PAIN ON TOP OF MY FEET AND ON THE SIDES..

by LORIE
(MILWAUKEE)

IVE HAD TOP OF FOOT PAIN FOR MONTHS NOW,,,X-RAYS RULED OUT STRESS FRACTURES,,,THE PAIN IS ON BOTH FEET,,,IVE HAD TO RESORT TO TAPING THEM BEFORE I GO TO WORK.I'M A NURSE AND I'M ON MY FEET FOR 8-9 HOURS..I WEAR TENNIS SHOES WITH SPENCO INSERTS..HELP...I'M HURTING,,,AND CANT SEEM TO FIND ANSWERS,.,,IS IT MY SHOES,,,,IS IT SOME UNKNOWN FOOT DEMON???HELP..

RESPONSE

Hi Lorie,

I am going to go with the foot demon explanation.
Actually I am going to base your problem (and answer) on the nurses that I see at my local hospital. The problem obviously is not limited to nurses and tends to encompass anyone who does a lot of standing and walking on hard floors such as those found in a hospital, school, office building, factory, etc.
The chances of having bilateral stress fractures, although not impossible are fairly remote so that would not have been my first thought.
What I would be looking for on your x-rays, primarily on the lateral view would be the quality of the bones and their joints in the midtarsal area, essentially the area just behind the base of the metatarsals.
There are two conditions that come to mind based on the fact that you spend long hours walking on the hard floors of the hospital.
The first and probably the condition you are suffering from, is what is known as a midtarsal fault.
This is essentially a collapsing of the arch with a resulting jamming of the bones on the top of the foot in the midtarsal area. What you would tend to see on a lateral x-ray would be spurring occurring in the midtarsal area. This is a result of long term jamming of these bones when the foot flattens out. Keep in mind, this collapsing has been going on long before you started in the hospital; it is just that hospital floors which are tiled floors on top of concrete, have no "give" to them so they just exacerbate the problem.
If you happen to be overweight and I do not mean 10-15 pounds, but rather substantially overweight, this too will exacerbate the problem.
You are on the right course in the sense that you added a Spenco innersole to your shoes which I assume have helped a little.
What you probably will need is an orthotic of a more supportive nature, as Spenco products just essentially cushion without adding much support.
By adequately supporting your feet, you will prevent the foot from collapsing and thus reduce the jamming effect that is occurring.
May sound like an obvious statement, but make sure your work shoes are of adequate width and the sole is not overly worn out as this can add to the problem.
A diagnosis of midtarsal fault is usually only made by someone very much familiar with foot pathology. Your GP or even your average orthopedist will miss the diagnosis.
If you have not already done so, I would suggest consulting with a podiatrist to either make the diagnosis or rule it out.
My second choice as the cause of your problem would be tendonitis of the tendons on top of your foot that bend the toes and the foot upwards. Again, walking on the kind of floors that you walk on can cause this issue as well.
The problem with foot problems is that it is hard to rest the area, so every time you walk you are essentially re-aggravating the problem. That is why foot problems can take so long to heal.
But in order to alleviate the problem, you must first have an accurate diagnosis. I would suggest you see a podiatrist as soon as possible.

see related article....midtarsal fault

see related article....tendonitis


Marc Mitnick DPM
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