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

Pain in Foot Pad

I have high arched foot (with bunions) foot tends to pronate in due to some turning in of feet pigeon toed tendancies. I was on my feet all last year on concrete working at a school. No problems other than typical aches. I wear flip flops regularly and 5 weeks ago was literally strolling when I started to feel a pulling sensation in between 1st and 2nd toe where strap is of shoe. It eventually got worse and within a week felt like I had a rock there. Went to Podiatrist and he took x-rays but said he did not see stress fracture and called it nerve inflammed/capsulitis. Had a cortisone shot to that area and ordered orthotics. It took up to one week after shot before I could even attempt to walk and then only in a padded soccer slide shoe. I then had to use callous pads the following week to pad under the foot pad area to being able to bear any weight. 3 weeks later I start to experience stronger pain in between the 2nd and 3rd toe area and go back for evaluation. There is an obvious lump that I can feel and cannot bear weight as it feels like I am stepping on a rock. He manipulates the area and it causes unbelievable pain. He feels that this is either a neuroma or a plantar plate tear. No MRI or further test is done, however he injects this area with Cortisone and places a metatarsalgia pad in the area. I am now one week out from this shot and still have

tenderness and swelling to foot pad area. It is swollen larger than the metatarsalgia pad so still makes it difficult to walk and feels bruised/tender to the entire area. If I step down towards the front on the foot pad it is like an electrical current or shock is going through the entire front of my foot. At this point I can only step by placing weight on heel or arch pad and it is causing stiffness and stress to my knee and hip joints. I am scheduled to leave the country in a couple of months for 6 months and will have no use of a vehicle and be required to walk everywhere...which at this point is impossible. Any advice/help would be greatly appreciated. I am not sure either why it takes so long after a cortisone shot with swelling on the pad, tenderness and bruising?

Hi,
Capsulitis, nerve entrapment or plantar plate tear are certainly all possibilites which would lead me to consider ordering an MRI if my patient did not show favorable response to the cortisone injection.
Additionally, the problem with these types of injuries is that walking on them generally further irritates them, or at the very least slows down the healing process because every time you take a step, you are further injuring an injured area.
I would recommend an MRI to try and get a more definitive diagnosis. In addition, since time is not on your side, I would recommend considering a walking cast in an effort to "rest" the area. Speak to your doctor about these possibilities.
Marc Mitnick DPM

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(location unknown)

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Unknown location

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New Zealand

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Arizona

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Poland

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Bre

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Dr. Mitnick, Thank you so much for your reply. I did let my physician know and they took an x-ray - all is well! Also, thank you for providing this wonderful site, it is very helpful with lots of useful information! I appreciate your gift of time! God bless.

anonymous

Dr. Mitnick, Thank you, you were 100% correct. The pain finally brought me to the ER. I spent 8 days in the hospital. The Doppler you spoke of was able to show that there was no pulse in that foot. This was an arterial clot that split and traveled throughout my leg. My leg was almost amputated. I am in rough shape but have all my parts intact!! You certainly know what you are talking about. Thank you for taking the time to answer. Yours Truly!

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New Jersey

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Evansville, IA

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San Diego, CA

Dr. Mitnick, Just want to say thank you so very much for your quick response and very informative reply! After reading what you had to say, I called the doctor's office and was able to get in and see him the same day as my injury. Toe was x-rayed and luckily, it is not broken or fractured. Very badly bruised and will probably lose the toe nail. And although my toe and toe nail are still very black and blue and very sore, they ARE both starting to feel a little better. So again, thank you! I am so very happy that I came across your website. The service you provide is outstanding and immeasurable!

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Albany, NY

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Whichita, KS

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Boston, MA

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Colorado

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Colorado

Wonderful advice

by: Anonymous

This is the best site for foot problem info.

Thank you for this information. This description fits my pain and inflammation behind my 2nd toe perfectly.

by: Max

location unknown

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Canada

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Wisconsin

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North Carolina

Many Thanks Dr Marc!
Thank you for your response. It sounds like a good plan to me. He did not cut the wart out first ...

KG

location unknown

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Bessie Mae

Florida

Dear Dr. Mitnick, Thank you so very much for taking your time to answer my question. You have greatly relieved my anxiety related to the continual tingly I feel in my feet. I will share your response with my podiatrist next week. God bless you for having this question and answer page on your website! Most gratefully,

Lynne T.

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Your webpage is excellent, I commend you on sharing your knowledge to the public.

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New Jersey

Thank you. you were more detailed than what others have told me they finally called from the last xrays and my son is now in a cast for 2 weeks he did have a fracture that was not noticeable.

a mom

location unknown

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Lenoir, NC

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Bellevue, WA

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Jodi

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