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

Stabbing pain on top of both feet

by Jamie
(Santa Barbara, CA)

I have had this stabbing sensation on the top of both of my feet for about 4 1/2 years now. I am 43 years old and I stopped teaching fitness classes because the pain finally happened while I was on a spinning bike. I have seen every doctor in Santa Barbara, no one can figure it out. I was recently sent to UCLA where I was hoping to get diagnosed, no luck. My symtoms are very much like the other peoples blogs on this web site. It might happen when I'm standing, sitting, lying down, or walking. I will sometimes get a stab on the top of my right or left foot, though the stabbing sensation only happens to one foot at a time. The stabbing pain feels like someone is using a steak knife and driving it through the top of my feet. Sometimes I might get one stab and then it's gone for a month. Sometimes it will come and go frequently for a week and then disappear. I wear Lidocaine patches on both feet everyday. I'm only supposed to wear them for a 12 hour period, but I wear them 24 hours a day. They don't eliminate the pain, they just dilute it a bit. I recently had my second MRI of the lumbar region and I have bulging discs from L2-L5/S1. All of the doctors that have seen my reports say that the foot pain is not connected, because my condition is too minor. I have tried eliminating lunges in my exercise routine for about 3 months to see if that helps..it doesn't. During the spinning class when I felt the stabbing pain while I was on the bike teaching that was the first time in 4 1/2 years that I had ever felt it WHILE I was teaching, it usually happened after the workout if it was going to happen. I am so frustrated because

no doctor knows what this is. I have had two doctors say that possibly it is entrapment/compartment syndrome, but when I say to them "then why is it when someone has carpal tunnel syndrome in the right hand how come it doesn't affect the left hand?" I ask that because when I first had the symptoms it happened to BOTH FEET at the SAME time? It just doesn't add up. I should also let you know that I am also a personal trainer so I am very aware of biomechanical movement, etc. I was really hoping that someone at UCLA would have seen at least one person like me, it was a huge let down. The pain doesn't happen everyday, but when it does it shuts you down. Do you have a suggestion? Any help would be appreciated.

RESPONSE

Hi Jamie,

I would hope that perhaps at this point you read my section on midtarsal fault as that is the condition that best matches your symptoms.
The stabbing sensation that you describe on the top of either foot sounds either like a nerve entrapment or an arthritic pain from the "collapse" of your arch both of which are described in the midtarsal fault article.
I too agree that I am not so sure your foot pain is related to your back issues.
Have you actually been seen by a podiatrist who is biomechanically oriented because for any other specialist examining your foot, more than likely the collapsing of the arch and subsequent pain would never occur to them.
Rather than go into a long discussion of this condition, take a look at the article and see if it fits your problem. Keep in mind the problem does not have to occur daily and it can readily bounce back and forth between feet. Even in carpal tunnel the pain is not necessarily present all the time.

Marc Mitnick DPM
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Jan 15, 2012
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Replying to You
by: Jamie in S.B.

Replying to your e-mail response, by the way thank you for your promptness. I have been seen by a podiatrist, and I've also had orthotics made for my feet due to supination. It doesn't seem to help. If I were to go back to a podiatrist and ask them if I could have midtarsal fault could they tell by doing x-rays again?

A combination of x-rays and excessive pronation in stance is the way to make the diagnosis. If you supinate that to me means you have a high arched foot and people with high arched feet can have nerve issues from wearing shoes particularly athletic shoes that are tied to tight and thus put a lot of pressure on the superficial nerve running down the top of the foot. I am not sure that this type of nerve entrapment will cause stabbing pain, but everyone is different and so it may happen.
If that turns out to be the case then the orthotic may actually work against you as it pushes the top part of the foot into the shoe.
I hope I am not confusing the issue for you.

Marc Mitnick DPM

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Stabbing pain on top of both feet

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