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The response to the question below was authored by Marc Mitnick DPM
Sudden onset sharp pain top of feet nearest big toe on both feet.
by Tracy
(Evansville IN)
I got up and starting walking in the kitchen last night and all of a sudden I had alot of sharp pain in the top of my foot when I put weight on it..it's top of the foot on the big toe side...makes me have to walk with weigh on the outside of foot because it's so painful.then this morning I got out of the bed and started to walk into kitchen and now it is happening in the other foot too same place but even more excruciating! I can barely walk and it's even worse when I try to walk barefoot. My feet have become very flat in the last year or so and I'm overweight and have had to walk limpy because of problems that started with my knees and leg this summer...what could be happening..I'm really scared. Doesn't look swollen or red or hot..just came out of nowhere and now I can barely walk. (sorry no way of submitting a picture..no camera right now.)
RESPONSE
Hi Tracy,
Since there is no history of trauma, coupled by the fact that you state you are overweight, my first thought would be that of a midtarsal fault. This condition can be seen in patients who may be overweight and exhibit flat feet. Basically what happens is that your excess weight is forcing downward pressure on your feet. As the foot collapses (flattens), it causes a jamming effect on the bones at the top of the arch and as the foot collapses the bones in question create excessive friction. Over time this excess friction will cause an arthritic degeneration of the bones and thus the pain begins when you walk, particularly if you walk barefoot.
This would seem like the most likely scenario for someone experiencing pain in both feet in the area that you mention, with no history of trauma.
A good way to see if this is the case would be to start wearing a good laced shoe with a rigid arch support. You can try a store bought arch support but make sure it is rigid and not real flimsy.
Wear this regularly, avoid walking barefoot and give it a week to ten days and see if you do not notice some improvement.
If there is some degree of improvement then that is probably your problem. If that strategy does not improve your symptoms than I would suggest you contact a foot specialist in your area and have your feet examined.
Marc Mitnick DPM
DISCLAIMER
Comments for Sudden onset sharp pain top of feet nearest big toe on both feet.
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ADDITIONAL REFERENCES
University of Rochester Medical Center
American Academy of Pediatrics
Columbia University Department of Rehabilitation
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