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The response to the question below was authored by Marc Mitnick DPM

Pain at the base of the third and second toe

by Samantha

I am having pain at the base of the third and second toe on both my left and right foot. It started on both feet back in December and I had cortizone injections that helped the pain greatly. The doctor thought I was suffering from Morton's, and I also got orthodics. In April, my 2nd toe on the left foot began to hurt and she thought I had a stress fracture. That wasn't the case confirmed by an MRI. Swelling, inflammation, etc. above the third metatarsal due to stress injury or something. I have orthodics but haven't gotten to wear them yet. Now both feet are killing me. I can take my index finger and put it in between my 2nd and 3rd toe and the pain is horrible. I almost feel like passing out. The corns on the tips of my toes on my left foot are terrible lately. I don't know what to do. My feet are killing me. I have went up a size in shoes, and I am trying to do all I know to do. Nothing seems to work.

Hi Samantha,
You do not mention your age, but certainly going up one shoe size is going to create problems for you if you are still wearing your old shoes. Two things here. The fact that you are getting corns on the tips of your toes is suggestive of wearing shoes that are too short and tight. If this is the case then those same shoes are going to worsen your neuroma pain. No matter what your doctor does for you, it will be negated by your old shoes.
Start wearing properly fitted conservative shoes (for now), see if there is some reduction in pain. Then let your podiatrist treat your symptoms. Proper shoes and good foot care should improve your situation.
One last note, sometimes neuromas to do not respond to treatment and in that case you may have to consider having them surgically removed.
Marc Mitnick DPM

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May 15, 2008
by: Samantha

I don't believe it is a Neuroma. I forgot to mention that the MRI said there were none. I am 29 by the way. My right foot was operated on when I was 16 for tailor's bunion and a wire was put in and no MRI was done on that foot, but I tried wearing a boot on the left but the pain got worse. The pain is terrible between the second and third and some between the third and fourth. More so on the left foot than the right, but still quite a bit on the right foot as well. I'm also a teacher so I do lots of standing all day long. The bones in my foot have begun to roll outward almost and my toes are curled. They have always looked deformed. My oldest son's have already started to look somewhat like this but not as extreme. He plays lots of sports and has started to complain that his hurts as well. He's almost 8. She said it was genetic. There is some bruising on top of my foot around the base of my third and fourth toes. My third and second toes are so sore to touch also when I rub them as well as the ball of my foot.

Hi Samantha,
Obviously it is hard for me to make a diagnosis without actually examining you, but I will tell you that over the years I have done many MRI's on patients for neuroma that came back negative, only for me to take them to the operating room and end up removing a neuroma. So much so that I very rarely ever order an MRI when I suspect neuroma.
Neuroma would be the number one thing that would cause the kind of pain you are experiencing. Secondly would be capsulitis. A stress fracture or soft tissue growth of some sort probably would have shown up on the MRI.
If you are not having any relief from the doctor who is treating you perhaps a second opinion would be indicated.
Good luck.
Marc Mitnick DPM

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