Infrequent stabbing pain in my heel

by Carmela Cugini
(Pittsburgh, PA)

Recently I have begun to experience a very sharp stabbing pain in the bottom of my right heel. It began a few months ago and does not bother me all the time. I could be walking and suddenly feel the pain (it is like knife stabbing my heel). It literally takes my breath away at times. Any ideas?

Hi Carmela,
My first thought would be either a heel neuroma or a heel bursitis, both of which could cause that type of pain, but not all the time. If you are noticing an increase in the pain or an increase in the incidence of pain, it is time to see a foot specialist.
Marc Mitnick DPM

Osteomylitis from a sore

by Jennifer
(Chatham, Ontario Canada)

I have a birth defect called Spina Bifida. Over a year ago. I developed a sore on the bottom of my foot and it became infected with osteomylitis. After 2 mths. on oral antibiotics and then another 5 mths. on a pick line for I.V. antibiotics I got rid of the infection, but had a minor flare up a few months later. So in total it was 10 mths. on antibiotics. I was just recently told by my general surgeon that I may have osteomylitis again in a new wound but, in the same spot as before. I have been told by my spina bifida specialist that I will be dealing with these sores the rest of my life. All the websites discuss methods of diagnosis and treatment. I would like to know all the possible outcomes if you choose not to fight the infection and also, possibly choose not to amputate?

Hi Jennifer,
There is a multitude of problems that can occur with osteomyelitis, however some people do live with a chronic ostemyelitis but it is usually in an area like a toe where everyday functioning is not affected by the infection.
With an osteomyelitis some of the things that can happen is the infection can spread and if it hits the blood stream one of the possibilities is that you could die. Additionally, an infected area like an osteomyelitis can undergo malignant changes and you would end up with a type of cancer. Thirdly, depending where the bone infection is located, the surrounding bone could weaken and you would lose function in that area.
I know a lot of the potential complications are scary and truthfully, I cannot tell you the percent of untreated bone infections that end up like this but if you are otherwise a healthy individual, then you would want to do all that you can to clear up any bone infection that may develop.
Marc Mitnick DPM

Numbness in my big toe

by Lena Flagel
(Cashmere, WA USA)

Ten days ago I was getting into the driver’s side of the car and caught the tip of my toenail on the brake. It ripped my toenail up and I had to have the rest of the nail removed. The toe became swollen and was very painful for more than a week. Now that that he swelling is down and the nail bed has healed I have noticed that my toe joint is very tender, achy and now my big toe is numb from the top of the toe down the outside edge of the toe. It tingles and stings when I walk. I cannot fully bend my toe, but do not have excruciating pain when I walk, just some soreness—like it was sprained well. I can drive and walk (almost normally) but am concerned that I have caused some nerve damage to this toe. Since the accident I have iced the toe 2-3 times a day, soaked the nail in Epsom Salts 2 times a day and keep the toe bandaged. The nail bed has healed very well, but now the joint is my issue along with the strange numbness.

Should I seek more medical treatment or will this eventually work itself out? I leave in 6 days for a 10 day trip to Florida which means a lot of walking and standing in lines at Disney. Do you have any suggestions for what to do about this numbness and occasional pain?

Thank you for your help!

Hi Lena,

Depending on the severity of the trauma, you could have caused some nerve damage and you might have even irritated the joint, both of which should subside and improve over a short period of time.
If you can tolerate anti-inflammatory medication you could try two weeks of that to see if it improves the toe; if not, you may have to seek additional medical treatment including an xray to make sure you did not break anything.
Marc Mitnick DPM

LEG PAIN WITH FEET GETTING COLD AT THE TIME OF LEG PAIN

by ERIKA
(PALACIOS, TX )

BOTH LEGS TEND TO GET A PAIN WITH A BURNING SENSATION THAT RUNS DOWN THE WHOLE LEG. THE KNEE ON DOWN TENDS TO HURT THE MOST. ESPECIALLY MY CALVES AND MY FEET. ALSO MY FEET GET COLD. IT LASTS ABOUT AN HOUR AND THEN GOES AWAY. ALSO MY BACK HURTS TOO. I HAVE NO WATER IN MY LEGS. I CHECK MY BLOOD PRESSURE WHEN IT OCCURS IT'S GOOD THIS TIME AROUND IT WAS 104/78 HEART RATE 67. IM ON DIOVAN HCT 80/12.5. CAN YOU PLEASE LET ME KNOW WHAT COULD BE THE PROBLEM. THANKS.

Hi Erika,
Keeping in mind that I do not have the luxury of examining you, anytime you get pain in the lower leg and the leg turns cold that could be the sign of diminished circulation into the leg, even the possibility of a blood clot. I do not mean to alarm you but your symptoms are suggestive of that and for that reason you need to see a vascular surgeon immediately, who can at least rule that out.
Make sure you do not delay in seeking treatment, this is very important.
Marc Mitnick DPM

Lateral Foot Pain

by Mary Kay
(Buffalo, NY)

Hi,

I suffered a sudden onset of L lateral foot pain yesterday after playing tennis. I play 3-4x/week and have not had the problem before. It began just as we were finishing 2 sets, about one and a half hours of running around. The pain is on the bottom lateral edge of the foot from the MTP back to the middle.

I do wear good shoes, Nikes, for tennis and have been wearing this pair for about a year.

There is no pain to palpation, but pain with walking about a 6/10. Celebrex did not relieve it.

If it is tendonitis, how long to heal? I am a physician assistant, but really do not do orthopedics.

Thanks! (Love the SBI site..I have one too!)

Mary Kay

Hi Mary Kay,

It may be tendonitis of the peroneus longus tendon as it passes underneath the cuboid bone, but it may also be a bruise of the cuboid itself and of course there is always the possibility of a stress fracture.
You can try the RICE routine for a few days to a week, if that does not work you may want to have an xray and have the foot examined.
Marc Mitnick DPM

Morton's Neuroma After Surgery...

Dear Doctor,
Being a come back “patient” and having removed three (3) Morton’s Neuromas from both my feet, I thought it could be of some help to other patients, a photograph of how the surgery looks after four (4) weeks.
My right foot (also having a sesamoiditis problem) is slower in recovering but hopefully I will be able to walk properly in a few more days.
Thank you again for your advice. I only wish I was closer ,with no custom issues, in order to be able to have a prescription orthotic as recommended by you.

Paola

Hi Paola,
Hopefully once the recovery period is over you will have pain free walking.
Marc Mitnick DPM

Lump On 2nd toe

by Martin
(UK)

I have had this lump on my toe for around 5 years. It has not given me any pain at all and around a year ago the dog stood on it and the lump went soft like there was liquid in it. It went back to it's normal size a couple of days later.

Over the last week or so, it has got bigger to the size in the photos and it is starting to get in the way. It is not a corn as it is not hard skin but it looks like clear liquid inside. Yesterday I tried to pop it with a sterilised pin but it hurt too much. I did break the surface with the pin but no liquid came out. That's what the little red scratch is in one of the photos.
Any ideas what it is and what would the treatment be for it?

Hi Martin,
It appears to be a cyst. This type of cyst is fairly common on the toes.
Since you cannot break it yourself, you may want to see a podiatrist.
Because it is superficial, the chances of removing the cyst are fairly slim because more than likely the cyst will burst before it can be excised.
One option is to have it drained and then have the area cauterized. This may prevent recurrence.
Marc Mitnick DPM

Neuroma between second and third toes with swelling and pain.

by eeed
(Denver)

I have never worn heels. I worked at a job where I stood on my feet 6 to 8 hours a day but wore good tennis shoes with orthotics. I do have fallen arches. I've suffered with Plantar Fasciitis for 18 years and have worn orthotics for about 10. For the past 5 years I have experienced pain and swelling and separation of my second and third toes on my left foot. It took me 4 years and getting out of my HMO before I received any treatemnt. In 2009 I was treated with steroid injections and then had alcohol injections to deaden the nerve. I am still unable to wear any type of closed shoe without pain after 10 minutes. My toes are so widely separated that when the shoe pushes them together it causes pain. I have moved to another state and will see a new Podiatrist in a week or so and wonder if surgery is the right move for me at this time and what possible complications come with such a surgery?

Hi,
When the toes are spread so far apart and pressing on the area causes severe pain, it suggests to me that you probably have a large neuroma, meaning conservative treatment may not be enough and surgical removal may be your only real option.
The key to a successful surgery is to make sure you surgeon is sure it is a neuroma (opposed to a cyst or other type of soft tissue growth in the area that may be mimicking neuroma pain). Other than that the only other major complication is what is known as a stump neuroma where the nerve is not adequately excised further back in the foot. Any foot surgeon who removes neuromas should be aware of this potential complication. Discuss this with your doctor.
Marc Mitnick DPM

Left lateral plantar foot pain

by Edwin Hanson
(Guantanamo Bay, Cuba)

Hello,

I have had this left lateral plantar aspect foot pain x's 4 yrs. Have had fasscittis ruled out. Its mid area from 3rd medatarsal between heel. It's constant and aggrevated with running/walking. It's very painful and have done the RICE thing. Please give me ideas...Eddie

Hi Eddie,
The most common cause of pain in the area of the foot you mention is plantar fasciitis but if that has been ruled out then the next area I would look into would be tendonitis of the peroneus longus tendon as it cuts across the foot from the lateral side to the medial side.
The RICE thing is probably not going to work as that is generally reserved for more acute problems.
Since the problem has been going on for so long I would think an MRI would be indicated to get a better idea of what is actually going on. Once a diagnosis is made, treatment can be initiated. You may be a candidate for orthotics, or a cortisone injection or perhaps physical therapy depending on the diagnosis, but as just stated you first need an accurate diagnosis.
Marc Mitnick DPM

itchy sore feet

by Tracey
(Muskegon, Michigan)

I have recently been experiencing severe itching on the bottom of my feet followed by sharp stabbing pain in the bottom of the feet. It is an itch that I can't get rid of by scratching no matter how much I scratch! Then the sharp stabbing pain follows for a few minutes or hours. It varies.


Tracey

Hi Tracey,

Does the skin appear abnormal at all, like a rash? If not the sensation you are experiencing may have a neurological origin.
You could certainly wait a few weeks and see if it goes away, if not you should see a podiatrist.
Marc Mitnick DPM

im have two spots on my foot that look like callous but are yellow and it hurts to walk

by Dale
(michigan)

they look like callous and are yellow and it hurts to walk on that foot

RESPONSE

Hi Dale,

Looks to be a wart. Generally speaking if a person has one wart on their foot, I tell them to leave them alone. If, however, the wart hurts or they are spreading then they should be treated.
I would suggest you see a foot specialist in your area have them looked at to confirm they are warts, and then have them treated.

Marc Mitnick DPM
DISCLAIMER

jumped and landed awkwardly - now have pain on the outside of the foot

by E
(Colorado)

I jumped and landed awkardly on the outside of my right foot. Most of my weight came down on it. Initially I thought I mildly sprained my ankle but then realized there was no swelling whatsoever and my ankle didn't hurt, the outside of my foot did.

I can walk (slowly) and put weight on the foot (as long as I don't roll the foot towards the outside. If I keep my weight on the inside I don't notice much pain at all). The top and bottom of the outside of the foot ache at all times but it really doesn't hurt that much to just stand on the foot. There is a spot which is tender to the touch but not excruciating.

My question is: can you break your foot and still have no swelling after 3 days? Can you sprain your foot and have no swelling? I have a little bit of bruising but not much. The pain just doesn't seem to be getting any better but I don't want to have to pay for Xrays unless I absolutely have to.

Thanks!

ANSWER

Hi,

Yes you can have a broken bone without much swelling. It may just be a small crack in one of the bones on the outside of your foot and so there is not much swelling.
You may have also partially dislocated one of the bones on the outside of your foot.
Unfortunately, there is no way to really tell what damage you did to yourself without having an x-ray.
As a doctor I would tell you to have an x-ray, sooner rather than later because if there is a break of any kind, the more you walk on it without proper treatment, potentially the more damage you can do to it.
If a fracture is not properly treated it can lead to permanent pain which I am sure is something you would like to avoid.
It has been three days, but I have to tell you even the amount of time that has gone by does not give me an indication if there is a break or not. Go have an x-ray.

Marc Mitnick DPM
DISCLAIMER:

injured big toe

by Diane
(MO)

On 4/22 I jammed my big toe into a wooden box. Can hardly walk on the foot. Bruise on top of knuckle and underneath of my big toe. It is swollen as well as the next two toes and top of foot. Was told by nurse friend that she didn't think it was broken because it wasn't bruised as much as it would if I had broken it. When I walk on it, it feels like there is a rock stuck in the bottom of my big toe. It is also starting to itch on the bottom of my big toe. Constant throbbing.
How should I take care of this and why the sudden itching urge?

Thank you.

Hi Diane,
Your nurse friend is wrong. The amount of bruising has nothing to do with whether or not it is broken.
You must have it x-rayed to determine whether there is a fracture or not.
The itching is from the inflammation that is going on.
Do yourself a favor and go get an xray.
Marc Mitnick DPM

nerve pain at top of foot down to big toe

when I touch or put pressure on the top of my feet I get shooting pain into the big toes, this also happens when I stretch out and point my toes. I have been a proffesional driver for 10 years and wonder if this is related and how to fix it.

Hi,

Read my section on midtarsal fault. In that discussion you will notice the paragraph where I discuss your symptoms almost the same way you described it.
What is happening is because of irritation to one of the superficial nerves (the nerve directly under the skin) by shoe pressure pressing the nerve into an underlying bony prominence, the nerve has become irritated.
I would not be surprised that the nature of your profession has contributed to the problem.
If you want to try something on your own, you can try placing a doughnut type pad over the area of most sensitivity, then lace your shoes. This should remove the pressure directly on the nerve. This will not necessarily alleviate the pain immediately, but over time you should see a reduction in symptoms.
If you are looking for quicker relief and an accurate diagnosis, you should make an appointment with a foot specialist. Many times a cortisone injection will calm down the nerve irritation, you will probably also need the doughnut pad otherwise there will always be pressure on the nerve and your symptoms will continue.
At times when conservative treatment as mentioned here does not work, a foot surgeon can go in surgically and try and free the nerve from its associated scar tissue and this can be very helpful, however it is not often an easy procedure as the nerve is very thin and sometimes difficult to find.

Marc Mitnick DPM

DISCLAIMER

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Morton's neuroma

by Paola
(Greece)

After having and MRT of my feet I was told I have Morton's neuromas between the 1st and 2nd toe and 2nd and 3rd on both feet.
I was also told that I should operate them both simultaneously and that I would be able to walk a few steps at a time after 2 weeks with full recovery between 4 to 5 weeks.
Could you please tell me if operating both at the same time is the best thing to do and if not which is the usual process in similar cases.
Also,I have been reading that there are two ways of performing this operation (upper side or under side of foot)which is most effective or at least after which method do you think walking again is easier/faster??
Thank you in advance for you help.
Paola

Hi Paola,
I would be a little suspect about a neuroma occurring between your big toe and your second toe as that is rarely the problem since the space between the first and second metatarsal bone is wider than the other bones, so the nerve does not get entrapped. I would be thinking more along the lines of a sesamoiditis (read my section on that topic).
Having the nerve removed either from the top or bottom of the foot is the preference of your surgeon. It is easier to reach the nerve through a bottom approach, but you run the risk of scarring which can end up hurting on a permanent basis. If you are going to have both feet done at the same time, I would be reluctant to have the incisions done on the bottom of the foot.
When I make incisions on the bottom of the foot, particularly the weight bearing portion of the foot, I keep pressure off the area for three weeks and then remove the sutures. I do not know how you would do that if you have both feet done at the same time.
Marc Mitnick DPM