Toe Pain No Gain Get A Proper Diagnosis
The good news is that if you catch this problem early, there are some non-surgical, conservative treatment options that can get you back on your feet and toes pain-free. To diagnose capsulitis of the second toe, youll want to see an expert, such as podiatrist, who can properly evaluate your feet and your biomechanics. The reason for this is that capsulitis often resembles another condition, Mortons neuroma, but the two require different treatment.
It is often misdiagnosed as another condition known as Mortons neuroma, but they are distinctly different, Dr. Dobrusin said. The difference is that Mortons occurs in the nerves and not the joints and presents with sharp, excruciating pain in third and fourth toes and not the second toe. Youll want to see someone who can distinguish between nerve and non-nerve related conditions so proper treatment can be given.
To diagnose capsulitis, your doctor may apply pressure to your foot and maneuver it to reproduce symptoms. They may also order X-rays to confirm a diagnosis.
What Causes The Pain In The Ball Of The Foot
This pain is generally the result of excessive walking and running. Metatarsalgia is an overuse injury, and the condition is often due to abnormal weight distribution, persistent pressure on the area, and other musculoskeletal stressors. All causes result in excessive, localized pressure on the forefoot, which creates the pain in the ball of the foot.
Many conditions and habits can lead to ball of foot pain, including high levels of activity, prominent metatarsal heads, weak toe flexor muscles, tight toe muscles, a tight Achilles tendon, ill-fitting footwear, and excessive pronation, which is the side-to-side movement of the foot when walking or running.
However, experiencing pain in the ball of the foot is not always the result of physical activity. Sometimes, inherited anatomical conditions may predispose people to metatarsalgia. This may include having a high arch, a Hammertoe deformity, a short first metatarsal bone, or a long second metatarsal bone. Any of these conditions can affect weight distribution across the foot.
This pressure and weight distribution causes inflammation, which in turn causes the foot pain. Blood vessels in the ball of the foot dilate, and blood flow increases to allow white blood cells to swarm the injured area. In some cases, the forefoot will become red or swollen.
Causes Of Top Of Foot Pain
While many conditions can lead to pain on the top of the foot, several are more common. The typical causes of this issue can generally be divided between acute injuries and more chronic health concerns. Among the more frequently seen acute causes are:
- Midfoot osteoarthritis
Injuries to the top of the foot usually happen during a distinct painful event or due to excessive repetitive activities . For example, Lisfranc injuries occur when the midfoot joints dislocate after the ligaments in this region are torn. This injury commonly happens when the foot is in a downward pointed position, and someone lands on top of it. It can also occur after an auto accident or a fall.
Overuse injuries usually occur over time after the volume or intensity of a repetitive activity is quickly increased. This can include extensor tendonitis, where the tendons that help lift the foot and toes become overused and painful, or metatarsal stress fractures, where a small crack gradually develops in one of the bones at the base of your toes.
In the case of chronic health conditions that lead to dorsal foot pain, the causes are more varied. For example, gout is a form of inflammatory arthritis that leads to sudden, severe pain in the foot or base of the big toe. This condition occurs when high levels of uric acid cause a buildup of irritating urate crystals in a joint.
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Causes Of Pain On The Outside Of The Foot
Listed below are the most common causes of pain on the outside of the foot. Use the links to read more and learn how to best treat pain in this area . A fracture of the long bone behind your little toe in particular can be very serious and resistant to healing so make sure you dont delay your diagnosis. Use the links below and follow the instructions we give for treating these problems .
Where is Your Outside of Foot Pain?
Some of the common causes of pain on the outside of your foot are listed below in order from problems close to the toe heading back toward the heel. Use the links to find detailed diagnosis and treatment information on each problem:
1. 5th Toe Hammertoe A curled pinky toe often results in shoe pressure that leads to pain and possibly the formation of corns. Treatment goals include reducing pressure on the painful portion of the toe through the use of pads, shoe changes, lacing changes and more. Detailed treatment options are available at the link above. Use the link to learn how hammertoe pain can be eliminated.
5. Dorsal Compression Syndrome Achy pain with activity that is more toward the top of the foot, rather than the side. Often due to flattening of the arch causing compression between the bones. This condition responds very well to conservative treatment focused on supporting the arch. Using better shoes and arch supports is often a cure. Use the link to learn about dorsal compression syndrome.
The Many Causes Of Metatarsalgia
The most common explanation for ball of foot pain is basically temporary pain and swelling that stems from strenuous activity , improper footwear, or being on your feet all day. These activities can stress muscles, tendons, and ligaments due to overuse.
However, a number of related foot conditions can also produce metatarsalgia symptoms. These include conditions such as Mortons neuroma, a thickening of tissue surrounding a nerve near the base of toes, or an injury to the sesamoid bones in the forefoot.
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Pain On Outside Of Foot
Pain on the outside of the foot is a common problem we treat in our Seattle foot and ankle clinic. In most cases outside of the foot pain responds well to treatment.
Call or use our Patient Portal to schedule an appointment for an evaluation and treatment recommendations.
If you cannot visit us at our Seattle clinic, you can find self-treatment suggestions for pain on the outside of the foot at the bottom of this page.
Pain On The Foot’s Outer Edge
The outer edge of your foot, the fifth metatarsal bone, is a commonly broken bone in the foot. Pain, swelling, and bruising along the outer foot edge after an injury are symptoms. If you think you may have broken a bone, see a doctor and have an X-ray.
To treat it:
- Rest, ice, and elevate your foot.
- Donât walk on it.
- Ask your doctor if surgery is necessary.
- A cast may be necessary in some circumstances.
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Abnormalities In The Arch Structure
Conditions such as flat feet and high arches do not necessarily need to be caused by tendon dysfunction. They can simply be a genetically inherited way that the feet have developed over time.
Unfortunately, such structural abnormalities can still cause an uneven distribution of weight and forces across the feet, leading to pain in the arches or other areas. Stretching and custom orthotics can often help provide conditioning and corrective support for relief.
How To Treat Top Of Foot Pain
Some conditions that cause pain on the top of the foot can be treated with common at-home remedies. For example, avoiding irritating activities and using ice and NSAID medication can help improve the symptoms of extensor tendonitis or midfoot arthritis. This same treatment is also commonly needed for metatarsal stress fractures, along with using crutches to avoid weight-bearing through the injured area.
Other conditions require the use of prescription medications. A gout flare-up, for instance, is typically treated with colchicine, a medication that helps lower uric acid levels, or oral steroids. Certain classes of medication, including anti-seizure, antidepressant, and antiarrhythmic drugs, are also commonly used to address peripheral neuropathy.
Finally, a more invasive intervention may also be utilized for your dorsal foot pain in certain situations. For example, the pain from gout or midfoot arthritis is occasionally severe and needs to be treated with a pain-relieving cortisone injection. Surgeries may also be needed in some cases, including many types of Lisfranc injuries, and infrequently for midfoot arthritis or certain types of stress fractures.
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What Causes Tarsal Tunnel Syndrome
Common causes are:
- Ankle sprain or other injuries that result in swelling close to the tarsal tunnel and compress the nerve
- Suffering from flat feet, causing the heel to lean outwards and therefore stretch the nerve on the ankles inner
- A ganglion or similar swelling that exerts pressure upon the nerve
- Diabetes or other condition like midfoot or hindfoot arthritis that may be responsible for swelling near the tunnel
When To Get Medical Advice
You can usually treat metatarsalgia at home without seeing your GP.
However, you should get medical advice if:
- the pain doesn’t improve despite trying self-help measures
- the pain significantly interferes with your normal activities
- you develop sudden and very severe foot pain or a change in the shape of your foot this could be a sign of a more serious problem that requires immediate treatment
They can also refer you to a health professional that specialises in foot care, such as a podiatrist, , physiotherapist, or foot and ankle surgeon.
These specialists may recommend additional treatments, such as custom-made insoles , foot and ankle exercises, steroid injections or, in rare cases, surgery.
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What To Expect At Your Office Visit
Your provider will do a physical exam. Your provider will ask questions about your symptoms and medical history.
Treatment depends on the exact cause of the foot pain. Treatment may include:
- A splint or a cast, if you broke a bone
- Shoes that protect your feet
- Removal of plantar warts, corns, or calluses by a foot specialist
- Orthotics, or shoe inserts
Why Does My Big Toe Foot Or Ankle Joint Hurt
Gout is a kind of inflammation caused by the buildup of uric acid crystals in a joint. How your body handles uric acid is partly genetic, but certain lifestyle factors such as your diet can also contribute.
A gout attack can happen in a variety of areas, but the big toe is most common. Symptoms involve swelling, tenderness and sharp pain, and can last anywhere from a couple days to several weeks. The affected area may also become very red.
Along with dietary and lifestyle changes, there are medications that can help prevent gout flare-ups. Gout attacks can also be soothed with a corticosteroid shot or a short-term medication prescription.
If you think you may be experiencing a gout attack, make an appointment with a podiatrist right away. Gout can be diagnosed during a flare-up when the joint is hot, swollen or painful, and lab tests find uric acid crystals within the affected joint.
Osteoarthritis is the most common kind of arthritis. It usually occurs in the foot and ankle when the cartilage that cushions bones at their joints breaks down.
Without cartilage in a joint, the movement of that joint can feel grating and stiff, and its range of motion may decrease. The joint can also swell and become painful.
In some cases, osteoarthritis can lead to hallux rigidus, an arthritis of the big toe that causes painful stiffness in the main toe joint. It can also lead to pain and inflammation in the ankle and be associated with tendonitis.
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Dorsal Foot Pain Symptoms
Depending on the origins of your dorsal foot pain, several other corresponding symptoms may also be present in this area. These include, but are not limited to:
- Redness or warmth in the forefoot or toes
- Extreme sensitivity and difficulty putting on a sock or shoe
- Swelling in the foot, ankle, or toes
- A palpable nodule on the top of the foot
- Limited range of motion in the foot or toes
- Difficulty standing, walking, or climbing stairs
- Numbness or tingling in the foot or toes
- Bruising on the bottom of the foot
Some of these symptoms are unique to a particular diagnosis, while others can be seen with numerous causes of dorsal foot pain. A formal evaluation by a healthcare provider is the most accurate way to determine a true diagnosis. That said, keeping track of your symptoms and when they originated can help you hone in on the potential cause of your condition.
How Is Ball Of Foot Pain Treated
There are many home remedies for ball of foot pain. If your symptoms arent caused by a larger health condition, such as Freibergs disease or diabetes, your doctor will probably recommend some or all of the following. You could experience relief in a matter of days.
Rest your foot when you can, especially after periods of activity. Use an ice pack for 20-minute intervals every 2 to 3 hours. The ice may help alleviate inflammation and reduce swelling.
Wear comfortable shoes. If you wear high heels, your doctor will probably recommend that you change your footwear. Youll also want to make sure that your shoes fit properly. Tight shoes can cause your feet to misalign while you stand and walk, creating improper balance.
Exercise. While you may not want to participate in running or certain high impact sports during this time, targeted stretches might ease pain and increase flexibility and strength. You may want to practice your stretches a few times a day until you feel pain relief.
Use orthotic inserts. Depending on the level of severity, your doctor may prescribe orthotic inserts or recommend commercial shoe inserts. Orthotic inserts are made to help align the foot and provide extra cushioning. A pad under the ball of the foot may ease pain as well.
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Beating Ball Of Foot Pain
Although heel pain is probably the most common complaint we hear from patients needing help with aching feet, its far from the only spot on the sole that causes problems. Another common foot problem is ball of foot pain, also known as metatarsalgia. Although it sounds like a specific condition, its really just a catch-all term for painful symptoms localized just behind the bases of your toesthe word simply means metatarsal pain.
What Questions Should I Ask My Healthcare Provider
If you have Mortons neuroma, ask your provider:
- Can I treat this at home?
- Will I need surgery?
- What shoes will help my foot feel better?
- Will the neuroma come back?
- What medications can help?
A note from Cleveland Clinic
Mortons neuroma is a treatable foot condition. Symptoms of Mortons neuroma include pain in your toes. You may also feel like your socks have bunched up or that theres a pebble under your foot. If you have pain, tingling or other uncomfortable foot symptoms, talk to your healthcare provider. Mortons neuroma treatment includes steps you can take at home to relieve symptoms, such as rest and using shoe pads. Other treatments include medications, injections and, in severe cases, surgery. Treatment is often successful in returning you to your active life, pain-free.
Last reviewed by a Cleveland Clinic medical professional on 11/04/2020.
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More On Injections For Second Toe Pain
Generally, cortisone injections are only used for certain conditions after failed simple treatment. These conditions include second toe arthritis and Mortons neuroma.
Overall, you should be aware of cortisone injections potential benefits and side effects. Also, injecting under ultrasound improves accuracy and effectiveness and reduces the chances of damage to other structures.
What Tests Will I Need For A Doctor To Diagnose Mortons Neuroma
Most of the time, your provider can diagnosis Mortons neuroma based on your symptoms and a physical exam. An X-ray wont show a neuroma. But it can help rule out other conditions that cause foot pain, such as a stress fracture or arthritis. You may also need an ultrasound or MRI to confirm the diagnosis.
Sometimes, your provider may recommend an electromyography procedure. This test measures the electrical activity of your nerves and muscles. It can rule out nerve conditions that can cause symptoms like those of Mortons neuroma.
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What Are The Potential Complications Of Toe Pain
The potential complications of toe pain depend on its cause. Mild toe pain due to wearing ill-fitting or tight shoes usually responds to conservative treatment, such as switching to more comfortable shoes.
Toe pain due to chronic or progressive conditions is likely to get worse without medical treatment. Left untreated, chronic conditions can cause permanent damage or other complications. So, it is important to contact a healthcare professional when you experience any kind of persistent pain or other unusual symptoms in your feet.
When you have an accurate diagnosis, following the treatment plan your doctor outlines helps lower your risk of potential complications, such as:
Second Toe Stress Fracture
Like Friebergs disease, a stress fracture leads to bone fatigue, swelling, and breakdown. However, the stress fracture site is usually in the shaft rather than the head.
Generally, symptoms consist of gradually worsening pain with impact activity. In addition, there may be swelling in the bone.
Overall, MRI is the investigation of choice. X-ray or ultrasound may also detect stress fracture changes, although they may miss some cases.
Treatment consists of rest from running in a walking boot followed by a graded return to running slowly over a few months. However, recovery can take much longer for stress fractures higher up in the foot .
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