painfully sore, with pain that feels like splinters

by Jessica
(Virginia)

I've always had a problem with my feet being overly sore. But when I started seeing a Dr. about an old ankle injury, he noticed that my feet turn inwards when I stand/walk. He gave me some inserts that would "help support my ankle" and sent me on my way.

I wore these inserts every day for almost two months before I broke down from the pain. It felt like the arch of my foot was being stretched out. He continued to insist the "uncomfortableness" would eventually subside. Unfortunately, I was on a job were I could not go to a store to buy new inserts, so I had none in my boots for 2 weeks. The soreness was almost unbearable but still 100x better than with those inserts, the arch pain went away almost immediately.

Now, when I walk, even barefoot on carpet. It feels like there are a million splinters under my feet, but when I look there is nothing there. I'll admit it's been a week and I know my feet have not fully recovered. (Ball and Heel are extremely tender still) But I have no idea what to do from here. There isn't any swelling, but some areas do appear to have minimal bruising. (Could be unrelated not sure)

Thank you in advance for any and all help.

RESPONSE

Hi Jessica,

When I read narratives sent in by visitors, in many instances as I am reading I try to visualize the problem because certainly I do not have the luxury of examining you or even taking a medical history. So, the narrative is all I have to go on.

What I see here is a doctor who saw you were flat footed as I assume that is what you meant when you say he noticed your feet were turning in, as opposed to someone who in-toes where their feet actually point inwards when they walk. There is a big difference between the two condition. But, since you do not strike me as being a child, I will assume he was referring to flat feet.

So he recommended an orthotic that you wear to control the flat feet, or as we call it--pronation. According to his diagnosis this would also help your ankle, which in many cases it will. Apparently this hurt your feet more than helped it and contrary to his insistence you were still having pain after the so-called break in period. In my way of thinking, if a pair of orthotics is not fairly comfortable after three weeks, then there is a good chance they will never be comfortable.

In the two months you wore the orthotics I would be curious to know how your ankle felt. In general terms if the ankle actually felt better then you may actually need orthotics, just not this particular pair.

Depending on how flat your feet are to begin with coupled with how much "lift" the orthotic affords you, there may be issues in adjusting to the orthotics. People with very rigid flat feet, in other words, feet that are flat whether you are bearing weight or off your feet will tend to have trouble adjusting to a high arched orthotic; it just does not work.

So you stopped wearing the orthotics (again wondering how that affected your ankle) and now you have pain on the bottom of your feet described as splinters in your feet even though there is no such situation.

The feeling of splinters suggests to me that you have a nerve issue with your feet. The first thought that comes to mind is the possibility of a tarsal tunnel which is the foot equivalent of carpal tunnel found in the hand. This could be from nothing more than not wearing your inserts and what happens then is the inside of your foot at the level of the ankle stretches the structures including the nerves that innervate and give feeling to the bottom of your feet.

Tarsal tunnel will typically cause numbness or pain on the bottom of the foot or feet due to an impingement of the nerves running down the inside of your ankle which become "trapped". You can read about tarsal tunnel on my site.

The second possibility may be what is known as a radiculopathy or irritation of the nerves as they come out of the spinal column and they too can cause abnormal sensation of the bottom of the feet. Wearing or not wearing orthotics may have a profound effect on the lower back.

Both of these sources are from mechanical issues as a result of wearing, then not wearing orthotics. Neither of these address other possibilities such as diabetes, alcoholism, neurological disease but quite frankly since your symptoms seem to be related to the inserts I would lean more towards the mechanical source of this pain.

That is about all I can offer you from the other side of the internet, since I cannot examine you. I would suggest you speak either to your original doctor or seek consultation from another doctor. As you suggest, this problem may resolve itself perhaps aided by some anti-inflammatory medication (if you can tolerate it) and maybe even some physical therapy.

The problem here is that there is a chance the problem could also persist and in general cases like this are better treated sooner rather than later.

It would seem to be me that you will need some kind of orthotic, but you will have to work with your doctor to find a pair that you can tolerate. Like any other problem, sometimes there has to be a degree of compromise where for example in your case you might have to accept a more "forgiving" orthotic which will allow you to wear it, but at the same time may mean less positive results for your ankle pain. Then hopefully your feeling of splinters will just be a passing experience.

Marc Mitnick DPM
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