Not what you're looking for? CLICK HERE INSTEAD
The response to the question below was authored by Marc Mitnick DPM
Pain in the dorsal forefoot
by Ann
(Kentucky)
About 4 weeks ago, I began experiencing pain when walking on my left foot. It was not bad so as a nurse, I just kept walking. Two weeks ago the pain suddenly escalated to where I was in tears after walking barefoot in my house. It continued about 15 minutes after I went to bed. The following day, I was in clinical with students when it did the same thing again. I had the foot X-rayed. No fracture was seen, but after seeing a podiatrist, he put me in a cast boot and ordered a bone scan. My foot is better after a week of little activity (walking) on it. I am still wearing the cast boot. The pain is sharp, and almost burning achy just behind the great toe joint. It will radiate to the left and cover my entire forefoot. It also may radiate backwards to the midfoot or there is a tender place there which aches. It swells by night. I can hardly stand for anything to touch the dorsal forefoot. Any thoughts?
RESPONSE
Hi Ann,
You did not mention the results of the bone scan but I am assuming the doctor was looking for a stress fracture. Typically the first metatarsal is not the metatarsal that fractures for no apparent reason, but anything is possible.
So your pain seems to be in the neighborhood of the great toe joint.
One possibility would be an inflammatory problem in the joint. Have you had any blood work, to rule out gout or perhaps some of the other collagen diseases that could inflame the big toe joint? I do not know your age, so I do not know if gout is a viable option.
You mention you had an x-ray, I wonder if you have any excess bone spurring in the joint. This too, could set off a fair amount of pain.
That is two most common causes for pain in that area of the foot. If those possibilities do not pan out, you might want to consider an MRI to see if you inadvertently tore something just from simply walking.
The fact that you are in a cast boot and the foot feels somewhat better does not give me any indication as to what the problem may be. I would give the cast boot at least four weeks of regular wear before I would consider that treatment a failure.
You could and should certainly have blood work done now and if in a minimum of four weeks, the foot is not virtually healed, then I think the next step would be an MRI. Keep in mind that an MRI should also be able to pick up a small fracture if that is what the problem seems to be.
Marc Mitnick DPM
DISCLAIMER
ADDITIONAL REFERENCES
University of Rochester Medical Center
American Academy of Pediatrics
Columbia University Department of Rehabilitation
Recent Articles
-
Why do fingernails grow faster then toenails?
Jan 16, 22 10:26 AM
The rate at which any nail grows is proportional to the amount of blood coming into the growth plate of the nail. The nail matrix or growth plate is the part of the nail just under the skin at the bac…
-
NHS reveals the 20 most painful health conditions you can suffer from
Jan 15, 22 01:13 PM
The UK Health Services recently published an article on the 20 most painful health conditions a person can suffer from. Most of them would be obvious to most people. What I found interesting is the fa…
-
Do you lose balance without a big toe?
Jan 14, 22 03:46 PM
Over the course of my career I have a number of patients who did not have a big toe, either from amputation due to poor circulation, such as Buerger’s disease, or diabetics who developed an infection…
