Sharp shooting pain in the sole of right foot

by Paroma
(India)

I get these shocking pain in the sole of right foot when I bend down or lean forward to pick up something..started a couple of months back.(every couple of weeks and about three to four times) and the intensity has gone up.It's like a shock wave along with acute sharp shooting pain that lasts only for a few seconds and I have to stop doing everything because the pain is so unbearable.is there any explanation?

RESPONSE
Hi Paroma,

There is always an explanation but since I do not have the luxury of actually examining you I will discuss the most probable cause of this burning pain and then mention a couple of other possibilities.
The most common explanation for these burning symptoms in your forefoot would be a Morton's neuroma
. What this condition actually is in its simplistic explanation, is a pinched nerve. Generally, the nerve that passes between the third and fourth metatarsal bone becomes "pinched" and the patient experiences a sharp shooting, or burning, or stabbing type pain. Keep in mind this condition is not limited to just the third and fourth metatarsal space but can actually happen in the other metatarsal spaces as well.
Do you notice any abnormal sensation going into any of your toes, such as burning, tingling, shooting pain or numbness? Usually the toes will be somewhat affected.
When you bend over and thus the toes bend up, you end up stretching the nerve against the adjacent bones and this may be causing your symptoms.
However, in most people the symptoms will be noticeable beyond just bending over. Wearing shoes that have thin soles or are too narrow in many instances will also set off the neuroma type pain.
Morton's neuroma is the first condition that comes to mind but there are a couple of other conditions to consider as well.
The next would be capsulitis. Capsulitis is a stretching of the ligaments that attach the toe to the metatarsal bone. When a toe is bent upwards too much, it over stretches the capsular ligament on the bottom of the toe and there is pain. My experience over the years is that although capsulitis can be painful, it generally is not as painful as you describe, however, in most cases it will be limited to the types of motions that you mentioned above such as bending down or leaning over.
A couple of other conditions also come to mind which are less likely sources of your foot pain, but should be rule out.
One would be a stress fracture of one of the metatarsal bones in your forefoot. The break may be small enough that only certain motions cause pain.
Other potential causes might include and tendonitis of the tendon that runs under your toes, so that when you bend over, the tendon gets over stretched and painful, but again, I would think it would not be excruciating pain.
There are also conditions such as an inferior metatarsal bursitis and metatarsalgia which also need to be ruled out.
So, although your symptoms appear to be most consistent with Morton's neuroma with capsulitis being a secondary possibility, you will need to see a doctor in your area, who specializes in foot conditions, in order to get an accurate diagnosis. If you notice the symptoms are worsening than it would be in your best interest to see someone as soon as possible.

Marc Mitnick DPM
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