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feels like i am stepping on a marble between 2nd & 3rd toes on the front of the ball of the foot

Marc, this started approx. 3 to 4 yrs. ago, first on the right foot, it felt like my sock was bunched up, i would take my boot off and look, and the sock was nice and flat, then probably a yr later it started in the left foot.

since then i have been to 4 podiatrists, 2 prescribed orthodics that did not work, the other 2 really did not know what it was. all 4 took x-rays, found nothing, 2 said it was not mortons neuroma.
recently during my annual visit to the family doc, he asked how my feet were, i said the same, so i had an mri of the right foot done, he said the mri showed no problems, so with that thought it may be a nerve issue and prescribed a drug with side effects of sleepiness and imbalance, i'm sorry, not going to do that.
last resort at this point, went to see a chiropractor friend of mine, he ultrasounded, and recommended i try a GOOD shoe, ECCO is what he wears, although i have always worn red wing boots-shoes, i am a plumber.
i went to a reputable shoe store where the owner is a licensed pod?????? to make orthodics, this is where i heard the term CAPSULITIS for the very first time, i tried several different brands and types of shoes red wing, merrell, ecco.
purchased the ecco, he added some structure to the bottom of the original insole, naturally try this, see how it feels, give me a call, stop in any time, basically still feels the same, the pain seems to concentrated back of my 2nd toe.
so when i got home i got on line to look up capsulitis and this is how i found you, i have read your info. the off the shelf orthodics don't sound like an option, since i have been told i have very flat feet and no one has mentioned cortisone shots at all.
The one really crazy thing is that when i get home and slide into my pair of nike plain old foam flip-flops i feel perfectly normal, soon as i step off them onto carpeted or tile floor, there is the pain, none of the docs had an answer for this.
WISH I LIVED IN N.J.

Thanx, Tony B
Hi Tony,
Without being able to physically examine you, this is a tough one. But one thing I would suggest you, is to take those foam flip-flops back to the podiatrist you like best and show him what makes your feet comfortable and let he or she work backwards to try and figure out how to incorporate that comfort into your everyday shoes. BTW, did any of the orthotics you had made contain a metatarsal pad? That would be the first line of treatment in an effort to get the metatarsal-phalangeal joint to line up better.
Marc Mitnick DPM

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small knot on bottom of foot.

by Hannah
(Kentucky)

I have a small, almost tiny knot on the bottom of my foot between my heel and arch. it is hard to say which it is on because it is right between both. It is small and the knot seems to be under the skin. It hurts when pressure is put on it and there is a slght redness around it.

Hi Hannah,
The two most common causes of knots under the skin would be warts and porokeratosis, both of which actually occur in the skin.
Deeper would be the possibility of a plantar fibroma which is a benign growth.
You may read about all these conditions on my site, but my advice to you would be to see a foot specialist to get an accurate diagnosis, just to make sure it is nothing more dangerous.
Marc Mitnick DPM
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I get a sharp pain in my middle toes on my rigfht foot

by Joe
(Hudson, wi)

throughtout the day and night i get sharp pains to my middle toes it just shoots pain that can wake me up even. it has started for no apparent reason, and it comes and goes. Can you help me

Hi Joe,
The most common cause of that type of sensation would be a Morton's neuroma, but of course the problem may be coming from other sources.
Read my section on Morton's neuroma and see if that does not sound like your problem.
If this sensation is going on long enough and it bothers you enough then you will need the services of a foot specialist.
Marc Mitnick DPM
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Throbbing toes with a pain akin to a toothache; it wakes me up every night with pain radiating from my foot to my legs.

by Teresa
(Troy, AL, USA)

In the winter or cold months, I have a problem with my toes, especially my big one. The pain wakes me up (it throbs like a toothache and I cannot get in any position to make it feel better). I get out of bed and I get some relief once I stand up. I am waking up every night now with the pain. I told my doctor about the problem, and he thought it was arthritis. I mentioned that maybe it was gout... I suggested it, not him. He said he could give me some medicine to help with uric acid, but it would give me diarrhea. I don't know that I have a lot of uric acid... no tests were given.
Does this sound like gout?

Hi Teresa,
This does not sound like gout; it sounds like a vasospastic condition, meaning when it is very cold the blood vessels in the toes clamp down causing pain, you stand up and gravity improves the blood flow somewhat and so your toes feel a little better.
Do you sleep with socks? You can try that, but you should really have someone examine your circulation to make sure it is fine. BTW, if you are a smoker, that will only aggravate the situation.
Marc Mitnick DPM

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foot problems

by Brandy
(Little Rock, AR)

My father-n-law is a Diabetic, he got a nail in the bottom of his foot and never knew it until tHAT night when he took his boot off, he was in hospital and nearly lost his foot, this has been almost two months ago and now he has two toenails that are BLACK. I remind you that for YEARS he has uncontrolable blood sugars. please help me

Hi Brandy,
Unfortunately, the only help I can give you is to insist you take him to the doctor immediately. As you witnessed with the "nail" incident, diabetics particularly poorly controlled diabetics are very susceptible to infections and potential loss of limb. The sooner he receives medical care, the better off he will be.
Marc Mitnick DPM

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weird feeling in my foot

I have played sports all my life, I am not a senior in college age 22. I am currently in my final season of basketball and have recently gotten a cortisone shot in my left foot with the belief that I have Morton's neuroma. Ever since the shot, it feels like there is a bubble ( or as if the area is asleep) in the middle of my foot right where the toes start.

Thank you for your time

Hi,
It is very possible that when you got your cortisone injection, the needle actually traumatized the nerve thus causing a neuritis or inflammation of the nerve itself. If the area is not red and swollen that is probably all that happened.
You might want to bring it to the attention of the doctor who gave you the shot.
Marc Mitnick DPM

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Sesamoiditis

by Mia G
(Miami Beach, FL)

I found out I had sesamoiditis in both feet about a year ago. I was put in a walking boot for around a month and they were feeling much better. Every now and then (after running, wearing heals, exercising, etc) I'll feel the same sharp pain. What can I do about this. Icing doesn't usually help.. is there a special brace for people with this issue?

Hi Mia,
Since you are apparently prone to recurrences of sesamoiditis, I would suggest you make an appointment with a local podiatrist and see about havong an orthotic made. This device which fits into your shoes can be made in a way to take pressure off the sesamoid bones.
One bit of caution: if you are starting to get sesamoid pain again, I would be careful about exercising until you have an orthotic, as sesamoiditis can be very,very difficult to remedy if it gets too severe.
Marc Mitnick DPM

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sudden pain on the side of foot, no trauma

by Lora
(San Diego)

Yesterday i woke up and i barely could step on my foot. With no reason i had pain in the middle of the outer side of my food. It seems to be a very small area that hurts when i press on it. There is no sign of inflammation. I went to bed and i can feel the pain during the night. It is worse when i move the foot. Today i cant step on it at all. I should mention that i am 3 months pregnant. Any idea what it can be?

Hi Lora,
Three possibilities come to mind and you can read about all of them on my site. 1. subluxed cuboid which is a possibility since in pregnancy there are hormonal changes which can affect the ligaments and if you have put on a fair amount of weight, the combination may have played a role in subluxing the cuboid bone. 2. stress fracture of what is known as the fifth metatarsal base, again, could occur from doing nothing more than walking and being aggravated if you have put on much weight. 3. Peroneus longus tendonitis, which is a tendonitis of the tendon that comes down the outside of your foot and turns abruptly to go under you foot. It turns at the level where you are complaining of pain.
If the pain persists for more than a couple of days I would suggest you consult a local doctor.
Marc Mitnick DPM

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Severe pain in left foot--painful to lift foot or flex it

by Susie
(Nashville, TN)

On the top of my left foot, toward the inner side, I have a soft bump that is painful to touch. It is very painful to lift my foot or flex my foot. The only time it is not painful is if I am sitting very still & not moving my foot at all. I have had gouty arthritis in this foot, but it was on the bottom by the big toe. It was painful, also, but this is worse. I have had no injury to this foot. This is also very painful at night & the pain wakes me up. It is very painful in the morning, but the pain does not seem to lessen as the day goes on.

Hi Susie,
The "soft bump" you mention would lead me to think of a ganglion cyst, but I am only guessing since I cannot examine you.
From a very practical standpoint, if you have a growth that you cannot account for and you are having pain that does not seem to be going away, then the smart move would be to see a local doctor and get an accurate diagnosis and treatment.
Marc Mitnick DPM

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left foot feels tingling when I sit.

by Marcie
(Mtn View)

When I started wearing shoes, I wear sandals all the time, as winter started, that is when my feet started giving me problems
I am fine walking, etc. but when I would stop, like waiting in line or standing doing something I would feel a tingling, like a motor running in my left foot only
especially on my big toe. Sitting affects me the same way. When I sleep I have to lie with by big toe not touching anything cuz it feels like it will go numb.
I do not have diabetes but I have low thyroid & I tend to suffer from sciata, as well as back aches when I stand too long.
I do not have any pain anywhere, just when my sciata acts up, then the pain runs down my left leg but does not affect my foot.
I am wearing orthotics which feels good but again when I stand still I feel the tingling
Any ideas what is causing this weird feeling ???

Hi Marcie,
With a history of sciatica that would be the first thing I would consider as the source of the tingling.
Next in line would be a tarsal tunnel (read my section on that). The only way you will find out what is the true cause of your tingling would be to visit your doctor.
Marc Mitnick DPM

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Bilat plantar fasciitis, tendonitis. I'M MISERABLE!!

by Bobbi Leeds
(Cincinnati, Ohio)

Hi Dr. Mitnick,
I'm a 48 year old, very active female. I've been an avid exercise walker (approx 3.5 MPH pace x 2 miles daily x 12 years), and I am a hospice case manager. (That being mentioned because I visit 3-4 nursing homes daily which involves walking through many long nursing home hallways all day.)
Last year, I developed R plantar fasciitis. In the last 4-5 months I've also developed L plantar fasciitis and bilat tendonitis. Since last year, I've had 4 cortisone injections in my R heel, (which stopped working after the 1st 2), did PT for a while (had to stop after 5 weeks d/t expense), iced, soaked feet daily, have taken gobs of ibuprofen or diclofenac, tried diclofenac patches, wore a boot on my R leg,(which only helped for a little while, but the gait change aggravated the tendonitis in my L foot), and my most recent treatment was getting custom orthotics about 3 weeks ago. (Unfortunately,I did not break them in, I went right to wearing them all day long.) I do do stretches daily, and have recently gotten very involved in yoga as I had to give up my beloved walking as exercise.
At the beginning of all this, I would have R foot pain about every 2-3 months, but in the last 4-5 months, I have had chronic pain from one degree or another. On my best days, my feet are fatigued w/ mild-moderate R foot/heel pain. My inner ankle areas are always tender to touch as is my L lateral foot. I had an MRI of my R foot which revealed "thickening of the plantar fascia, most pronounced at the medial cord with approx. twice the normal thickness as well as increased T2 signal.This is also associated w/ a 5mm bony spur and is also associated w/ mild edema in the heel pad." Also "moderately severe degenerative arthritic change at the ankle joint predominantly involving the tibial plafond w/ areas of full-thickness chondral loss and subchondral cystic change." (No big surprise as I fractured that ankle as a child.)
MY feet have been hurting more and more over the last 4-5 months, more acutely in the last week or so, and today, the tops of my feet hurt SO BAD I am hobbling around.
I am so discouraged by all of this, I don't know what to do. I think surgery is probably in my future, but I wish I could find SOMETHING that would alleviate my daily pain enough so I can just perform my usual routines. My job is fatiguing and pain-causing, I can't walk my dogs anymore, and even grocery shopping is difficult. I, however, do not wish to quit my job, and I know oft times I try to do too much, ignoring my limitations because I've been so active all my life.
Please, any advice you might have would be greatly appreciated!
Thank you so much for allowing me to go on and on!
Bobbi

Hi Bobbi,
Whew! You certainly do a lot of walking and of course therein lies part of the problem. I have this discussion daily with patients. If you were to injure your hand, you would put in a sling and allow it to rest to get better. Unfortunately, we do not have that luxury with our feet; every time we walk we just aggravate an aggravated area thus making the problem worse.
Surgery might eventually be in your future, but if you are looking for another option, here is what I would recommend.
1. Limit your walking to only essential tasks, for now exercise is not an essential task.
2. I do not know what kind of orthotics you have, but I would recommend a soft orthotic (not plastic) that is firm enough to support your arch.
3. Bite the bullet and go back to Physical therapy
4. Get yourself on a regimented dose of oral anti-inflammatory medication, under the supervision of your doctor.

Give it four weeks, if you notice at least 50 percent improvement, continue with this therapy. If you are not at least 50 percent better, then you may have to look into other options including surgery.
Re-read my section on "heel pain" as there are descriptions of other mildly invasive procedures for heel pain and plantar fasciitis.
Marc Mitnick DPM

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Pain in ball of foot

by Graham Smith
(New Zealand)

Have a very tender area in the ball of my left foot for about 4 years.
Now have pins and needles senstaion in my 3rd and 4 toes, for the last year.
Cannot walk barefoot without a huge amount of discomfort.
An orthopeadic surgeon had me walk back and forth. Noticed on examination that I was tender in the toes, but did not examine the ball of the foot.
Told me to contact a Neurologist.
Two GPs both believe it is Mortons Neuroma.
Have you any information that may point me in the right direction?

Many Thanks

Graham S

Hi Graham,

Pins and needles going into the 3-4 toes is "almost" a giveaway for Morton's neuroma. The only other thing that would cause that type of sensation would be some sort of growth in between the third and fourth metatarsal which might put pressure on the nerve thus causing the same type of sensation.
You need to find a doctor who is more familiar with foot pain as this is a very common problem and there are various treatments available.
Marc Mitnick DPM

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I fell 7 weeks ago, it was xrayed and was told it was a sprain on the rightside of my foot.

by Dwaylene Evans
(Fort Dodge, Iowa)

After, the fall I went to ER. The x=ray showed the left ankle was sprained and the rightside of my right foot was sprained. I had pain and some swelling.I was told to go to my foot Doctor the next day. He sees me every 2 weeks and I have been healing good, the Dr. had x-ray it and it was healing good, then about a week ago, when I woke up in the morning and I had severe pain in the right foot, that my daughter had to take me to ER again.It was x-rayed and they took Labs to check on my uric acid and that came back fine, but I still suffering and my foot is very swollen again. In fact the pain is more severe and have to use my walker at times. What happened?
Thank you
Dwaylene

Hi Dwaylene,
If you are having worse pain and the xray still shows nothing, then I would suggest an MRI to see if there is any soft tissue damage. If there is not, then your doctor should send you for physical therapy.
Marc Mitnick DPM

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pinky toe is swollen,red and tender

My pinky toe is very swollen and red . This has been going on for 2months now and actually seems a little worse now. No other toe is affected. I read up on gout but i don't seem to fall in that catagory. I do tend to put off going to doctors but feel like i should probably go see one.

Hi,
Since I do not know anything about you or your medical history I will only guess as to what it might be.
Most people who present to my office with a swollen toe generally are suffering from either, 1. inflamed bursal sac, 2. possible gout, 3. broken bone 4. vascular compromise or 5. infection.
Obviously a swollen, red, tender toe is not normal and my advice to you would be to seek the care of a foot specialist in your area to determine the actual cause.
Marc Mitnick DPM
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top foot & lower leg pain when skating

by Jen
(Norman, ok)

Started rollerderby a year ago and past 3-4 months I've experienced severe pain, from knees down, at times when skating.

1. First, 3-4 months ago, started getting pain on the top of right foot (my pusher foot)...right over the middle.
2. Followed by, about a month later, my calf muscles have gotten extremely tight where i feel pain from light massage, whether having skated or not. I did a backwards toe stop several weeks ago and felt both calves lock up (and felt like they were close to tearing or something). Last hard skate my right calf locked up again into a charlie horse after i took a fall.
3. Shin splints - i have not struggled with these in about 7 months up until the past few weeks
4. past couple weeks - ankles suddenly started feeling weak and unstable

I am a big girl and was very seditary for about 10 years after gaining a lot of weight and feeling to "big" and self-conscious to do very many activites. Derby got me up and moving again and losing weight AND I just stopped smoking! so i want to avoid injuries!

Anyway....the foot pain is a big henderence, but mostly I'm worried about my calf muscles since i tore or severly strained my right calf muscle last year (right before derby when attempting a bootcamp fitness program). It kept me from being able to really walk for about 6 weeks and was soooooo painful so I am fearful of this possibility. (when it happened, there had been NO previous warning signs and I'd stretched 3 times during the hour before the tear).

Thoughts? I've tried using an arch insert as suggested by other players, but they seemed to just cause my legs to wear out faster and caused pain in both feet so i took them out.


Thanks!!!

Hi Jen,
You do not mention your age but going from being sedentary to roller derby is a big lifestyle change. The first thing I think of is the fact that your legs are out of shape for this kind of activity and that may be the source of all your pain.
I would never discourage anyone from exercising particularly if they are looking to get back into shape, but I think you should be evaluated by a local foot specialist to make sure you do not do any serious damage to your feet and legs (and yourself). You also want to make sure you are healthy enough to participate in a rigorous activity such as skating, so you might want to check with your family doctor as well.
Marc Mitnick DPM
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Ball of left foot swells throbbing pain in great toe,second and third.

by meg
(Huntsville ,Ala.)

about a year ago I fractured the metarsal bones in my left foot,it was missed on xray by the E.R.after 10 days and swelling xray showed two fractures.I wore a surgical boot for 4 weeks.However for about the past six months the ball of my foot continues to swell,even into the calf of my leg at times.The pain is in the base of my great toe,second ,and third and continues into the start of the arch.I have dark spots on the front of the great toe and second near the base of each one.I have had several xrays all negative.No one knows what is wrong with my foot. The pain and swelling interfers with my life,to the point that after working my week-end shifts I will sit with my foot up all week to reduce the swelling not to mention the pain.Please lead me in the direction of help.I am very tired of limping and hurting.

Hi Meg,
I would recommend you have an MRI to look at the soft tissues in the area as an xray will only show bone structure. If your fractures are healed and you still have pain in the same area then you have to investigate the soft tissue in the area.
In the back of my mind I am also a bit concerned about the possibility of a phlebitis because you are getting swelling into your calf, although in most cases the swelling would be constant.
Marc Mitnick DPM

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I had a rerlease for tarsel tunnel

by lora
(jacksonville il usa)

On jan. I had my first release done I was told it was released,after about two months it started bothering me agin my doctor gave me another shotin the scar area. He said it was scar tissue and i needed to massage it and it would get better.Well I went to get a second opinion he said he belived I still had tarsel tunnel so he ordered a emg it confermed that it was back so he decided to do another release so on nov. 15 I went in for another surgery he said it was very compressed. ok my question is I have numb toes and the bottom of my foot how long does this take to resolve.

Hi Lora,
I would have expected that you would have noticed some improvement at this point. The problem with nerve damage is that the symptoms may remain even after the surgery. In other words there may have been permanent damage to the tibial nerve depending on how long you suffered from tarsal tunnel before having surgery.
The other problem is that there is probably scar tissue because you have had two surgeries in the same area in less than one year.
Have you tried any physical therapy? That might be helpful in reducing the inflammation in the nerve and at least improve, maybe not cure, your symptoms.
Marc Mitnick DPM

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i am getting pain in my big toes i do suffer from gout but not like this i can hardly walk for three days is ther any thing i can do or take ?

by chris
(sheffield)

I did some sport after the next day my right big toe was sore on the outside as i walked around it felt a bit easier i played some sport again then the next day i could not walk and it was painful to touch anyway 3 days later it went off then i did some sport agian witch was alot of walking in the cold the same thing happened again but to the left toe so what do you think thanks

Hi Chris,
Depending on how many gout attacks you have had in your big toe, you would have to be concerned about permanent damage as a result of all those attacks. So, every time you play some type of sport you run the risk of having pain just because the joint is "shot".
You need to have an xray to assess the degree of damage that the gout attacks have caused in your big toe joint.
In situations like this, sometimes surgery is the only permanent solution.
Marc Mitnick DPM

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numbness in both big toe

by ava
(trinidad)

numbness in both big toe on the inner side more the right toes for the last 10 days it started after doing a lot of standing up for like 12-15 hours per day for almost a week also my right toes has a little pus under the nail

Hi Ava,
If you are having numbness in both big toes I would look for the problem originating from the lower back, also possibly the result of wearing shoes that were too narrow.
If you have pus on one of the toes, that tells you it is infected and you should see a local doctor.
Marc Mitnick DPM

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Foot Pain

by J
(USA)

My problem is between my toes are cracked and scaley, I have callouses on both my heels, and I have dry cracking areas all over the soles of my feel. Specifically between my toes is painful and occasionally the callouses are also. I use antifungal powder during the day as my feet sweat and are in leather sneakers most of the day. I change my socks when I get home. I just am not seeing any improvement.

Hi,
Sounds like athletes foot aggravated by the fact that your feet sweat on a regular basis.
Your need to try and reverse the perspiration. This may mean seeing a foot specialist to get a prescription for a drying agent that actually dries out the skin. Additionally, you will probably need a stronger anti fungal cream then just the powder you are using.
I am stating the obvious when I say this, but if you do not control the excess perspiration, your problem will never go away.
Marc Mitnick DPM
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