pain in toes and ball of foot

If I am sitting at my desk all of a sudden it feels like my two toes just before the little toe feel like they are going to snap off and the ball of my foot all of a sudden feels like a rock under the toes. Very sharp pain and takes a while to get relief. Usually have to take off shoe and have my toes wiggled back forth. Also if press on the top of my foot just below the toes middle of foot really hurts when pressed on. Also get the pain when I am driving the car and the right foot gets the same pain and have to pull over and take shoe off. When carrying heavy things up stairs - flares up.

RESPONSE

Hi,

Probably would have helped me to know if you are male or female and what kind of shoes you generally wear.
Although I cannot say for sure without the luxury of examining you, your symptoms sound very much like those of a Morton's neuroma.
In a Morton's neuroma, the nerve that travels between the third and fourth metatarsal heads gets "pinched" usually by wearing shoes that are too narrow or sometimes by wearing shoes with very thin soles and perhaps shoes with high heels. So without knowing your gender, I do not know if we can blame the shoes or not.
In any event the third and fourth toes are the toes most commonly affected by neuroma pain, but it is important to point out that they are not the only toes that can be affected.
I have had numerous patients over the years relate a similar story to yours. They are either sitting or perhaps driving and they get this terrible pain in the ball of the foot just behind the third and fourth toes. The pain (or tingling, or numbness) then usually travels into the toes.
Most people will state that if they remove their shoe and rub the area somewhat for a minute or two, the pain will subside, however, the pain may resume once they put their shoe back on.
We also see a similar situation in people who have neuromas and are walking. Typically, they will walk a certain distance and the pain sensation will begin. They take off their shoe, rub their foot, the pain subsides, they put their shoe back on. They then walk almost the same distance and the pain returns.
The only thing most people with neuromas do not complain about is pain on top of the foot. The nerve involved in a Morton's neuroma occurs on the ball of the foot.
Two possibilities come to mind. Either you have a very large neuroma which essentially extends from the bottom of your foot to the top (which can happen), or you also have either a tendonitis or even a capsulitis on the top of your foot. Again, without examining you, I am only guessing.
One other point that should be made is that aside from a Morton's neuroma, there is a possibility that you have what is known as an intermetatarsal bursitis.
This is an inflamed bursal sac that lies between the metatarsal heads. It itself can be painful, but because of its location, may be pressing against an otherwise normal nerve, thus giving you neuroma type pain.
On occasion during neuroma surgery, I have actually removed bursal sacs.
Those are the most common causes of your type of pain but I should mention not the only possible cause.
So, what it comes down to, is how much pain are you in?
If this problem appears to be worsening and you get no substantial relief from a change in shoes, then the best advice I can give you is to see a foot specialist in your area.

see related article....Morton's neuroma
see related article....bursitis

Marc Mitnick DPM
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