toes feel like locking up and hard rock like sensation in ball of foot

by Patricia
(Auburn Wa King)

I am female age 66. My foot problem may have started several years ago, but more intense in the last 10 years. I wrote before and left out my age and gender. For many years I have carried groceries up several stairs and noticed that I put a lot of pressure on my right foot as the push off foot. I have noticed that my shoes (even wide ones) have a great indention in the big toe area. I have tried different shoes New Balance, Rockports and still seem to get the same flair up pain where my middle and second to last toe next to little toe feel like they are going to snap off. This happens when I am just sitting or driving. Occasionally when I am walking it feels like a rock in the ball of my foot all of a sudden. I had gone to a doctor once before and he said no evidence of a break in the foot but that I have a nerve that runs clear up to my butt and that when sitting I may be pinching the nerve.

I am overweight, but this even happened when I weighed much less.

When I am walking on a hard service ( my kitchen tile floor) that seems to cause pain in ball of foot.

When I wear my Birkenstocks I don't get the pain as much.

I do have a high instep and high arch and cannot step into boots and have trouble finding shoes with straps that can go over the top of my foot. I hate trying to find shoes.

Often when sitting in a movie I have to remove my shoe...no matter what shoes I am wearing.

Yes, wearing cotton socks are uncomfortable. If wearing socks I have to have soft stretchy nothing that will bind my foot.

RESPONSE

Hi Patricia,

Even though you gave a fairly detailed analysis of your problem, you are one of those patients that I would actually have to examine, but based on your narrative I have a couple of ideas.
Generally speaking, an odd sensation encompassing the third and fourth toe requires an investigation into Morton's neuroma which is essentially a pinched nerve that occurs just behind the toes, in between the metatarsal heads. Typically as the nerve is irritated it will send uncommon sensations into the third and fourth toes as well as pain at the base of the toes where the nerve is actually being "pinched".
The fact that apparently you have a bunion, which you mention as a protrusion on the inside portion of your otherwise wide shoes can lead to neuroma pain, as the bunion gives you a wider foot and thus the more side to side pressure created by a narrow shoe, the greater the possibility that you will get nerve pain.
You mention that you have seen a doctor and he/she mentioned a nerve issue that runs all the way up your leg. Although neuroma pain, in theory, could run up your leg, the worst case I have ever seen only sent pain back into the foot and not up the leg. Most of the pain is in the spot of the neuroma and into the adjacent toes.
The other issue that needs to be explored is the relationship between your high arch and possible forefoot pain.
People with very high arched feet can and do develop pain in the ball of their foot simply because of the excess pressure placed on the ball of the foot since the mid arch does not pick up any body weight when you walk.
So, there is a real possibility that you may also be suffering from a capsulitis which in essence is an overstretching of the ligament that attaches the metatarsal bone to the toe bone. This happens because of the increased angle of the metatarsal bone as it lines up to the toes; there will be an over-stretching of the capsular ligament on the bottom of the foot.
Walking on hard floors with no shoes can set off either condition, but neuroma pain can occur even when not walking, as you mention you can get pain when driving.
Anyway, those are the two main conditions I would look into. There are treatments available for both conditions, so if you are in enough pain, then a visit to a local foot specialist would be in order.

Marc Mitnick DPM
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