abnormal sensations into the toes.
It is important to note that other causes of forefoot pain like capsulitis or intermetatarsal bursitis may also put pressure on the nerve and create neuroma type symptoms without actually being a neuroma.
Obviously, the only way to tell for sure would be to see a foot specialist and get an accurate diagnosis.
Apparently, this problem is now over two weeks old and does not appear to be getting any better, in fact the left foot is also now bothering you. If you can identify the causative problem (shoes, certain activity, etc.) and eliminate it, the pain may begin to subside. If that is not the case for you then this will require medical attention.
Marc Mitnick DPM
DISCLAIMER
ADDITIONAL REFERENCES
University of Rochester Medical Center
American Academy of Pediatrics
Columbia University Department of Rehabilitation
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