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severe pain in heel of foot

Approximately a year ago I was wearing ballerina shoes very thin soles and ran up a gravel driveway and stood on a large stone in the middle of my heel. I have since then developed pain in the heel which seems to carry on if you press the sides of my heel or underneath it ? I at first thought i had perhaps broke my heel ? but it still wouldnt hurt now would it ???


ANSWER

Hi,

You need to go see a foot specialist. In a worse case scenario you may have broken the heel bone and I am concerned about that because you state when you press side to side the heel hurts; that is suggestive of heel fracture.
At the very least you may have nothing more than a bone bruise from stepping on the stone in the ballerina shoes. If that turns out to be the case, the problem with that scenario is that every time you take a step you are re-injuring the heel and it never gets better.
Heel pain can be very difficult to get rid of for the simple reason, as I just stated, just the simple act of walking never lets the injured heel get better and thus the pain continues.
My best advice to you is to make an appointment with a local foot specialist, have an x-ray, possibly even an MRI to see exactly what is going on.
You mention that you traumatized your heel a year ago. This pain can be now classified as chronic and chronic heel pain is generally more difficult to eradicate than acute heel pain.
The simple fact that a year later you still have pain is reason alone to see a doctor about your problem.

Marc Mitnick DPM
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Tingling feet

by Ashley
(Maine, USA)

When I press there

When I press there

When I press there
It tingles here

I've noticed for the past few weeks when I stand on my feet they tingle like they are asleep. I've been to the ER and the doctor did an exam for blood flow. He said my blood flow was good. I've noticed some more than when I press in the middle of my foot it makes it tingle. I work a lot with standing on my feet for 8 hours or more I'm 20 years old, I take coumadin because I have risk factor Leiden. I'm not sure if it has to do with the shoes i'm wearing or if I'm having back problems. I'm extremely concerned. Any help would be great.

RESPONSE

Hi Ashley,

My first thought is that you have what is known as a nerve entrapment meaning that the nerve that passes right where your finger is pressing is being irritated, so when you press on it or when you stand and the foot flattens out somewhat the nerve is being irritated and you get the tingling feeling that you describe.
If the ER doctor checked your circulation and your feet feel warm to touch and they have normal color, then chances are it is not a circulation issue.
My best advice would be to see a foot specialist, rather than a general doctor, who will be more familiar with the anatomy of your foot and should be able to give you adequate treatment to try and alleviate the problem.
Because you can reproduce the symptoms by pressing on the bottom of the foot I would tend to doubt it is a back issue.

Marc Mitnick DPM
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right foot pain below 3 and 4 toes

by BONNIE
(INDIANAPOLIS)

I have broken right foot and had a fusion done and a revision and hardware removal
and another hardware removal.All was going ok except for arthritis pain and nerve pain. A month ago I had the misfortune of having a 24 oz can of spaghetti sauce hit on the top of foot and it bruised the heck out of it. I have had pain ever since then . I went to the ER x-rays were done and they said no broken bones post op shoe was put on and sent home to follow up with Dr in a few days. The DR says 2 stress fractures in the 3 and 4 metatarsal. How can they arrive at that diagnosis without seeing films? I do have bruising but thought it was just from the trauma that my foot had went through. PLEASE HELP ME I AM A DIABETIC AND WANT TO KEEP MY FEET BONNIE

ANSWER

Hi Bonnie,

The first thing to do immediately is find yourself another doctor. There is no way you can make a diagnosis of fracture without an x-ray, I do not care how bad the foot may look or feel.
If you still have a lot of pain, have a second x-ray as sometimes small fractures will not initially show up and it can take upwards of ten days for 'bone callus' to form which will indicate fracture healing.
If the second x-ray is also negative then you need a good diagnostician to figure out why you are having so much pain. Obviously without a fracture, one can assume you suffered a soft tissue injury.
Since you dropped the can on top of your foot, the first thing that comes to mind would be damage to the tendons that are on top of your foot that allow your toes to bend upwards.
As you may know, being a diabetic requires you to pay special attention to your feet and they should be under the care of a good podiatrist. So, it is important to get an accurate diagnosis in order to prevent the condition from worsening and thus creating perhaps other foot problems as well.

Marc Mitnick DPM
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Top of the foot pain

My son was playing soccer and all of a sudden could not put any pressure on his foot. The top of his foot was very tender, and it was swollen. Took him to the ER and they did an x-ray and nothing was broken. The doctor did not know what it was and claimed that maybe it could be a cyst. Do you have any ideas what could be causing this? He also said that it hurts to wiggle his toes.

Thanks.

ANSWER
Hi,
The fact that the top of the foot hurts when he wiggles his toes is highly suggestive of tendonitis, which is inflammation of a tendon, in this case the tendons on the top of the foot which bend his toes upwards.
Certainly, there is always the chance of a stress fracture from playing soccer and I would warn you that sometimes fractures of this sort do not show up on initial xray and either the xray has to be repeated in ten days or sometimes a bone scan has to be performed in order to see what amounts to a small fracture in the bone.
I would suggest you contact a foot specialist in your area to get an accurate diagnosis. A proper diagnosis needs to be made in order to institute appropriate treatment.

Marc Mitnick DPM
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ankle growth

by adrieanna
(wisconsin)

Right backside of ankle has what feels to be a bone growth under the skin but also is accompanied by itching around that area. Also tenderness in the ankle area. Have noticed its growth in the last two weeks. Just wondering what this could possibly be?

ANSWER

Hi Adrieanna,

It could be a number of things and without actually being able to examine you, I cannot say for sure. What is throwing me off is the fact that it itches. That would sound like some kind of insect bite, but those only last a few days and probably would not have prompted this post from you.
The most common cause of a bone growth in the back of the ankle is what is known as a pump bump or Haglunds deformity. This is basically an overgrowth of bone seen primarily in women as a result of wearing dress shoes. The top of the dress shoe cuts along the back of the ankle and over time the bone begins to thicken.
Sometimes this extra growth of bone is just a normal finding in some individuals as it constitutes their bony make up, however, this is probably not the case with you as you have just noticed it.
You can learn more about this condition by reading my section on heel pain.
Any abnormal "lump" should probably be looked at by a doctor just to confirm that it is nothing more than a Haglunds deformity.
Of course, if it hurts enough, your doctor should be able to offer advice on how to reduce the pain.

Marc Mitnick DPM
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sciatica with electric shock feelings in the toes

by Vicky
(London)

i have sciatica bought on by either twisting funny or joging. I have had it three weeks and today it has progressed to tingling and unbearable electric shocks in my toes. This is relieved by walking and bought on every time I sit down. The sciatica did appear to be improving so i have been trying to do some stretching exercse of the glutes and hips, i believe this has aggravated the condition further. I am getting very worried about the toe pain, does this mean I have some serious damage going on? My doctor has examined me and said there was nothing to worry about but that was before this toe thing. Im so worried

RESPONSE
Hi Vicky,

I would be a little more concerned than your doctor is about the tingling in your toes. Yes, it is probably true that the toe issue is related to your sciatica and so one can assume the sciatic nerve is further inflamed.
The problem here is that you do not want to end up with permanent damage to the sciatic nerve. It is also safe to say that the stretching exercises you recently did actually aggravated the nerve.
The best advice I could ever give you would be to consult a neurologist in your area. These doctors are the experts in this type of problem. A good neurologist will be able to evaluate the extent of damage to your sciatic nerve and determine a proper course of therapy. This is the simplest way to reduce your anxiety about the tingling pain you are experiencing in your toes.

Marc Mitnick DPM
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Abnormal feeling in toe

by Holly
(Tx)

Four days ago I stubbed my right 2nd toe. It was stiff and fairly painless for the first day. The 2nd day it was a little swollen and very slightly reddish/purplish, still stiff, a little sore. The 3rd day it was more painful (4 out of 10 at the most), discoloration gone, and felt like I have a rubber band around it at the base, and when I walk it feels like I'm walking with a ball under my toe. Today is the 4th day and I still feel the band-like and ball sensations, it isn't too painful, but I do feel some pain with certain movements. I am more concerned about the odd sensations rather than the pain.

ANSWER

Hi Holly,

Unfortunately, the only real way to know what is going on with your toe is to have an x-ray. You cannot tell just by how the toe feels whether it is fractured or not. The fact that it hurts less than it did a few days ago is not helpful to me in terms of whether or not there is a break.
The "funny" sensation you mention could either be from a fracture or it could be from normal swelling that will take place from any degree of trauma to the toe. The swelling will cause tightness around the toe.
In any event you would want to know the degree of damage that you sustained because broken toes depending on the type of fracture need to be treated.
Simple fractures can be treated by splinting the broken to the adjacent toe in an effort to stabilize the fracture site and allow for healing. More severe fractures , although not common, sometimes have to be fixed surgically.
The reason fractures need professional care is that if not properly attended to, they may not heal completely and will leave you with what is known as a pseudo-arthrosis or false joint. This means you may end up with chronic pain and that won't be much fun either.
So I would recommend you see a foot specialist, have an x-ray and get some professional treatment.

Marc Mitnick DPM
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trauma to my foot

Someone stepped on my foot with a skinny high heel pretty much above my smallest toe last night. there is no swelling (or very very minimal swelling) and a reddish slightly purplish bump on the exact location and a little surrounding it. it was excruciating at the time but now that spot is very painful to the touch and my foot is very sore and a achy up my foot past my ankle- midway up my leg. i can walk on my foot and bear weight on it with little pain- it is achy and sore far up. Could it be a fracture? Is this something that should be checked out?
What could it be?
Thanks

ANSWER

Hi,

There is a very good chance that you may have fractured a bone. The only way you are going to be able to tell for sure is by having an x-ray.
You cannot look at the foot or "feel" the area to determine whether or not there is a fracture.
Taking this one step further. Sometimes a small fracture may not show up initially on x-ray and only after a few days will it actually appear. This does not mean you should wait, but I bring it to your attention because many doctors, mainly those that do not specialize in musculo-skeletal disease are unaware of this phenomenon and will tell you that there is no fracture, but your foot will continue to hurt and you will wonder why.
If the toe happens to be fractured the addage "nothing can be done for a broken toe" could not be further from the truth.
In a simple break, the treatment of choice is to tape the broken toe to the adjacent toe in an effort to splint the broken toe so that it can heal. This is very important for the simple reason that if left untreated, you run the risk of what is known as a pseudo-arthrosis meaning the break did not completely heal and you may be left with chronic pain in the toe.
So do yourself a favor and go have an x-ray.

Marc Mitnick DPM
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foot pain

by troy
(wyoming)

pain deep in foot at the middle between heel and ball. It hurts when I try to walk after I have been off of my feet for any length of time. It goes away in a couple minutes. I am wearing insoles (over the counter) that are pretty hard and stiff since I have flat feet and have and lower back problems.

ANSWER

Hi Troy,

My first thought would be plantar fasciitis. Every one thinks of plantar fasciitis as a condition that affects the heel, but keep in mind the plantar fascial ligament travels from the heel to the ball of the foot, so the ligament has the propensity to become inflamed any where along its course.
I see plantar fasciitis in the middle of the foot all the time, even though I do see it more frequently in the heel.
When you sit for a period of time, the plantar fascial ligament tightens up, so that when you stand up, you stretch the ligament and it hurts. As you walk around, the ligament further loosens up and in most cases feels better.
Compare the spot on your foot with the same location on your other foot. Does the affected foot feel more swollen than the good foot? That would be an indication of an inflamed plantar fascial ligament.
People with very flat feet, although that can cause back pain, in many cases have problems with orthotics because their feet cannot tolerate the support under the arch. In the orthotics I sell on this site, I give readers that warning.
In general if you want to help your back through the use of orthotics, you will have to find an orthotic that cushions more and lifts less, than an orthotic that just lifts the arch.
In general you will have trouble finding that kind of orthotic in a store.
It would seem to me that you would do much better by seeing a podiatrist in your area who could work with you in finding an orthotic that will help your back and not aggravate your foot.
Please keep in mind that although it sounds like you have plantar fasciitis, that is not the only condition that could cause this type of pain.

Marc Mitnick DPM
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joint under big toe

Could joint be broke if? Dropped a box weighting about 25 lbs. across the top of foot,not on my toes,on the joint below the big toe. Medium amount of swelling,coloring light reddish-purple,tip of big toe white lightly numb.Can move all toes,but the big toe just a little (HURTS BAD).The joint HURTS VERY BAD X 100 (scale 1 to 10 = 10 +) Happen 1 week ago to day.

ANSWER

Hi,

The only way you are going to know if you have a fracture of not is by having any x-ray. No one can just look at your toe and tell you if it is fractured or not.
If you are still having this much pain then you need to see a foot specialist in your area, have an x-ray and determine if there is a break or not. Even if there is no fracture, your doctor will give you advice on how to reduce the pain and suggestions on ways you can speed up the healing process.

Marc Mitnick DPM
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"Shifting" of the Great Toe 6 weeks after Tightrope Procedure

by Monie
(Texas)

Hello,

After my followup visit my doctor told me that my Great toe is shifting again. Looking more like a bunion. I'm only 6 weeks post-op. Is this normal? She thinks maybe the rope has stretched??? She wants to re-xray in 3 weeks to make sure it has stopped. My xray on August 31st also showed a very slight shift that she wasn't aware of until my appointment on September 14. Previous xrays showed my great toe in perfect alignment. I'm so disappointed and confused how this could happen so soon. Can I do anything on my part to prevent any further shifting? Any info or adavice you can offer will be greatly appreciated. Thanks.

ANSWER

Hi Monie,

Since wire is used to perform the tight rope procedure I do not know how it could stretch unless it was a very low tensile strength which then should not have been used.
My "guess" is that the wire broke at its insertion either into the first or second metatarsal bone and thus is not "pulling" the first metatarsal closer to the second. If it has not actually broke then it has loosened up.
You could try wearing a bunion splint to keep the toe straight and maybe stay nonweightbearing to see if the attachment will fuse, but the reality is if there already has been enough stretch then the attachment is probably doomed.
If it turns out that the tight rope has failed then you will have to consider additional surgery. I would think re-doing the tight rope would not be an option because every time you drill holes into bone, it inherently weakens the bone and you could end up with a fracture.
From strictly a theoretical standpoint, as I cannot examine you nor have I seen x-rays, I would think you would be a candidate for an osteotomy procedure, whereby the the first metatarsal bone is realigned and then set with screws or k-wires.
My best advice is if you have faith in your surgeon, then go with what she recommends. If you have lost confidence or perhaps am unsure of her recommendations, get a second opinion from another doctor in your area.

Marc Mitnick DPM
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sore toes

by kerry
(glasgow)

I often get woke up at night with the tips of my big toes being very painful. After 5 or 10 minutes the pain will pass. The pain is like a very extreme tingling but always just in the tips of my big toes.

RESPONSE
Hi Kerry,

It would help if I knew more about you, your age, medical history , etc. but since I do not let me just point out a couple of conditions that might be causing your pain in your toes.
My first thought would be a radiculopathy, meaning an irritation of the nerves that come out of the spinal column. Depending on the position you sleep in and depending on whether or not you have any back issues to begin with, the nerves that innervate your big toes, may be irritated as they come out of the spinal column.
This certainly could cause tingling or numbness or pain in each of your big toes. If you find that the abnormal sensations subside in a few minutes than that is one plausible explanation. You do not mention what you do to stop the tingling; do you get out of bed, or do you change positions in bed?
The second possibility would be vascular compromise or poor circulation going into the toes. It would help if I knew your age, whether or not you smoke, are you diabetic, etc.
When the feet are elevated, such as in sleeping there is diminished circulation into the feet. If you have poor circulation in your feet to begin with, the elevation of your feet will further exacerbate the problem and you could end up with abnormal sensations including tingling.
Most people with poor circulation into their feet will end up sleeping, sitting in a chair. or let their feet dangle over the bed for a few minutes, so that gravity can help force more blood into the feet and reduce the abnormal sensations that they are experiencing.
So, that is the two most common causes for your complaint.
My advice to you would be to see your doctor and explain your symptoms and let he or she determine the source of your tingling.

Marc Mitnick DPM
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My toenail is falling off

I have been playing football for the past 5 days and over this course my toenail has been pushed back and is now on the verge of falling off and it is extremely painful. I know that I should probably keep it on and wait for a new one to grow underneath but I was just wondering if there was anything I could do in the mean time to minimize pain because I have to continue practice and it is extremely painful. I have got new cleats that are bigger that give the toe a little more room but it is still swollen and the tape that is over it for protection just makes it to large so there is a lot of pressure from the cleat on it. I need this pain to stop because it is affecting my running and I play in a highly competitive league so it is not like I can just take days off because of toenails.

ANSWER

Hi,

Since you are in pain, the smart move would be to go to a foot specialist and have the nail removed. Taping the loose nail back on really does you no good.
The problem is two fold. One, it hurts and two, if left in its present condition you run the risk of developing an infection and possibly doing damage to the new nail that will eventually grow out.
You really have nothing to lose by having it removed in the sense that the toe hurts already and generally a nail removal is not an especially painful procedure.
Yes, there will be some tenderness on the existing nail bed, but my guess is it will not be any more painful that what you are experiencing now.
Lastly if you do develop a paronychia which is an infection you more than likely will be in more pain than you are presently experiencing and you will almost certainly end up missing time on the field.

Marc Mitnick DPM
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Spanish language site and thanks

by jean
(Mexico City, Mexico)

Hi Marc,
Thanks for answering my question. I'll take your advice and see where it leads me.

I wanted to mention that I was looking over the Spanish version of the site, and I noticed several errors. If you would like to fine-tune what Google's automatic service has done for the site, I do translations and offer very reasonable rates.

One thing is essential to correct. The left-side link to the Spanish-language site is labeled "piede dolore", but foot pain, what I'm sure you intend to say, translates to dolor de pie.

Best!
Jean from Mexico City
[email protected]

Hi Jean,
Thanks for the heads up. I will make the correction and if I decide to expand the spanish content of my site, I will contact you and will see if we can work out some kind of arrangement.

Marc Mitnick DPM

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foot pain after leg fracture

Hello my nephew had fractured his leg between the ankle and knee. Was in a boot for four weeks when given the ok by the doc had lots of trouble walking on it. He has bumped the bottom of his foot twice now and is in great pain when it happens. Took him to the doc and they did x ray to find out that he has had several fractures to his foot in the past but have healed. They have him in physical therapy now but seem to think its a mental thing have not had a mri on it yet what is your take on the situation. Thanks

ANSWER

Hi,

If the xrays show that he has a foot fracture, and particularly ones that have not healed, then his pain is hardly in his head.
If there are still open fractures, of any variety, physical therapy is not going to help that. The actual fractures have to be dealt with. I do not know how old the fractures are nor do I know the extent of the fractures, but I will tell you this. Unhealed fractures cause what is known as a pseudoarthrosis which means a "false joint", meaning the crack in the area is subject to stress placed on it when your nephew walks. The stress on the fracture line in most cases will cause pain.
Depending on the extent of fractures and their duration, sometimes a bone stimulator can be extremely helpful in healing the fracture. In other cases surgical intervention becomes necessary in order to manually fix the broken bone.
I think a second opinion by a foot specialist would be indicated.

Marc Mitnick DPM
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Extreme pain between ball and top of foot when right foot transitions from flat into a normal step.

by Ashley
(Asheville)

Hello. I am an avid hiker but sort of overdid it this past weekend. I did long hikes both Saturday and sunday with hilly terrain. Sunday I was sore but nothing unusual. Monday morning when I tried to walk on my right foot, I experienced severe pain. I can put weight on the heel, and I can stand on tiptoe by forming the "tiptoe" in the air first (no weight) and then standing. But I cannot go from a flat stance to a normal raised step without unbearable pain in what feels like the area starting in the ball and shooting up to the top of my foot. If I am sitting and flex my foot or bend the big toe or massage the foot there is no pain. It is only when I am putting weight on it from directly above. On my hardwood floors I cannot bear any weight on the ball when just standing, but the intense pain comes when trying to take a normal step. Thank you so much for your time.

ANSWER

Hi Ashley,

The first thing that comes to mind would be a capsulitis which is basically an overstretching of the ligaments that attach the toe bone to the metatarsal bone, located at the ball of the foot. This certainly could happen during a long hike and certainly give you the symptoms you are experiencing.
Whenever a person exhibits pain in the forefoot particularly after a long activity like hiking you also have to rule out a stress fracture. Your symptoms do not sound like one, but I would be remiss if I did not suggest you have a routine x-ray just to make sure.
Read my section on capsulitis for ideas on how to treat it. Basically you want to stop the toes from bending upwards; this motion stretches the capsular ligament (capsulitis) and continues to aggravate the problem so healing ends up being delayed.
That is one of the problems with most foot pain. If you do not eliminate the motion that is causing the pain, the foot problem just continues and can take forever to heal.

Marc Mitnick DPM
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Broken Toe

by Jag
(Georgia)

Two days ago i stubbed my toe. Because of swelling and my foot turning blue the next day I went to ER. The PA said I had Two fractures and gave me a number of an orthopedic Doctor to make an appointment with. I have no insurance, and I have always heard there isn't much they can do with broken toes (it's the one next to little toe). I am not in much pain today, my foot is sort of numb, was hurting yesterday. My question should I spend the money to see this DR. as it would put a hardship on me.

ANSWER
Hi,

The problem here is that I do not know how bad a fracture you sustained. Yes, a simple fracture might heal uneventfully if the toes are taped together, but if the fracture is more severe such as in a displaced fracture where the bone fragments are not close enough to come together, you could end up with permanent pain if the toes are not properly treated.
I realize that you state the toes do not feel quite as bad today, but that does not mean it is a simple fracture.
I would be remiss if I did not suggest you follow up with an orthopedist or podiatrist and make sure the fracture is being properly treated.
If you have no insurance, call the doctor's office and tell them you have no insurance and will they offer a cash discount.
People call my office all the time needing my care with no insurance and those instances we offer a substantial cash discount because I for one realize not everyone has insurance and health care can be expensive.
Call a few offices, I am sure you will find a doctor who has some degree of compassion.

Marc Mitnick DPM
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Stubbed little toe badly

by Charmaine
(Denver,Co.)

Two and half weeks ago, I stubbed my little toe on my left foot which I have a corn on it, and the toe has become quite swollen and hurts very badly and I can't walk on it, plus I have to take off my shoe every now and then. My toe looks it has a blister on it. To get some relief from the pain, I sometimes put a little pressure on the toe, almost like stopping the blood going to it.

ANSWER

Hi Charmaine,

You need to see a foot specialist. There is always the possibility you fractured your toe and the only way you are going to know is with an xray.
The fact that you state you have a corn on that toe also leads to the possibility that you irritated the corn or even worse, many corns have a bursitis associated with them which may have become inflamed from the trauma.
The blister you mention may be just that, or it may be a small abscess from the trauma. If it is an abscess it will have to be drained.
As you can see, seeking professional care would be in your best interest and there are potential problems here that may or may not resolve on their own.

Marc Mitnick DPM
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Pain after Bunion Surgery

by Garrison K.
(Naperville, IL, USA)

I have had bunion surgery on my left big toe and the surgeon inserted two tiny screws into it to keep the straightness. Once in a while on accident, I come down hard on the toe and bend it like forward and it hurts so much. What can I do to avoid these things?

ANSWER

Hi Garrison,

You do not mention how long ago you had your bunion surgery but if it has been within the last 12 months, you can expect residual discomfort from time to time, as it takes upwards of a year for bone to remodel itself and thus heal.
Trauma during that one year period to the bunion surgical site will almost always yield some kind of pain.
If your surgery was over a year ago and you only have pain when you traumatize the area, then the obvious answer is to be very careful about your foot. If you need to, wear very protective shoes, avoid walking barefoot. In other words do things that will lessen the chance of hurting your foot.
If your surgery is over a year ago and the it is only minimal trauma that causes your foot to hurt, then I think a visit to your surgeon would be indicated. Most successful foot surgery after a years time can withstand trauma to the area; if that is not the case with you then it may indicate that there is a problem, so as I said, check with your surgeon and let he or she make sure there is nothing wrong with the surgical site.

Marc Mitnick DPM
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foot swelling, hurts

by Annie
(saratoga)

my right foot, between the third and fourth toes. it was very itchy. and when i wanted to bend it it would hurt a little. then today it wasnt as itchy but it starting swelling up like crazy. and whenever i walk it hurts alot.

ANSWER

Hi Annie,

The first thing that comes to mind based on your description is that you might have had an episode of athletes foot in between the toes which would explain the itching.
What may of happened here, and I am only guessing because obviously I cannot examine you, is that you developed a secondary bacterial infection as a result of the opening in the skin created by the athletes foot.
This happens quite often and that is one reason why it is important to clear up athletes foot, even simple cases.
If indeed the swelling, and I would suspect redness is responsible for the swelling and stiffness then this must be taken care of immediately.
The problem with infections is that they can turn into very serious problems. I do not know anything about you including your age, health, etc. but if your health is at all compromised such as in diabetes or poor circulation than an infection in the foot becomes even more serious.
The smart thing to do would be to make an appointment immediately with a local doctor and have he or see take a look at it.
If it is an infection, antibiotics should take care of it and save you a lot of potential problems.
If the swelling is from any other source your doctor should be able to treat that as well.
Most other causes of swelling in the forefoot are usually just musculo-skeletal issues which can be remedied, but an infection is a different situation and should not be avoided.

Marc Mitnick DPM
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hard knots on foot

I stepped on a thumbtack about 6 months ago and now I've got a hardened knot around where the tack went in. Also I've got about 6 more of these all over the bottom of that same foot. What do you think it is?

ANSWER

Hi,

Without having the luxury of actually examining you I cannot be 100 percent sure, but what I have seen over the years in many people is that when there is trauma to the bottom of the foot such as stepping on a thumb tack very often, due to the opening that is created, a wart develops.
The reason I am "guessing" that these are warts is because they are spreading which is typical of warts.
Other potential conditions like a granuloma or possibly a sterile abscess will not spread, so that leaves warts as the most likely candidate.
You potentially have 2 problems here if they are warts. The first is the possibility of pain; your may or may not hurt. Generally, the location of the wart will determine whether or not there will be pain.
Secondly, they are obviously spreading. In general, I tell patients that one wart that does not hurt, can usually be left alone. However, once they start to spread, they need to be treated. In a worst case scenario you could end up with hundreds of warts on your foot and I will attest to the fact that can happen as I have seen it numerous times.
Obviously a few warts are relatively easy to treat. Hundreds of warts become a totally different situation. Not only are they difficult to treat but they can become disabling.
So, if I can offer you any good advice, that would be to consult a foot specialist in your area, get an accurate diagnosis and if they are warts, start on a treatment regimen.

Marc Mitnick DPM
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corn that has swollen

my second toe on my right foot has a corn. After running a 15 mile run the corn has swollen please can you advice what has caused this and how to treat it as it is painful when I wear some of my footwear.

ANSWER

Hi,

Two things come to mind. One would be the possibility of an inflamed bursal sac or bursitis at the level of the corn. Very often not only do people have corns but there can be an associated bursitis in the same area. Both the corn and bursitis are a result of excessive friction on top of the toe.
The second possibility is that of an infection, although that is less likely unless you have noticed a break in the skin particularly a break in the corn.
Most open wounds take 36-72 hours to develop an infection so I would lean more to the bursitis.
Since I do not offer treatment options for conditions I cannot examine first hand, I think your best bet would be to see a local foot specialist who will be able to make a proper diagnosis and offer sound advice.
One thing I will say is that make sure the toe box of your running shoe had enough depth (from top to bottom) to account for your hammertoe. If it does not, you run the risk of having this problem every time you go out for a long run and some point in time you will get the area infected.

Marc Mitnick DPM
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