Pain in Top of Feet

by Marcella
(Chicago)

I a 58-year-old female. I am in excellent health and not overweight. I stand for most of 8 hours at my job. I wear very comfortable shoes and have no pain in my legs or feet while I'm standing.

If I am off of my feet for 10 minutes or longer (including when I get out of bed in the morning), when I get up and begin to walk, I feel enough pain in the tops of my feet that I have trouble walking and people ask me what is wrong. After about one minute of walking, the pain is gone and I'm walking just fine. I've had this for about one year.

Also, if I squeeze my foot sideways, just below where the bottoms of the toe joints are, on the outside of my foot, I feel a dull ache, almost the same feeling as when I am massaging a sore muscle. Yet if I massage that same area, there is no pain at all. This is in a completely different area than the first issue with my feet. However, both of these types of pain started causing problems at the same time.

My GP is clueless as to what the cause might be.

Hi Marcella,
As far as the first pain goes, read my section on "midtarsal fault" as it sounds like an arthritic problem on the top of the foot in the mid section.
Not sure what you mean by your second description so I cannot offer any suggestions.
I would suggest you see a local foot specialist who should be able to make an accurate diagnosis and give you some helpful advice.
Marc Mitnick DPM
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Pain between heel and arch

by Diana
(Miromar Lakes, FL)

I fell forward on a flight of stone stairs in mid-January. I think my toes caught the upper step and my heel slammed back on the previous stair as I tumbled. The pain was horrific and I couldn't put weight on that area of my foot for weeks. The x-rays taken the day of my fall didn't show a break, but there is still a great deal of discomfort on the fatty pad that is just between the heel and arch (which seems like the area that took the direct hit). It throbs in the night & hurts most when I've been off of it, then stand upright. Once I begin walking, I can put weight on it and walk but a tolerable pain remains. Should I re-visit the doctor for another look?
Thank you.

Hi Diana,
If the heel still hurts you most certainly should re-visit the doctor. By your description it sounds like you damaged the plantar fascial ligament just where it attaches into the heel.
If you were in my office I would consider doing an MRI to assess the damage to the ligament with the possibility that you even tore part of it. The MRI would also tell me if the heel bone (calcaneus) was fractured, something that might not have shown up on the original x-ray.
My rule of thumb, is that a musculo-skeletal injure of two months or longer is probably now classified as a chronic problem and without medical attention there is little chance it will get better on its own.
Marc Mitnick DPM

Pain in the middle of my foot, on the bottom

by Paula
(Supply NC)

recently I have been having a sharp pain run from the top of my foot down the middle on the bottom of my foot. It feels like someone slicing down the middle of my foot with a knife. It continues for about 20 seconds. It's very painful.

Hi Paula,

Read my section on Morton's neuroma as that would be the first condition that I would consider. Over the years I have seen people come into the office with tears in their eyes because the pain was so intense. Many times through out the literature Morton's neuroma symptoms may be described as a stabbing pain located in the forefoot.
Typically a patient will state that they are walking along and they get this sudden sharp pain; they stop, maybe take off their shoe, rub their foot and the pain subsides. They begin walking again and in just about the same distance the pain will start once again.
They types of shoes that you wear can have an influence on the pain as the more narrow the shoe, the greater the liklihood of pain. Sometimes wearing a very flimsy shoe like flip flops, or even walking barefoot may cause the neuroma to act up.
If this describes your symptoms then you might want to try shoe modification to see if that helps. If not, then I would suggest you see a foot specialist in your area who will be able to make a proper diagnosis.
Morton's neuroma is probably the most common condition, but not the only condition that could cause the type of pain you are experiencing.

Marc Mitnick DPM

DISCLAIMER

Pain at the ball of my foot.

I woke up today with this excruciating pain on the ball of my foot right below my big toe. I am 9 months pregnant, I dont know if that has anything to do with it. When I walk on it, it feels like I am walking on needles. It feels like I have jumped off of something and landed on it really hard, but I have not done anything to it that I can recall that would injure it. I have tried to walk on the outside of my foot to avoid walking on the ball of my foot, but that just makes my ankle hurt. When I am not walking on it, there is just this throbbing pain, but it is not as bad as when I'm walking. It doesn't feel warm to the touch, is not swollen or red. I'm not sure if I should go to the doctor, or just wait it out and see if it gets better on its own.

Thank You!

RESPONSE

Hi,

I tend to agree with you that there is no urgency to run to the doctor just yet. I say that because according to you there was no history of trauma, nor is there any swelling or redness which would be indicative of inflammation.
The most common cause of pain in the area of the foot that you mention would be a sesamoiditis which is an inflammation of one of the two small bones that are embedded in the tendon that allows your big toe to bend downwards.
If you actually take your big toe and bend it upwards towards you and that reproduces the pain then it is probably sesamoiditis.
Just because there was no history of trauma that does not mean you cannot develop foot pain, particularly in your situation; nine months pregnant.
Two factors are in play. One is weight gain. If you have happened to gain a lot of weight in the last few months, then the extra pressure on your feet could have set off something like sesamoiditis.
Additionally, pregnancy will cause hormonal changes and one of the things that hormonal changes do is cause ligament laxity. A ligament is a leather like structure that attaches bone to bone to stabilize the alignment of bones through the body. This "loosening" of ligaments may be the pre-cursor to your problem as the foot may have become destabilized. This would be worsened if perhaps the day before this problem developed, you happened to do a lot of walking, particularly if you were wearing flimsy shoes like flip-flops or even heels.
Of course this is all conjecture on my part since I cannot actually examine you, but as I stated earlier you could give it 24 hours, take Tylenol is that is ok with you obstetrician, rest the foot and see what happens.
If the following day there is no dramatic reduction in pain, then you might want to consider seeing a doctor about your foot, but keep in mind, in your present condition there is not all that much that a doctor is going to be able to do.

Marc Mitnick DPM
DISCLAIMER

Pain on my right foot n a swollen ankle

For about a month now, my right foots swollen. My family doctor couldnt diagnose me for about 2 weeks. I then went to see a podiatrist and he diagnosed me with stress fractures on my #2 and #3 metatarsils n the swelling around my ankles, he diagnosed my with gout! Now, a little over a month now and it still swollen. As if it feels heavy when I lift up my foot. Since this is my first major complication with my foot, just wondering how long this can go on or if there is a medication other than Allopurinol and chocicine? Any help/stories would be great. Thanks!

Hi
Allopurinol should be reserved for people who have chronic elevated uric acid levels, if that is not your case I would question your doctor why you are on it.
I have never been a fan of colchicine. As you know the directions are to take it until you develop diarrhea. Well, in mind, I think diarrhea is a worse condition than the pain from gout.
Assuming you can tolerate them, there are certain anti-inflammatories such as Indocin and Naprosyn which are indicated for gout. You can take them short term until the symptoms subside. They will require a prescription.
Keep in mind, most gout attacks only last for about one week then the pain subsides. I am not quite sure why your ankle is still swollen so far down the road unless there are other medical issues you have not mentioned.
Marc Mitnick DPM

pain in ankle and heel

by Debbi
(Owingsville,Ky)

I had achellis tendon surgery the 29th day of April,he also took a bone spur off and I had what he called a hagerty's deformaty on the back of my foot.He put in 3 anchors and sewed up with wire.I was not allowed to put any weight on it for 6 weeks and then 25% of my weight for 2 weeks until I was allowed to put 100% of my weight which was July 22.I was going to PT,about 4 days after I reached 100% of weight,I started having a lot of pain and by the end of the day the pain was so bad,that I would get real sick to my stomach and could not put any weight on it.I went back to the dr. and he did a MRI and said that there were some little breaks and he though I had a stress fracture,he put me back on crutches and ordered a bone healing system,I have had 38 treatments as of today.I went back to him yesterday and I still have a lot of pain,he took X-rays and he said it didn't show anything,but he wanted to have a bone scan done to be sure.He checked with an orthopedic dr.and the other dr. said it could be where I hadn't been walking on my foot and not using it.Could not using it be the cause of all the pain and when I do try to walk on it is then causing the pain.Will a X-ray show a stress fracture?What is he looking for by doing the bone scan.

Hi Debbi,
Since you were going for physical therapy, you were "working" the foot and ankle so I am not sure I buy into the notion that because the foot was immobilized it is now painful.
A bone scan is much better at picking up small fractures then an xray and I would recommend that over an xray.
Just a thought, but I wonder if the placement of the anchors or staples is causing irritation and pain; you might want to ask your doctor.
Marc Mitnick DPM

pain in outer edges of heel

by Brenda
(Monticello, IN)

For months I have had pain all the way around my heel on right foot. I have bought numerous pairs of shoes and many inserts hoping that would fix it but the pain is still there and getting worse.

Hi Brenda,

Apparently, the time has come to seek medical care. There are many conditions that will cause heel pain (read my section on heel pain). In many instances changing the shoes that you wear, adding heel cushions or arch supports will do the trick. When they do not and the pain has persisted, it tells me there is a more severe problem going on.
In my experience when patients complain of pain through the whole heel, that is suggestive of a heel bursitis which is a bursal sac that becomes inflamed from the constant pounding of the heel on the ground. This symptom may also indicate a heel neuroma which is basically a pinched nerve that may also cause diffuse pain in the heel. In both cases the pain generally gets worse the more you walk.
Another consideration would be a tear of the plantarfascial ligament. There does not need to be a history of trauma in order for this to occur. This is unlike plantar fasciitis or heel spur that most people are familiar with. In these cases the plantar fascial ligament actually tears and in general tends to be more painful than plantar fasciitis and is usually not resolved by self care on the part of the patient.
So, as you can see in order to get relief, you are first going to need a proper diagnosis.
That is why I would suggest you contact a foot specialist in your area and have a thorough examination of your foot to determine the cause of your pain.
Once an accurate diagnosis is made it becomes far easier to alleviate the pain.

Marc Mitnick DPM
DISCLAIMER:

Pain in foot after stress fracture

Back in July, 2008 I received a stress fracture on the distal end of the third metatarsal of my right foot. I have had pain on the top of my foot, mid-way between the toes and the ankle, ever since. The last x-ray shows that the fracture line has healed and is barely evident. The x-ray report states there is a mild deformity and there has been some thickening of the bone. The doctor is not sure why I am still having the pain. Any ideas or thoughts?

Hi,
I have no idea why you would still be having pain, but if you were my patient I would order an MRI to look for additional pathology that the x-ray does not show. The pain may be nothing more than the result of walking differently on the foot while the fracture site was healing. This leads to referred pain.
If the doctor does not want to order an MRI, you could try some anti-inflammatory medication (assuming you can tolerate it) and some physical therapy.
Marc Mitnick DPM

Pain and swelling on top of left foot that radiates down third metatarsal

by TSW
(WV)

I have had this problem with my left foot for the past 4 months and I am getting frustrated. I have been prescribed an anti-inflammatory by my general doctor. He took an X-ray and said nothing was broken. After a few weeks the anti-inflammatory helped with the pain, but the swelling and discoloration weren't going away. So, I saw a podiatrist and he took and X-ray and an MRI. He said the MRI showed a possible stress fracture of the third metatarsal and a deep bone bruise. He said I have a leaking of the bone marrow and this is what is causing the swelling. I have been wearing a surgical shoe on my left foot for almost 3 months now. But, I still have pain, tenderness and with the swelling I can't fit my foot into a regular shoe. Is this normal??? The podiatrist also gave me a cortisone injection on the top of my foot but it really didn't do anything. Why isn't my foot healing? The only accident I had was tripping in a hole in my backyard. I twisted my left foot. Could this have been caused by that? Also, I was thinking that I had bought a pair of Nike Shox shoes and when I was out for walks I would sometimes over extend my toes on my left foot. This would cause a terrible pain in my toes and tingling. This really hurt but it didn't always happen. So, I wonder if the shoes may have caused the problem. Also, I want to add I have recently been diagnosed with diabetes. So, now on top of the foot problem I am worried that my foot may not be healing because of the high blood sugar. My doctor's want me to walk to bring down my blood sugar, but how with my foot in this shape. Please help. What should my next move be?

Hi TSW,
I never heard of bone marrow leaking out of the bone, so I would try another podiatrist. If you have a true fracture, you may have a non-union,or lack of fusion. This would have to be addressed. A simple xray at this point will tell you if there is a fracture or not.
I personally think a surgical shoe is useless; you need to be in a boot which will better immobilize the area.
I guess the next thing you have to do is get a proper diagnosis and in my mind that would mean choosing a different podiatrist or perhaps an orthopedist.
Marc Mitnick DPM

Pain in my right foot

by Raymond Sandoval
(French Camp California)

All night last night I had a dull toothache-like pain in my right foot, it felt as if it had something to do with 3rd and 4th toe. But in the morning when I got up, I placed my foot on the floor and WOW!!!! I was unable to put any weight on the foot! Pain radiates from the right outer edge of the right foot...pain is also felt in the arch area..the outer edge and bottom of the outer edge, really hurts when I raise my knee as if to put on my socks. there is also a dull pain in my hip but nothing like the pain in the foot...it was really swollen too. I took some motrin but it did no good. The pain seems to now radiate under foot towards the heel.

Any ideas?
Thank You
Raymond

Hi Raymond,
Based on the site of the dull ache you experienced last night, it sounds like it might be a neuroma.
You do not mention what you were doing the day before but I find it hard to believe the pain came about so quickly and so severely.
Neuromas can be very painful; the literature will describe them as if someone took and knife and stabbed them in the foot. Most neuromas that I see are not quite that painful.
With that kind of pain you should see a podiatrist, he or she will also want to x-ray the foot to rule out other problems.
Good luck.
Marc Mitnick DPM

Pain when walking and wearing my shoe.

by Evelyn
(New York)

I had my 2nd hammertoe and bunion surgery on the left foot back in December 2009. To date, (Aug. 2010), I am still having burning and sensitivity where the cuts were made. Also underneath the second toe on which was the corrected hammer toe, I am experiencing pain when walking and when I have my shoe on. Presently I wear my sneakers.

What do you think it could be? My doctor tells me that it is still swollen. How so after nearly 9 months? And he said if the burning and sensitivity doesn't go away where he cut the bunion, he will cut away the somewhat keloid skin. Will any of that help?

Hi Evelyn,
If your sensitivity is where the incision line is then you may have a superficial nerve entrapment in the scar from the incision and yes, it might require having the excessive scar excised and repaired. Prior to doing that, your doctor could consider giving you a cortisone shot in the thickened scar as that might reduce your symptoms.

Eight months seems a bit long to still have swelling but it is possible depending on a number of factors, not all related to the surgery itself.

Since I cannot examine you I do not know why you are having pain under the second toe. In general, if you notices as the weeks pass that there is less and less pain, then even though the area still hurts, you are probably doing alright as everybody heals at a different rate.

If you find that you have reached the point where there is no further improvement in pain reduction as the weeks pass, then it is time to look for a problem in the surgical area.

Marc Mitnick DPM

pain on both sides of feet

by Joyce M.
(North Kingstown, RI, USA)

I have had pain on both sides of my feet (the outer sides) for years. It comes and goes, but lately it never foes. It is about halfway between the ankle and the little toe where there is a hard ball. This hard ball on both feet gets red , stings, and swells. I believe that this is more of a systemic problem than an orthopedic problem. I had plantar fascitis several years ago, for which i had surgery that was successful. On a post surgery visit to the podiatrist, the doctor indicated that there was a bundle of tendons there that lead to front part of the foot, but she did not really know what was wrong. This pain is on both sides of my outer feet. It is making me miserable, and while I would like to walk outdoors or on my treadmill for exercise, the pain is always worse after doing it.

Hi Joyce,
That "hard ball" you refer to is the base of the fifth metatarsal base which does protrude in many people plus as your podiatrist mentions, there are a few tendons that attach around that area.
I have found that the most common cause of pain in that area is from people who wear shoes that are too narrow. Most shoe widths are measured from the width of the ball of the foot, but depending on the cut and style of a shoe, it may be too narrow further back in the foot and will irritate that "hard ball".
Look at the shoes that you wear on a regular basis and see if they are pressing into that area. By eliminating those shoes, you should be able to improve on the discomfort you are experiencing.
Marc Mitnick DPM

Pain, burning, and stinging on Top of my Left foot - abt 30 days

by Gary
(Ft Smith AR)

I am 57 yrs male. I have had pain on top of my foot down to my toes to some degree. Mostly top center of foot. Looks like a slight knot on top of it sometimes. BY the end of the day it is a little red and slightly swollen. No injury that I can think of. However, I have done a lot of walking and climbing with a 25 lb. tree climbing stand and crossbow often since Oct. 1. I have some relief when I rest it and keep it elevated. But the more I am on it or hold it down it will hurt and have some stinging and burning in it as well. I was wondering if I have had my laces too tight....but I have loosened them for couple of weeks and not really better. When I move my toes alot it seems I have more pain from top down too my toes. Almost like I have spranged or fractured something. I also have high arches. I am very puzzled.

Sincerely Appreciate your feedback

Hi Gary,
Read my section on "midtarsal fault", particularly the part about nerve entrapment.
Generally when a shoe or boot is tied too tight it puts pressure on the underlying bone and the superficial nerve that passes down the foot in this area, gets "caught" between the shoe and bone, thus giving you pain as well as the pain traveling down to the toes, as that is the course of the nerve.
Loosening your laces and possibly placing a doughnut shaped pad around the most pain spot on your foot may, over time, resolve the problem. If not you will need to see a foot specialist who should be able to give you some relief.

Marc Mitnick DPM
DISCLAIMER

If you found this information helpful please let others know by SHARING on social media, thank you.

Outside of foot

Pain on the outside of the foot below the ankle?

I woke up maybe 1-1.5 months ago in the night to visit the bathroom and was surprised when I stepped on my left foot. There was a very sharp pain on the outside of my foot right above where my foot meets the ground. The pain was slightly ahead of the ankle, by about 1/2 a cm. I was nervous about it till I reached the bathroom and realized the pain was gone. From that day on the same thing has been happening quite often at night. The pain was always disappearing very quickly. So I chose to ignore it. Now it has become more frequent and longer lasting. There are days when it is always there in the background as a dull ache. It only spikes a bit when sitting for a while then standing. It seems to be getting worse as time passes. I have new shoes with decent arch support and I am also a runner. But I have not been running much lately. I spend part of my day standing at work. In front of a computer. Otherwise there have been no situations I can recall that would have caused an injury. At least none that felt like an injury.

Thanks for you time,
Bill

Hi Bill,

My first thought based on the location you describe would have been a tendon problem, perhaps of the peroneus longus tendon where it curves around the cuboid bone, but in general tendonitis will worsen as you walk and you state your pain is the most evident upon stepping on the foot.
The next most common cause of pain in that area would be due to irritation of the fifth metatarsal base which many times occurs from shoes that are too narrow in the mid portion of the foot. The fifth metatarsal base has a normal lateral flare to it and in some people it is very pronounced. If your shoes, particularly your running shoes are too tight in that area you will get irritation.
Since you have not been able to run, I would suggest you see a podiatrist for some help.
Good Luck.
Marc Mitnick DPM

pain like an electic shock in my left toe

by narie
(ireland)

my left top toe gets a dart pain its like an electric shock in my left toe and it only happens every now and last for a few minutes but its a strange sensation.

Hi Narie,
Sounds like local irritation to a nerve, similar to "hitting your funny bone". If it bothers you enough, see your doctor.
Marc Mitnick DPM