sudden night-time pain in same foot of my 9 year old
My 9 year old daughter has struggled with foot pain for several years now. This started around age 5 or 6 and was intermittent so I called it "growing pains". However, after an xray showed a small circular area in the mid foot bone, we visited 2 podiatrists and a pediatric orthopedic specialist at Vanderbilt University. So far we haven't gotten a lot of answers. The last doctor ordered a bone scan of her foot to see if there was a calcification in the mid arch area. The scan was ok and they suggested blood work to rule out other issues. The blood work was fine so now they are suggesting an MRI of her back.
Hers is mostly at night, only one foot and she wakes up shaking in tears from the pain. I give her ibuprofen and rubbed as best I could and after about an hour she usually calms down and goes back to sleep. I hate to see her in so much pain! She was very scared during the bone scan and does not want to have an iv to go to sleep for the MRI and she doesn't complain of back pain. Could this be related to the back? Her pain is in the mid foot region. Her second toe slightly overlaps her first toe, but we were told she would probably out grow that. Also, her foot that has pain (the left one) is about a half size smaller than the right. She is also has low arches but we don't seem to see a correlation between activity or shoe type and the pain. Any recommendations?? Thank you for your help, signed a very concerned mom :)
Of course it is very difficult to make a diagnosis when I cannot examine the patient, but the one thing that jumped out at me in your explanation is the fact that you say she is flatfooted.
When a person is flatfooted the muscles in the lower leg has to overwork, particularly if she is active during the day. It would not be a big stretch to suggest that the "overworking" of her leg muscles is causing her pain at night.
Have you tried any kind of arch support. As a "test" I would purchase a pair of off the shelf orthotics (like the ones I have on my website) and have your daughter wear them during the day and see if it alleviates the pain at night. You have nothing to lose and everything to gain. It is actually a very common occurrence in children who are excessively flat footed.
I would also followup on the spot on her foot with an MRI just to make sure it is nothing.
Marc Mitnick DPM