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Lump on ball of foot.

Hi I have a smallish hard flat lump under the skin on the ball of my foot (in the middle). This happened after I stood on a drawing pin, not wearing shoes about 3 months ago. The lump is about 1cm down from the joint on my second toe.


The problem is that it hurts a lot of the time when I am walking and I mainly have to wear flat shoes as higher shoes puts constant pressure on it.

Is there a way to treat this or will I have to put up with it. I am a bit concerned about digging at it in case I do more damage.

I did go to a doctor, but he just told me to keep putting cream on it and rubbing it with a foot scraper.

ANSWER

Hi,

Without being able to visualize the lump I do not know what kind of lump you have. I am concerned that if this lump is from standing on a pin, the pin punctured the skin and you may be having a foreign body reaction. But generally, this would be more than just a lump. The surrounding area might also be a little red and swollen and certainly tender to the touch.
The fact that a doctor has looked at it and told you to apply cream and use a foot scraper leads me to believe it is just a callus.
It that is all it is, there are other ways to treat calluses than just putting cream on them (which generally does not work).
Sometimes you can add an innersole to your shoe to take pressure off the callus and thus reduce the pain.
Regardless of what type of lump you have on your foot, if it hurts that much, find yourself another podiatrist who will take a little more interest in your foot problem.

Marc Mitnick DPM
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return of capsulitis after cortisone injection

by Edie
(Boy ton beach FL)

I was diagnosed with capsulitis and given a cortisone shot 6 months ago. Now it is back, though not as severe. It also seems to come and go. Should I get another shot?

Hi Edie,
I see no reason not to have another cortisone injection. However, if you find that you keep getting recurrent episodes of capsulitis then you and your doctor should consider other options because repeated cortisone injections over the long term does not seem to be the best answer as cortisone itself can do local damage to the tissues in high enough quantity.
Capsulitis is generally caused by one of three problems. Foot structure with a long metatarsal bone that puts excessive pressure on the joint or foot structure exhibiting hammertoes which also stretches the affected joint.
Shoe selection may also play a role in the formation of capsulitis. Very high heels as well as very flexible soled shoes such as flip flops can create excessive stretching of the joint which can then cause capsulitis.
Lastly, a person's occupation may also exacerbate capsulitis. People who climb ladders quite a bit, those that have to squat down constantly will also cause excessive stretching of the joint between the toe and metatarsal bone thus causing capsulitis.
Some of these problems can be easily remedied such as changing your shoe selection or using an orthotic with a metatarsal pad that seeks to reduce the excessive stretching of the capsular ligament.
Altering the way one goes about their work may also help with capsulitis.
Capsulitis due to foot structure abnormalities is a bit more difficult to treat. Many times it will require surgical correction of the foot deformity in order to alleviate the pain associated with capsulitis.
Speak with your doctor about your options.

Marc Mitnick DPM
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Painful swollen stiff ankle

18 months ago banged my right foot on a wooden rocking chair runner in the night. It really hurt but half asleep went back to bed. Walked ok next day had big purple bruise for week or so. Continued to be really swollen six months later so visited local rural a&e dept. Advised probably tendon damage can take up to 2 years to recover and no X-rays taken. A year later it is still very swollen round knobbly bone bit and getting stiffer and more painful. Should I put up with it or see someone. I have lax joints usually as I have hypermobility syndrome and soft stretchy skin. I wore an ankle support all last summer Thank you

Hi,
Eighteen months is a long time to have pain from kicking a rocking chair. On the surface it would seem to me that there is more going on than just a simple contusion.
The only way to find out is to see a doctor and at the very least have an xray.
I know nothing about your overall health status including your age and weight so I do not know if they are contributing factors to your continued pain.
If your doctor cannot find anything on the xray, he or she might even consider an MRI. If nothing of any substance can be found, you might consider either going non-weightbearing for a period of time, or that is too difficult you might also want to consider a cam walker which is a cast that will allow you to walk but take some of the stress off the ankle so that it can heal.
Try and make an appointment with a foot specialist so you do not waste your time with being under treated.

Marc Mitnick DPM
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severe foot pain when lying down

by suzanne
(madison, indiana)

severe sharp stabbing pain on top of one foot...so severe I have to get out of bed...much worse when lying down. Sitting or walking gives some relief from severity of pain. Would like to sleep, but pain wakes me or makes it impossible to get to sleep. Had same type of pains a year or so ago, and after I stopped taking aspirin, the pains stopped. I'm no longer taking aspirin (have been taking naproxen daily for over a year) and today is the first time this pain has been back. Please help...I want to sleep in my bed!

ANSWER
Hi Suzanne,

I have no idea why you are having so much pain on the top of your foot. My first thought might be a nerve impingement in your lower back since it hurts when you are lying down.
I know nothing about your age or medical status, but sometimes poor circulation into a foot will cause severe pain and this too will be worse when lying down because the foot is getting less blood. By standing and walking, the pain diminishes.
In either event you really need to see a doctor and have the foot looked at, particularly if it is a circulation issue and this could turn into a more serious problem.

Marc Mitnick DPM
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toe and toenail discoloration

by Kaiyah
(prescott, arizona, u.s)

a week or two ago i noticed my left big toenail was a little green around the top. i thought nothing of it and i thought it would go away. well i looked at it again today (i look at my feet as little as possible) and now the same toe has discoloration along with the green toenail. the color is like a blue/green color and its only towards the top, by the toenail. theres no known sensitivity or pain or anything else but im not sure if this is something that should concern me or not. I dont want to lose my toe or my toenail for any reason. i didnt hit my toe or stub it or anything. what could possibly be causing this discoloration of my toenail thats now spreading 2 the rest of my toe?

ANSWER

Hi Kaiyah,

Sounds like you may have an infection under your nail. You should have it examined by a foot specialist to determine if it is an issue or not.
If it is a bacterial infection than that could be potentially dangerous; if it is a fungal infection, it may get worse and spread to the other toes.
So, in either event have it checked out to determine what it is and then have appropriate treatment.

Marc Mitnick DPM
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pain in foot, small bumps down side

by Becky

I started having foot pain in my right foot, on top, right under the two smallest toes a few months ago. It has gotten worse, and I can tell the pain comes from pushing on the bottom of my foot under the same toes. In addition, when the pain gets bad, it will go into both toes and throb, and also up my ankle. It can hurt to stand/walk, but also sometimes throbs when I am sleeping.
The other night I also discovered small bumps down the side of my foot that ache. I can't even have the side of my foot touch the bed when I am sleeping.
No other swelling or anything that I can tell.
Several months ago, I thought I broke my 4th toe, though the pain subsided after about a week. It was about a month later that this all started slowly, so I am not sure if it is related.
I have an appt with my podiatrist in a few days, but I was just wondering what I could expect...

ANSWER

Hi Becky,
First of all you will need an xray just to make sure you did not actually break your toe as that could be part of the problem, however, your symptoms in fourth and fifth toe area sound very suggestive of neuroma which in most cases is basically a pinched nerve.
Your doctor should be able to confirm the diagnosis but again I am a little concerned about the possibility of the trauma to the fourth toe as being part of the problem.
As far as the "bumps" go, I would have to see them to know what they might be, but I am sure your podiatrist will have an answer for you.

Marc Mitnick DPM
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top of foot pain

I rolled my ankle last week when I stepped in a pot hole crossing the street. Now there is pain in the midportion of the top of my foot. I have been icing and elevating my foot every night. Do metatarsal bones heal on their own?

Thanks.

Hi,

Hoping a metatarsal bone heals on its own is not a great medical strategy. It would all depend on what type of damage was done to the foot. You could have nothing more than a ligament strain, ranging all the way up to a ligament tear, all the way to a fracture of the metatarsal bone.
The key here is determining how much damage you did to the foot. That can only be done with a visit to a foot specialist who most likely will take an xray.
The problem that many people make is that they think their injury is "nothing to worry about" so they do nothing about it; the injury does not heal and when they finally go to a doctor they find they had a worse problem then they suspected. Now the problem becomes more difficult to treat.
There is no rule of thumb, but if your foot is still hurting after a day or so, it should be examined by a doctor.

Marc Mitnick DPM
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dark brown patches on Both my big toes

by Aftab
(Rochdale, UK)

On both of my big toes i have some dark brown patches which are significantly darker than the rest of my foot. These are on the joint at the middle of the big toes. They dont seem to come off and have been on my foot for a while now. They are slightly dryer than the rest of my skin as well.

Hi Aftab,
I have seen this condition over the years and it does bring people into the office.
Basically, in my mind, it seems to be an eczema secondary to chronic irritation from the tops of shoes. It seems to occur in most people only on the big toe(s) but occasionally people will present with discoloration on the other toes as well.
This is one of those skin conditions that is difficult to eradicate.
You can try a combination of cortisone cream and dry skin lotion, applying equal amounts twice a day over the course of a month, to see if that reduces the dryness and discoloration.
I have heard of people trying a the skin lightening creams used on other parts of body; I am not sure if they work or not.
Have you been to a dermatologist? That might be your best bet; to have a doctor actually look at the discoloration and make sure it is nothing more than what I have described. Also, avoiding shoes that put pressure on the tops of your big toes would also be a good idea.

Marc Mitnick DPM
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why do my ankles feel like something is pulling after i have been to gym

by Angelique
(Ireland)

i recently started gym and am doing circuit training, i find that after my 30 minute training session my ankles are really sore, on the inside of my ankles it feels like something is pulling, even just walking is difficult and going up and down the stair is almost impossible. Please if you have any idea what could be wrong, please let me know.

Hi Angelique,

You do not mention your age or weight so I will guess that you are relatively young.
The most common cause of ankle pain, without any history of trauma would be from a poor alignment of the foot relative to the ankle. This might occur if your are extremely flat footed for example.
On the other hand if you happen to have a high arched foot, your ankle pain may be due to poor shock absorption which happens in high arched feet that have limited motion.
Both situations are the result of structural deformities meaning, the way you are built.
The best advice I can give you is to see a foot specialist in your area and have a complete evaluation. You might find an orthotic is all you need to better balance your feet to the ground and thus create better ankle alignment and relieve your pain.

Marc Mitnick DPM
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Pain under big toe

I noticed the other day when I put pressure on the underneath of the big toe on my right foot it hurt and it still does. It feels like it is by the joint, it a sharp stabbing pain, it could even be the bone that hurts. It doesn't hurt to walk on it only when pressure is applied to it.

ANSWER
Hi,
Two things come to mind when we discuss pain under the big toe, especially in the joint area.
The first would be a tendonitis (inflammation of the tendon) of the tendon that allows the big toe to bend downward. It is known as the flexor hallucis longus tendon.
Things like doing a lot of walking or wearing very flimsy shoes like flip flops where the toe is over bending upwards, may stretch the tendon and thus cause it to become inflamed.
The second thing that comes to mind is the possibility of a small extra bone (accessory bone) that some people have in this same area. The bone is not true bone but is actually made of cartilage and so in many cases does not show up well on xray.
In these cases if you press around the area, most times you can actually feel the accessory bone and actually move it back and forth.
Your option here is to wait a while and see if the pain goes away on its own. It may also start to hurt when walking (as opposed to just pressing on it).
If you find that it does not go away or even gets worse, then you might be wise to see a foot specialist to find out exactly what it is and have some treatment rendered in an effort to rid yourself of the pain.

Marc Mitnick DPM
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Big toe painful one year after surgery

I had a titnamim piece put in big toe due to bone was rubbing against bone and painful. Had surgery one year ago and pain with every step I take. Have to walk on side of foot.Will this pain subside?

Hi,
I would be concerned if you are still having pain one year after surgery, particularly if the pain is substantial. In other words, if every now and then you get a little discomfort I would not be too concerned, but if your pain is still considerable, then you need to visit your surgeon and bring this issue up with he or she. The whole point of having the surgery in the first place was to alleviate pain, not continue the pain.
Pain that is still present one year after implant surgery probably is not going to go away on its own.

Marc Mitnick DPM
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crushed end of 3rd metatarsal

by karrann
(canberra)

my 13 year old daurghter had a soccer player step on her unshoed foot ( as kicking her shoe off as kicking the ball) lol she has crushed the end of her 3rd metatarsal bone about 3 or 4mm of it she is in pain but it has been 8 weeks and the doctor is not shore what to do . what could be done for her or can it be fix

Hi karrann,

The type of treatment would be predicated on the type of fracture. You do not mention what has been done up to this point. I assume your daughter was in a cast or surgical shoe of some kind.
The simple answer to your question is this: if your present doctor is not sure what to do, then seek out a second opinion from a foot specialist in your area.
You have to be careful of fractures in children and outside of the obvious pain, if these conditions are under treated they can lead to problems later on.

Marc Mitnick DPM
karrann

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a terrible looking wart

by Mila
(Canada)

I took my daughter Thursday to the skin specialist to get two foot warts removed that she have in the ball of her feet (in the inner side of each foot just below the great toes). The doctor didn't freeze them but in stead he used a method that he said it would be kinder to my daughter (less painful), it will take a few visits but it wouldn't incapacitate her as much as if they were frozen with nitrogen. After this procedure he put a cloth bandaid on each wart. It has ben five days and it wasn't until tonight that my daughter removed the bandaids from the warts. They are very swollen, white and the size of a penny and the area around the white is quite red. Is that normal or should I be concern? Since Thursday my daughter my daughter has been in terrible pain and has found it very dificult to walk, when she does walk she is using the outer edge of her feet to do so (which are now getting quite sore as well) Can you help, please?

Concerned mother

Hi Mila,
Although I cannot know for sure, it sounds like your doctor used one of the topical medications that creates a sterile abscess (blister) that separates the top layer of skin, wart included, from the deeper layers of skin.
This can cause the area to become painful as well as swollen in red. However, an infection will also cause the same set of symptoms.
My best advice to you would be to call your doctor and see if he or she would like to see your daughter. Ultimately your doctor is responsible for the consequences of the medication that is prescribed.

Marc Mitnick DPM
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pain in bones in foot

i broke my foot around ten years ago in two places and the outer side was bolted together with a metal plate and screws and on the ankle side a piece of wire was put in .this year for about the last two months when i get up in morning i can hardly walk on my bad foot for the first few minutes then the pain goose away well more of an ache i think it is the bone that aches please help as im worried it will get worse, im 46 and female and am very active and about a stone over weight thanks

Hi,
At the very least you need to have an xray to determine the status of the hardware that is placed in your foot and ankle.
Over time sometimes the hardware loosens up and this may be the source of your pain. In these cases the hardware may be removed.
My other thought would be that even with hardware implanted in your foot, if the original fracture did not heal properly your pain may be the result of arthritic changes going on in the fracture site.
Of course, I am only guessing, you need to be examined by foot specialist along with an xray to determine what exactly is going on with your foot and ankle.

Marc Mitnick DPM
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White lump bottom of foot

by Melissa
(Charlottesville, VA)

Hello, I was barefoot for several days and naturally stepped on some less-than-friendly rocks. I have a few puncture wounds that are open and healing just fine, but I have one that is a white lump or whitehead on the bottom of my foot. It is located just above the balls of my feet, between the big toe and the next smaller one. I do feel and see a lump, but not necessarily something in that lump e.g., a small rock or something. Thanks for your help!

Hi Melissa,

My first guess would be you have a small abcess in that "white" spot.
The best advice I can give you is to see a foot specialist in your area to make a proper diagnosis. If it is an abscess your doctor will drain it. It is not a major undertaking. However, if it is an abscess and you do not have it treated it could get a lot worse and then you will major issues.

Marc Mitnick DPM
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pain in outer edge of left foot when walking

by anita
(ireland)

I have pain when walking on outer side of left foot.i had a minor ankle fracture in february this year on this foot.I have been wearing flat pump shoes quite a bit recently.

ANSWER

Hi Anita,
Quite often when a person sustains an ankle sprain or even an ankle fracture due to the foot turning inwards, one of the things we look for is the possibility of a fracture at what is known as the fifth metatarsal base.
This is the protrusion on the outside of the foot mid way between the heel and the ball of the foot.
This is often overlooked by many doctors who do not routinely treat ankle trauma.
Even if it turns out that there is no sign of fracture there may have been trauma to the fifth metatarsal base or the tendon that attaches into this bone.
Another consideration is the possibility of a subluxed cuboid.
In this instance, the bone just behind the fifth metatarsal base (cuboid bone) becomes displaced. This too, will occur in lateral ankle sprains.
It is impossible for me to make a diagnosis without actually examining you, but I think since your pain has been going on for six months now, it is probably safe to say it will not be going away on its own.
I would suggest you find a doctor who specializes in foot pathology and have an examination and possible xray to rule out the conditions I have mentioned.

Marc Mitnick DPM
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Can't rise on ball of foot after 1 month from an ankle sprain

by JeremyK
(Boston, MA)

I had a grade 3 ankle sprain one month ago. I was told I know can start PT, but I can't raise up on the ball of my foot due to the pain. The pain is not in the ankle, but on the ball of my foot all around the base of my toes (top and bottom I guess). Why is the pain there now? My ankle doesn't even feel this painful at this point! If I touch the top of my foot it still feels like it is bruised! HELP, what is going on?

ANSWER

Hi Jeremy,

I agree with you that the pain in the ball of the foot is not directly related to the ankle sprain, other than the fact that if you were in some kind of boot or other ankle protection device that did not allow you to bend at the ball of the foot, there may now be pain due to the stiffness.
Most pain like this is a result of capsulitis which is inflammation of the joints that attach the toes to the metatarsal bones.
Since you are about to start PT, mention your pain to the physical therapist to confirm my diagnosis and more than likely they can give that area physical therapy as well.
As a side note, you did not mention that you had this pain prior to standing on the ball of your foot, but there is always the outside chance that you did injure the ball of your foot when you sprained your ankle, so if treatment on the ball of the foot fails to reduce your symptoms, you might be wise to have that part of the foot xrayed.

Marc Mitnick DPM

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Feels like there is a string tied around my big toe(s) upon waking

by Jennifer
(USA)

I have no other way of describing it...when I wake up it feels as though there is a string or a piece of yarn tied tightly around my big toe(s). It goes away if I rub the toes or get up and start moving around. This has been going on for about 1 month now. No history of diabetes but I am overweight.

Hi Jennifer,
Two things that come to mind are the possibility of a neuritis, where a nerve possibly as far back as your lower back is impinged (pinched) from the way you sleep and thus is giving you the feeling that you describe in your toes. Because it is in both big toes, the common denominator would be your lower back.
The other possibility would be compromised circulation running into the big toe(s). Many times in individuals who have compromised circulation, symptoms will manifest themselves in the feet when the patient is sleeping because the elevation of the feet further reduces blood flow to the foot. When you stand up and start to walk around gravity improves the flow of blood into your feet and toes and the symptoms improve.
I know nothing about you medical history including your age, whether you smoke or not, other medical conditions that you may be suffering from, etc. so it is impossible for me to be any more specific.
I do think however, that these symptoms warrant an examination by a doctor in your area to determine the cause. If it turns out to be a problem that requires medical attention then that can be instituted. If it is determined that the problem is really nothing to worry about, then you will have peace of mind.

Marc Mitnick DPM
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walking or driving

by jules
(west sussex)

i had a fall and thought i had sprained my ankle. had xray no break but 2 years on am really getting a lot of pain sharp shooting and burning pains like trapped nerve pain. i can wake up pain free but soon as ive been on it for hour or so it starts to really hurt. or if am driving i have trouble with cluch. pain killers do not work for more than an hour or so even strong ones the dr. has given. am beside myself now as what to do.

Hi Jules,
It seems to me that further investigation into your symptoms would be indicated. The first thing I would consider would be an MRI to see if there are remnants of soft tissue damage from the sprain two years ago. It is also important to keep in mind that sometimes small fractures do not initially show up on xray, but an MRI this far down the road might show a healed fracture.
If the MRI proves to be negative then the next avenue to explore would be the possibility of a nerve entrapment as you state the symptoms seem to neurological in nature.
Just taking pain killers is not a solution. Your doctor first needs to find the cause of your ankle pain. Once a proper diagnosis is made it will be much easier to treat the problem.

Marc Mitnick DPM
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Cannot put pressure on my foot... if i do it hurts and tingles.

by Harley
(Richmond, VA, USA)

Well, almost three weeks ago i fell from a rope i was climbing, about five feet high, my heel hit a rock pretty hard. Since then i have not been able to put any pressure on the heel. The heel only swelled a little. I work on the foot for two weeks, mind you i am a landscaper. This past week I have only been using crutches, and did not work. Now its been three weeks, i still cant apply any pressure without pain and tingling. Iam wondering if i broke my foot or maybe just sprang it.... should i wait another week and if not better go to the doctor?

ANSWER
Hi Harley,
I think three weeks is long enough to wait; in fact your probably should have seen a doctor a few days after the accident.
If indeed there is a fracture, the sooner it is treated the more likely it will heal without complication.
If the xray proves negative for fracture, and after treatment by your doctor, the pain does not subside, then I would recommend an MRI or bone scan. Sometimes small fractures in the heel are hard to find on xray and it takes more advanced imaging to locate the fracture.
The tingling may be suggestive of nerve damage, but more than likely as the pain improves, the tingling should lessen.

Marc Mitnick DPM
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Collapsing Arch Pain and Biking

by jean
(Mexico City, Mexico)

About 10 years ago I was told I had falling arches. Previous to that, I don't remember any foot pain. At that time, I purchased Birkenstock sandals with an arch support, and began noticing that all my other footwear hurt my feet.

Right now, I'm 29 years old and have been experiencing foot pain for several years. It's generalized sometimes and in the arch area other times. I confess I've never seen a doctor about it. I wear over-the-counter arch supports and they help, but not much. I also notice that I have two hammertoes on each foot. I notice my feet "turns in" where the arches are, and recently, it hurts to stand barefoot on one foot, even for a few seconds.

I'm very active -- I bike 15 to 45 km a day, practice yoga, and run.

My questions are: How does biking affect my feet? I don't use bike shoes or clips, just regular pedals. What can I do to rehabilitate my feet? I will see a doc, but because of cost, surgeries are not an option. Thank you!

ANSWER

Hi Jean,
I am not sure biking actually hurts your feet, particularly your arches because biking is a nonweightbearing activity.
Quite often I have my patients bike instead of running or walking when treating them for plantarfasciitis.
If you are not wearing pedal clips then the arch of your foot is probably resting on the pedal and again because you are not really bearing weight on the foot, biking should not be the cause of your foot pain.
You may find that you need a better support than the orthotics you have purchased in the store. Even over the counter orthotics are made in various grades and you may have reached the point where you need something more supportive.
Try that first. If that does not work out, then you may want to make an appointment with a foot specialist.

Marc Mitnick DPM
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problem walking after resting

by Darren
(Tarbert, Scotland)

Hi

I have had a problem since I was 8 (now 30)

If I walk (e.g. a shopping trip) or stand (teaching) for extended period of times everything is fine.

When I rest - driving home, or sleeping, I find that I can't stand up. When I do I have a sharp intense pain like I was standing on stilts pressing into my feet I have to spend a long time massageing/ manipulating my foot so I can stand. I normally have to grab things to aid my balance, I walk worse than an old person. I take over the counter pain killers and pain relieving creams.

I went to a specialist and was told they couldn't see a problem - it only happens when i have been using my foot for hours.

My wife said I don't rotate through my foot when I walk, so I got some MBT (that make you rotate foot) they have reduced some of the pain. I feel my feet seizes up.

Even now my foot is sore, my foot klicks when I circle it, my ankles are painful, my foot is painful on the top.

Any suggestion to solve this would be greatful - it affects both feet.


Hi Darren,

It sounds like your feet 'stiffen' up after being at rest. I assume as you walk, things loosen up and eventually you can walk normally.
What is disconcerting to me is that these type of symptoms are suggestive of osteoarthritis, the wear and tear arthritis that we all develop as we age. The problem is, you are only 30 years old and this has been going on since you were eight.
Do any other family members have this type of problem? If so, it might be a genetic structural type problem and you may be stuck with it.
If not, I would suggest your doctor do some blood work to see if you suffer from any of the so called collagen diseases which can have an impact on the way the musculo-skeletal system functions.
Bottom line, you are too young to be having these types of symptoms and it should be investigated.

Marc Mitnick DPM

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Painless foot bruise

by Lisa
(Boston, MA)

I am a middle-distance runner, averaging about 25 miles a week. After running ~20 miles in 48 hours (slightly higher than normal, but nothing crazy!), I noticed that my right foot, though painless and experiencing no direct trauma, was showing huge bruises on the medial side, with the darkest spot on the middle of my arch. The next morning, my foot was swollen and the bruising was visible on the lateral side of my foot as well. However, I've experience no pain at all! I haven't tried running on the foot as I am afraid to give myself an overuse injury. What could I have done to myself?

ANSWER
Hi Lisa,
Obviously you bruised your foot (you did not need mt to tell you that), but the concern here is why. I am assuming you wore the same running shoes and traveled the course that you normally do.
You are correct, you did not seem to do an excessive amount of mileage, so why the bruising?
Without having the luxury of being able to examine you, I do not know what is going on.
You have two options. You can wait a few days until the bruising improves, or you can see a foot specialist now to try and determine why this is happening.
Certainly, if you wait it out, then go running and the bruising recurs, then you should definitely see a foot specialist to determine the source of your problem, if for nothing else, to make sure it is not a sign of a problem.

Marc Mitnick DPM
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pain on top and arch of foot

by Sue
(Illinois)

I had a lapidus bunionectomy 8 months ago, I had removal of plate and screws 2 months ago.. I now still have some swelling and pain in top and arch of my foot. My ankle is starting to hurt also, probably because of the way I am now walking. It is painful to walk with my foot completely flat , I tend to walk on the outside of my foot, I have had many orthodics, and tried many different shoes. I also did physical therepy for 2 months. My Dr. also said that when she removed the screws one was broken and stuck in the bone, which she said she did not want to retrieve, because she would have had to go in through the bottom of my foot, and would have put me back to square one with the cast and all.
The area that hurts most is the actual place the plate was. There also seems to be an indentation in that area with swelling around it. Is it common to have swelling 8 months after the original surgery..I must say it has been a nightmare!

Hi Sue,
Not knowing anything about your overall medical history, including age, activity and weight, it would not be unheard of to still have "some" swelling in the surgical site. They question you need to ask yourself is whether or not you are still seeing continued improvement, albeit slowly. If you are still noticing improvement as time goes on then you might be wise to wait it out.
Having said that, if you think the majority of your problem is coming from the area where the fractured screw still remains then you may have to eventually deal with having your doctor go back in and remove it.
Speak to your surgeon about your options. If you are not satisfied with the answers, seek a second opinion with another doctor who can examine your foot and view the xrays.

Marc Mitnick DPM
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Bent and twisted 4th toe left foot

by Cat
(Dallas)

I wore heels for many years. My toes were forced forward and squeezed into the toe of shoes. The 4th toe started to bend at the end and form a corn at the end of the toe. I've joked that the end of that toe is useless. It twists a little and is not very straight.
Had a doctor cut the tendon to ease the pain I get when playing tennis and running.
It doesn't seem like the toe stays straight and the twisting aggravates the pain.
It feels like a little swelling in the metatarsal area and inflammation.

I don't know where to start with this issue. I don't have health insurance and want to research as much as possible online before seeking medical attention.

Sports are a big part of my life so this is a setback.

Hi Cat,
For someone who does not want to invest a lot of money into this problem, the simplest and least expensive way to address this problem would be to try some of the over the counter pads that are available for hammertoes (and mallet toes).
Perhaps the easiest thing to do would be to purchase hypoallergenic cloth tape, one inch wide and tape the bad to the adjacent toe in order to keep it straight while walking or participating in sports.
I may be stating the obvious when I say this, but when a person has an abnormally shaped toe many times it becomes a question of trying to put a square peg into a round hole; simply put, your foot will not fit in all styles of shoes and you need to find a style to accommodate the toe deformity.
However, try taping the two toes or even some of the non-medicated pads that are available in the drug store or supermarket and I think you will probably get some relief.

Marc Mitnick DPM
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Bump on my left knee, bump on top of my left foot. Very painful to walk and stand. I have gout.

by Bradley
(Buena Vista, Va.)

The doctor said I have gout. I have had it for 5 years. I am 39. Now I have a big bump on my knee and on top of my foot. I couldn't work today because I couldn't walk for the pain in my foot. I have been taking the new Gout medicine Uloric for 2 months. My blood test showed last week that my uric acid level is 12.. The medicine isn't working. I am in extreme pain .. I drink 5 beers every day.

Hi Bradley,
Lets start with the beer. Alcohol promotes gout attacks, so you are working against yourself by drinking alcohol.
Gout generally does not occur in the knee, so you will need a more accurate diagnosis as far as the knee pain goes. Generally, the best way to determine the source of the "bump" is to have them aspirated and have the contents analyzed by a lab.
Obviously a uric acid of 12 is very suggestive of gout, but an aspiration might prove more informative.
If the Uloric is not working then your doctor ought to consider some of the old standby's like allopurinol or even colchicine in an effort to reduce your pain.
Oral anti-inflammatories like Indocin or Naprosyn can be very effective in relieving the pain, but these two medications should not be considered as cures as you cannot take them indefinately.
Many people state that drinking cherry juice is also helpful in relieving the pain from gout.
Lastly, you should sit down with a nutritionist and go over your daily diet. Besides the beer, it would not surprise me if some of the food you eat on a daily basis is also precipitating your attacks.

Marc Mitnick DPM
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pain top of foot and outer ankle

by Bill
(Curridabat,Costa Rica)

I have been having a pain when my foot flexes certain ways or when I am touched above the ankle bone on the outer side of the leg. In both cases the pain is felt near the 3rd and 4th toes on the top of the foot. There is no pain when walking and/or running, but the back of my ankle, achilles tendon area has been stiff. Any ideas?

Hi Bill,
The first thing that comes to mind would be a tendonitis of one of the tendons that travels along the top of the foot. The fact that it hurts when you twist your foot suggest that, the fact that it does not hurt when you walk means there is also the chance it is not a tendonitis.
If you have stiffness in the achilles tnedon and ankle it may be throwing off your gait resulting in the pain that you are experiencing.
If you can tolerate it you could try some anti-inflammatory medication for 10-14 days to see if that takes care of the problem. If not a trip to the doctor might be indicated.

Marc Mitnick DPM
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toe

by Wanda
(Hot Springs, AR)

recently discovered that there is a sort of callus formed at the base of the nail bed on top of my toe (next to the big toe); it doesn't hurt unless i probe it, but i notice the nail bed is becoming indented at the base. I do recall a few weeks ago that I rammed my bare foot into the base of chair; it really hurt at the time, but forgot all about it. I have never had corns or any trouble with my feet so think it's due to the injury. Should I just ignore it or? It does seem to be getting thicker....

thank you.

Hi Wanda,
If you think the nail bed is "dented" then there is always the possibility that there may end up being damage to the nail bed. The problem with this is that damage to a nail bed can then cause the nail to grow out irregularly. The nail may even become mycotic over time.
In order to know if that possibility exists, your best bet would be to see a foot specialist and let he or she determine whether or not there is an issue.

Marc Mitnick DPM
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stepped on a cord plug, my left foot went to side, its been almost 2 months and seems to be getting worse

by jacqueline
(san antonio, tx.)

the left foot went to side very quickly with shoes on when i stepped on a cord/plug, i thought it would stop hurting but i kept working on it and standing on it for almost 2 months and finally i couldn't stand another second cause the pain was so excruciating,it's originating on the side of my left foot in middle where the bone on the side is, if i bend my foot up it hurts, if you press to massage that area, the pain makes me jump, it travels to surrounding area up to ankle on shinbone on inside of left ankle, i think i may have a fracture cause my ankles are skinny but i weigh alot and when my foot went to side my ankle almost touched floor, minor clinic thinks its tendonitis, but it feels worse. my foot bent outward with outsde ankle bone almost touching floor really quick, could i have fractured something or torn something? i stand all day and need my foot.im a hairdresser. they took x-rays, but at a minor clinic, i don't think they specialize in this area of podiatry, i figured it was going to heal up quick and couldn't afford to miss work, so i grinned and bared it pretty much, i do'nt want to end up in a wheelchair someday.

Hi Jacqueline,

A second xray may be necessary as some times an initial xray may not show a small fracture. Assuming however, that the bone is not broken, you may have a tendinitis as there is a tendon which comes down the outside of the foot and then crosses under the foot in the exact area you mention. This tenon, the peroneus longus tendon is very often subject to trauma because of its location and the way the tendon courses through the foot.
The foot apparently is going to need more aggressive treatment. Speak with your doctor. Some things to consider would be a course of anti-inflammatory medication, possibly a cortisone injection. Padding added to your shoe in an effort to keep pressure off the tendon, as well as possibly a walking cast to "rest" the tendon so it can get better.
Make sure you see a foot specialist as any one else not familiar with the anatomy of the foot will probably be of limited help with this condition.

Marc Mitnick DPM
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I am expieriencing foot pain on bottom of foot between my second and third toes. It feels as though I'm

Theres a definite widening when I walk between my second and third toes. Feels as though theres a ball underneath the second and third toes. Pain is bearable but gets worse as day goes on. I'm on my feet usually all day. I do have bunions on both feet. Its only on my left foot that I'm expierencing this problem this bunion looks worse than the right foot. I am going to a podiatrist in a few weeks. I'm wondering if bunion surgery would be the answer. What can I do now to help the pain? I also have a terrible time finding shoes that are comfortable can't where flats thats worse than a heel when wearing flats my feet burn. I wear wide shoes but really don't think my foot is wide it just feels better because of the bunions. I also have a high instep. My mother also had bunions. Any informaton would be apreciated.

Thanks
Cindy

Hi Cindy,

If the spreading of the second and third toes is something new, many times this indicates a growth between the second and third metatarsal heads. this growth in the vast majority of cases us usually either a neuroma or even a bursitis. (read my section on each of these conditions).
Although you have bunions, they may not be related to the spreading of the second and third toes.
Going to a podiatrist is the best advice I could have given you. You need a doctor to actually examine the foot and determine the cause of your pain. This way, with a proper diagnosis you can receive appropriate care.

Marc Mitnick DPM
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May 23, 2014
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Custom orthotics not correcting excessive over pronation injuries
by: Anonymous

Hi! I have worn custom orthotics for 20+ years and only Doctor recommended footwear to correct my excessive overpronation. I have had my hip replaced along with back surgery to remove large disc herniations. I suffer from chronic severe foot pain, it band syndrome, SI joint dysfunction, chronic shin splints, piriforimis syndrome, sciatica, chronic tendinitis and bursitis and just chronic severe pain from the feet to the back. I push myself and keep moving until my legs give out from pain and fatigue after about 5 blocks. Do orthotics work In all cases and if not who can I see or what can I do to get relief. I have done extensive PT, 100's of different types of injections, use constant ice and heat and just about any other conservative method you can think of. I am only 51 years old have been on SS Disability for the last 8 years. I just am not ready to throw in the towel but do not know where to turn. Please help me. Thank you.

Hi,
I am painting broad strokes here simply because I do not have the luxury of actually examining you, but the point I want to make is that like most musculo-skeletal problems, over pronation worsens as we age and the treatments that once worked may become less effective over time.

As we age the body is less adaptable to the stresses placed on it, so whereas orthotics once controlled your pronation and improved the alignment of your legs all the way up to your lower back, that may no longer be the case.

Obviously, you have suffered the consequences of over pronation based on the laundry list you provided of all your ailments from the lower back down to your feet, so even in spite of orthotic control, your body has paid the price of excessive pronation.

One of my problems is that I do not know what kind of orthotics you have been wearing over the years. Sometimes the wrong type of orthotic can make things worse.

I would suggest you consult with perhaps more than one podiatrist in your area and get a consensus of the type of orthotic that would be required for you at this point in time.

I would also suggest to you that it probably take more than just orthotics to improve your situation and the improvement, while it should help, will certainly not be a cure. More than likely you will have to come up with a daily regimen of exercise, topical and perhaps oral medication along with orthotics that will allow you to get through the day.

Marc Mitnick DPM


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