|
June 30, 2000
Question:
I have been having this burning, sometimes throbbing pain in the area near the ball of my foot and my big toe. Sometimes it's a very "sharp" pain when I walk and it seems to 'travel' to the top of my foot in the same area. Just recently the pain has been getting worse to the point where I have to limp and can I have difficulty running on the treadmill. I don't where high heels, instead I wear flat shoes. I had to wear orthopedic inserts as a child because of my arches, and all my shoes have to be wide in order to be worn comfortably. Lately it has seemed like the area is red when I get this pain. Sometimes massaging the area or elevating my leg works. Hope I can continue running!
Doctor's Reply:
Based upon the information you have given me I would guess that you are developing an arthritic condition in the big toe joint. This is generally aggravated by tightness in the calf muscles as a result of your running. Quite often there appears to be normal motion in the big toe joint when you don't have weight on your feet. Try this: With weight on your feet check to see if the big toe will move upward freely. If not, this jamming of the joint is likely the cause of the pain. The radiation of pain is due to a tendon that is attached into the big to joint and it is being over worked as a result of the toe not moving upward as it should. The pain you are having in the ball of the foot, next to the big toe joint, is due to a transfer of weight bearing stress because the big toe is not moving freely. There is hope however... Make an appointment with a podiatrist in your area. They will take an x-ray to see what level of damage you may have in the joint. In an acute case they may suggest a cortisone injection or put you on an oral anti-inflammatory. Long term treatment should be orthotics. Orthotics are devices that fit into normal shoes (and your running shoes). Orthotics correct the abnormal motion in the foot that is causing the arthritis in the big toe joint. I have had very positive results with orthotics. On occasion a surgical procedure may be recommended, however following the procedure, you should use orthotics. The surgical procedure can rarely correct the alignment problem that caused the condition in the first place. My recommendation is to try orthotics first, then consider the surgery if they don't solve the problem. One last thing, make calf stretch a part of your regular routine. Stretch following your running. Visit www.PodiatryNetwork.com and check under the foot problems section and look for "treatments" Under "treatments" you will find instruction on proper stretching. Good luck and don't delay on making that appointment to see a doctor.
 Kirk Koepsel, D.P.M.
|
return to top
