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The response to the question below was authored by Marc Mitnick DPM

sudden onset of severe foot pain without an injury

by Pamela
(New Canaan, Ct.)

I am a 60 year old woman who is very active with spinning, elliptical, and weight training. I love to work out and do so daily. Yesterday I got up from a chair and noticed that my right foot was hurting. Several minutes later the pain became so severe that I almost fainted. The pain was in my right foot on the top right side a little in front of the ankle. I thought maybe I had a stress fracture. I was unable to walk even with a walking boot and crutches. I iced it, took some Advil and valium and the next morning the pain was nearly gone. What type of foot pain could cause such pain, without an injury and then go away? I'm wondering if I can return to spin? I will see a doctor but can not get an appointment with a foot specialist for two weeks.

RESPONSE
Hi Pamela,
Based on the part of the foot where the pain occurred and the fact that there was no history of trauma, but apparently you are very active, my first thought would be a subluxed cuboid bone. This bone is located in the area of the foot that you describe and could very well cause pain for no apparent reason and just as quickly go away as the bone moves back into place.
In very active individuals the most common cause of this condition is what is known as repetitive stress where a certain motion, mainly, some degree of inversion where the foot constantly bends inward will cause a loosening of the ligaments

that attach the cuboid bone to the adjacent bones and thus the cuboid bone will "move" and become painful. If the bone is pushed back into place, there is a good chance the pain will subside.
This is a difficult problem to diagnose because a routine x-ray will generally not show the movement of the bone. Sometimes an MRI will be able to show damage to the adjacent ligaments.
The diagnosis is usually made on the basis of history and palpation of that portion of the foot.
Of course, this is not the only cause for pain on the outside of the foot, but based on your story would be the most likely.
I may be stating the obvious here, but of course the pain could return, for no apparent reason, if the cuboid bone subluxes again.
If this turns out to be the cause of your foot pain, there are things that can be done to minimize the recurrence. The most common treatment is through the use of a cuboid pad build into an orthotic device that helps keep the cuboid bone in place. You will also need to take a look at some of the athletic activity you engage in and determine if any of them are aggravating the problem.
You are correct in seeing a foot specialist for this type of problem as this type of diagnosis would not be familiar to other types of doctors.
You mention a stress fracture as one possibility but in general, a stress fracture will continue to hurt and the pain will not disappear spontaneously.

Marc Mitnick DPM
DISCLAIMER

Comments for sudden onset of severe foot pain without an injury

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Mar 07, 2019
Rating

Severe foot pain w/o injury Foot turned in as well
by: Nina

I got up from a nap and my left ankle had turned and bulged in which I couldn't straighten.I was in excruciating pain.
I couldn't walk and definitely felt that I was passing out. The long bone on my leg pushed out as well. It took at least l5 - 20 minutes before I got some relief and then they both went back in place.

Called 9ll and was taken to the hospital. Although all kinds of tests were taken, they couldn't find anything

Jul 28, 2018
Rating

RA flare
by: Anna

I am in an RA flare. Taking Methotrexate and Remicade infusions. Yesterday got sudden onset of worsening foot pain. I say worsening because my feet hurt chronically due to the RA. This is in the location of the talonavicular, the ankle and lower leg. Tramadol did nothing. I welcome any thoughts, suggestions.

Apr 24, 2018
Rating

Same foot pain
by: Helen

So glad I read this as it perfectly explains my sudden onset agonising foot pain with the same symptoms and spontaneous resolution as previously described. I looked up the cuboid image and it was exactly the same spot.
Thank you for the great explanation as I thought I was going crazy !!!

Oct 25, 2016
Rating

Same foot issue
by: Pat

I have the same symptoms in my right foot as well. Went to the doctor had X-ray and ultrasound done and they said the findings were nothing but I'm still suffering with severe pain.This just started 2 day's ago. I've tried ice, heat, pain medication nothing seems to be working. Would you suggest that I go see a foot specialist?
------------------------------------------------
If the pain is unbearable to walk on or if it lasts longer then five days or so, you should consult with a podiatrist.

Marc Mitnick DPM

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ADDITIONAL REFERENCES

Mayo Clinic

Johns Hopkins Medicine

MedlinePlus

Arthritis Foundation

University of Rochester Medical Center

Harvard Health

Drugs.com

American Academy of Pediatrics

Penn State Medical Center

National Institutes of Health

Columbia University Department of Rehabilitation

ScienceDirect

Stanford Health Care

Illinois Bone and Joint Institute

Mount Sinai Hospital

Institute for Chronic Pain

University of Florida Health

American Family Physician

Cedars-Sinai

University of Maryland Medical Center

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(location unknown)

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(location unknown)

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(location unknown)

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(location unknown)

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Placentia, California

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Unknown location

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Unknown location

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New Zealand

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Sincerely

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Florida

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Poland

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South Carolina

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San Clemente, CA

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Pam

location unknown

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location unknown

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Bre

location unknown

Dr. Mitnick, Thank you so much for your reply. I did let my physician know and they took an x-ray - all is well! Also, thank you for providing this wonderful site, it is very helpful with lots of useful information! I appreciate your gift of time! God bless.

anonymous

Dr. Mitnick, Thank you, you were 100% correct. The pain finally brought me to the ER. I spent 8 days in the hospital. The Doppler you spoke of was able to show that there was no pulse in that foot. This was an arterial clot that split and traveled throughout my leg. My leg was almost amputated. I am in rough shape but have all my parts intact!! You certainly know what you are talking about. Thank you for taking the time to answer. Yours Truly!

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Poland

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Seattle, WA

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location unknown

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New Jersey

Thanks so much for answering my question. You've been more help to me than my own Dr. has been lately. Thanks again....I hope to be able to walk without pain someday.

Debbie

location unknown

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location unknown

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Evansville, IA

Dear Marc

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location unknown

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Jackie

San Diego, CA

Dr. Mitnick, Just want to say thank you so very much for your quick response and very informative reply! After reading what you had to say, I called the doctor's office and was able to get in and see him the same day as my injury. Toe was x-rayed and luckily, it is not broken or fractured. Very badly bruised and will probably lose the toe nail. And although my toe and toe nail are still very black and blue and very sore, they ARE both starting to feel a little better. So again, thank you! I am so very happy that I came across your website. The service you provide is outstanding and immeasurable!

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Albany, NY

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Jill S.

location unknown

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Jackie

Whichita, KS

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mark

Boston, MA

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....Keep up what your doing. Your a life saver.

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Colorado

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annielou

Colorado

Wonderful advice

by: Anonymous

This is the best site for foot problem info.

Thank you for this information. This description fits my pain and inflammation behind my 2nd toe perfectly.

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location unknown

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Canada

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location unknown

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Wisconsin

Thank you for your response. You have provided some great insight (to my question)....

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location unknown

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Renae

North Carolina

Many Thanks Dr Marc!
Thank you for your response. It sounds like a good plan to me. He did not cut the wart out first ...

KG

location unknown

Thanks again doc for having this website and we STILL need qualified Podiatrists in beautiful sunny Tampa Bay (Bradenton) Florida.

Bessie Mae

Florida

Dear Dr. Mitnick, Thank you so very much for taking your time to answer my question. You have greatly relieved my anxiety related to the continual tingly I feel in my feet. I will share your response with my podiatrist next week. God bless you for having this question and answer page on your website! Most gratefully,

Lynne T.

location unknown

Your webpage is excellent, I commend you on sharing your knowledge to the public.

Robert

New Jersey

Thank you. you were more detailed than what others have told me they finally called from the last xrays and my son is now in a cast for 2 weeks he did have a fracture that was not noticeable.

a mom

location unknown

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Lenoir, NC

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Bellevue, WA

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Jodi

location unknown

sudden onset of severe foot pain without an injury

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