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Lateral Foot Pain and Abnormailty

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Old 13th February 2009, 10:27 PM
gsf gsf is offline
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Default Lateral Foot Pain and Abnormailty

Hi Everyone, thanks for viewing my post. I'll try to be as concise yet informative as possible.

In mid-'06 I bought a new pair of shoes and couldn't get rid of the feeling that the shoe on my left foot was pressing on the outside (lateral) part of my foot. It felt like the foot was continuously telling me "There's something touching me", I never got used to the shoe pressing on my foot. The annoyance finally gave way to aching that became quite painful. All of this was in my left foot, but I had similar symptoms in my right foot, only milder. I returned the shoes and went through 2 other pairs of shoes with the same problem. I could only wear my old shoes.

I went and saw an orthopedist, he said I have falling(-en?) arches and splaying and that orthotics would fix the problem. I went and saw someone who made me custom orthotics (soft type). They solved the problem enough that I could get new shoes that would accomodate the orthotics and be relatively pain-free. I would say I got 80% relief, though the pain sometimes would occur, and sometimes when I was barefoot. The orthotics had arch support, a metatarsal pad and a lateral wedge, I believe.

Fast forward to Sept '08, I began having more pain, so I sought out a DPD. I saw him and he said the orthotics had probably worn out and would prescribe better ones (firm) that would last longer and be easier to fit into my shoes.

These orthotics were indeed easier to fit into shoes, but they did nothing to help my foot pain. I did some examining of the original orthotics, and realized that they were shaped in such a way that they were preventing my shoe from touching the sensitive part of my foot.

I went back to the doctor, he could not find a palpable cause of the pain, so he sent me for an MRI. The MRI came back normal, only showing some wear on my big toe joint, nowhere near my problem. With some more pressing on parts of my foot, he found that the pain came when he pressed for several seconds directly on my sural nerve at certain points. He injected a steroid around the nerve on the sensitive points. My foot was sore for a couple days, then the pain was reduced for about a week. After 2 weeks, I was back to where I was. He sent me to a neurologist who did an NCV/EMG study and determined that everything was perfectly normal.

Now for some important background information. I have disc degeneration and herniation at L5-S1, where the nerve root for the sural nerve branches off the spinal cord. This was diagnosed in '03 and I have been treating it conservatively. I get pain in my lower back, buttocks, hamstrings and twitching in my calfs. Pain is worse on the left side but also occurs on the right side.

I have no correlation between the back pain and the foot symptoms. The medication for my back pain does not affect my foot symptoms. Usually relieving the pressure on the disc (lying down, inversion table) will relieve my back symptoms, but it does not affect my foot symptoms. The Neurologist I spoke to was convinced that since I do not have numbness or tingling, the foot symptoms are not nerve-related.

I'm now in a situation where one doctor says it's related to my back injury, and another doctor says it isn't my back injury causing the foot symptoms.

I believe that I somehow injured my foot by sitting crosslegged with my feet crunched under my thighs. I do this to keep my pelvis tilted forward which takes the pressure of my back. It is the only way I can sit for any period of time. I have begun sitting with my feet out further so that are not 'crunched'.

I have found that stretching my hamstring causes my feet to tingle, which goes away when I release the stretch; the foot pain also goes away when I do this stretch. This gives me long periods of relief. This has dumbfounded the doctors, they have no explanation. This is a great way to obtain relief, but I need to know what is affecting the pain in my foot, and whether or not this will lose its effectiveness.

Do any of the experts here have any ideas?

Some more information:
*The exact spot of the pain and abnormal sensations is on the lateral aspect of my foot, in the half of my foot closest to my toes, exclusive of my little toe. Sometimes the pain feels like an ache in the bottom joint of my little toe. The pain is on the side of my foot and also feels like it could be coming from the bottom of my foot.
*The pain can be anywhere from a 1-5 on a scale of 1-10, but it comes and goes and can be extremely annoying. It is an aching, soreness type of pain. Sometimes exercise makes it worse, but I don't feel the pain until I stop exercising. The pain also is reduced upon standing and increased upon sitting. Walking further reduces the pain.
*Before I discovered that the hamstring stretch helps, I found that topical capsaicin would immediately remove the pain. I experienced severe burning once my feet started to sweat, and thus discontinued the capsaicin. I am considering trying TENS, though I tried it for my back pain and it did not help.
*When the first set of orthotics began to wear out, I was unable to continue my daily exercise routine of walking 60-90 minutes.
*I am a 30 yo white male in the US. I have had my blood tested, and besides slightly high cholesterol, I am normal. No diabetes.

Thanks so much for your help!

G
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Old 13th February 2009, 11:16 PM
FootDoc FootDoc is offline
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Default Re: Lateral Foot Pain and Abnormailty

DISCLAIMER:
THE FOLLOWING IS OFFERED GRATIS AS GENERAL INFORMATION ONLY, AND, AS SUCH, MAY NOT BE APPLICABLE TO THE SPECIFIC QUESTIONER AND/OR HIS/HER PROBLEM. IT IS CLEARLY NOT BASED ON ACTUAL KNOWLEDGE AND/OR EXAMINATION OF THE QUESTIONER OR HIS/HER MEDICAL HISTORY, AND IT CAN NOT AND SHOULD NOT BE RELIED UPON AS DEFINITIVE MEDICAL OPINION OR ADVICE. ONLY THROUGH HANDS- ON PHYSICAL CONTACT WITH THE ACTUAL PATIENT CAN ACCURATE MEDICAL DIAGNOSIS BE ESTABLISHED AND SPECIFIC ADVICE BE GIVEN. NO DOCTOR/PATIENT RELATIONSHIP IS CREATED OR ESTABLISHED OR MAY BE INFERRED. THE QUESTIONER AND/OR READER IS INSTRUCTED TO CONSULT HIS OR HER OWN DOCTOR BEFORE PROCEEDING WITH ANY SUGGESTIONS CONTAINED HEREIN, AND TO ACT ONLY UPON HIS/HER OWN DOCTOR’S ORDERS AND RECOMMENDATIONS. BY THE READING OF MY POSTING WHICH FOLLOWS, THE READER STIPULATES AND CONFIRMS THAT HE/SHE FULLY UNDERSTANDS THIS DISCLAIMER AND HOLDS HARMLESS THIS WRITER. IF THIS IS NOT FULLY AGREEABLE TO YOU, THE READER, AND/OR YOU HAVE NOT ATTAINED THE AGE OF 18 YEARS, YOU HEREBY ARE ADMONISHED TO READ NO FURTHER.
************************************************** *********
Without actually examining you I cannot offer you anything definitive in regard to a diagnosis or treatment. But what I CAN tell you is that, as one can elicit the pain by direct palpation or pressure at the site of the pain, it cannot be a back problem or a problem with a nerve other than at the site of the symptoms. The doctor who examined you and suggested that the problem might be related to a problem in your back should certainly have realized that if he/she was able to elicit symptoms with direct pressure to your foot. If that's all he/she told you, I think you deserve a refund.
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Old 17th February 2009, 08:48 AM
gsf gsf is offline
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Default Re: Lateral Foot Pain and Abnormailty

Quote:
Originally Posted by FootDoc View Post
DISCLAIMER:
THE FOLLOWING IS OFFERED GRATIS AS GENERAL INFORMATION ONLY, AND, AS SUCH, MAY NOT BE APPLICABLE TO THE SPECIFIC QUESTIONER AND/OR HIS/HER PROBLEM. IT IS CLEARLY NOT BASED ON ACTUAL KNOWLEDGE AND/OR EXAMINATION OF THE QUESTIONER OR HIS/HER MEDICAL HISTORY, AND IT CAN NOT AND SHOULD NOT BE RELIED UPON AS DEFINITIVE MEDICAL OPINION OR ADVICE. ONLY THROUGH HANDS- ON PHYSICAL CONTACT WITH THE ACTUAL PATIENT CAN ACCURATE MEDICAL DIAGNOSIS BE ESTABLISHED AND SPECIFIC ADVICE BE GIVEN. NO DOCTOR/PATIENT RELATIONSHIP IS CREATED OR ESTABLISHED OR MAY BE INFERRED. THE QUESTIONER AND/OR READER IS INSTRUCTED TO CONSULT HIS OR HER OWN DOCTOR BEFORE PROCEEDING WITH ANY SUGGESTIONS CONTAINED HEREIN, AND TO ACT ONLY UPON HIS/HER OWN DOCTOR’S ORDERS AND RECOMMENDATIONS. BY THE READING OF MY POSTING WHICH FOLLOWS, THE READER STIPULATES AND CONFIRMS THAT HE/SHE FULLY UNDERSTANDS THIS DISCLAIMER AND HOLDS HARMLESS THIS WRITER. IF THIS IS NOT FULLY AGREEABLE TO YOU, THE READER, AND/OR YOU HAVE NOT ATTAINED THE AGE OF 18 YEARS, YOU HEREBY ARE ADMONISHED TO READ NO FURTHER.
************************************************** *********
Without actually examining you I cannot offer you anything definitive in regard to a diagnosis or treatment. But what I CAN tell you is that, as one can elicit the pain by direct palpation or pressure at the site of the pain, it cannot be a back problem or a problem with a nerve other than at the site of the symptoms. The doctor who examined you and suggested that the problem might be related to a problem in your back should certainly have realized that if he/she was able to elicit symptoms with direct pressure to your foot. If that's all he/she told you, I think you deserve a refund.

Thank you for your reply. I had a feeling that this is a foot issue rather than a back issue, your comment helps to affirm this.

I was hoping you or someone else on this forum had some ideas as to what could be causing this pain. This problem is obviously a rare one that my doctor has not encountered (or does not remember encountering) either in a textbook or in another individual. My hope is that posting in this forum would allow me to reach a larger audience, in which someone is knowledgable about my symptoms.

I'm NOT expecting a diagnosis, just a direction for my doctor and myself to look in. My next appointment is 3/3/09, it seems like we are going to treat the symptoms (TENS, drugs, ???) but I would prefer to find the root cause first.

Thanks again for your assistance.
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Old 17th February 2009, 01:36 PM
FootDoc FootDoc is offline
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Default Re: Lateral Foot Pain and Abnormailty

When pinned down, just about every questioner claims that he/she is not looking for or expecting a diagnosis here. But I think that you and others who state that they come here only for "thoughts, ideas, direction, etc." in regard to a problem are indeed looking for a diagnosis, or at least an essential finding in the diagnostic process. That area of the diagnostic process to which I refer is termed the "differential diagnosis," and it is a list of possibilities formulated by the diagnostician from the initial evaluation. So, indeed, the thoughts, ideas or direction of which you and others wish to be advised is actually an integral part of the diagnostic process which does generally require, in part, an examination. That which has not be diagnosed by multiple hands-on examinations and testing by competent doctors elsewhere is unlikely to be gleaned here in the absence of such a hands-on examination and testing.
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Last edited by FootDoc; 17th February 2009 at 01:39 PM.
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Old 15th December 2009, 01:55 PM
777twist 777twist is offline
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Default Re: Lateral Foot Pain and Abnormailty

"gsn" I have the same issues... or at least what sounds like the same.

Here are some things about me and what I have noticed that may help (FYI, the doctors I have gone to haven't figured it out either):

1. I'm a fatty, I weigh 295lbs... I have noticed it's when I breach 280 pounds or more that I run into this foot problem.

2. It happens to me probably between 1 - 4 times a year.

3. Pain is off the chart!!! I can handle most pain, but damn, this is really bad. Maybe because I’m so fat it complicates it.

4. I play golf on the weekends... but at this point, that's about all the exercise I get.

5. I think I did mis-step the other day while walking, kind of mis-judged the curb. That was on Friday and the pain didn't really start until Monday.

6. I cut my toenails over the weekend (I don't think it has anything to do with it, but I read that it can cause issues in the foot).

Anyway, I have tried all kinds of remedies... Icy Hot on the top of the foot, cold packs, water heat, foot baths... nothing really seems to help.

The pain does go away after a few days - 10 days.

Anyway, maybe some of this info will help. Maybe mine was caused by the curb on Friday, but this has been happening for the past 5 or so years.

Hope this info helps...
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Old 16th December 2009, 10:33 AM
777twist 777twist is offline
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Default Re: Lateral Foot Pain and Abnormailty

Ok, so I may have tracked down the cause of my problem. I think it's these running sneakers that are really tight. I had to wear them this weekend because my regular sneakers got wet. Thinking back, I think I've had this problem when wearing those tight sneakers, but back then I wasn't sure if it was do to the exercise or what? Now I'm fairly sure it's the sneakers.
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Old 10th November 2011, 05:41 AM
gsf gsf is offline
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Default Re: Lateral Foot Pain and Abnormailty

Well, I've been managing with this foot issue for 2+ years, apparently. The hamstring stretch worked fantastically until...

I had back surgery. I'm two months out and the foot symptom has returned. I'm beginning to get some decent relief from the back and leg symptoms but the exact same foot symptom is back but I am now unable to get relief from the hamstring stretch.

I'm going to see the spine surgeon on Monday for an exam. I will bring my notes from the neurologist who did the NCV/EMG.

Does anyone have some ideas as to what's going on? If the spine surgeon can't provide a Dx, I plan to see a DIFFERENT neurologist, unless anyone has a better idea on what type of clinician to visit. I'm also considering asking my pain management doc about doing RF neuroablation on my foot.

Thanks in advance for the help.

GSF

PS - I had arthroplasty with Prodisc-L at L5-S1.
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Old 10th November 2011, 07:13 AM
777twist 777twist is offline
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Default Re: Lateral Foot Pain and Abnormailty

I just received an email about the post from GSF above. It made me take another look at my old posts.

Not sure if I said this anywhere on this board, but I found out my issue was related to the Gout. It wasn't the sneakers, it was basically not drinking enough water out on the golf course.

There's lots of talk about remedies for the gout, but I have found the water is by far the best cure and best way to prevent future episodes.

To cure a bout of the gout, just pound water... you can throw in a juice drink like Pom or something like that. But the rest of the stuff didn't seem to help me too much. Just pound the water and flush your system.

Now, this may (or probably does) not have anything to do with GSF's post, but since I posted an incorrect diagnosis, I wanted to clear it up.
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Old 10th November 2011, 04:22 PM
gsf gsf is offline
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Default Re: Lateral Foot Pain and Abnormailty

Hi 777, I'm glad you have found some relief, though I understand gout is extremely painful. I wish you luck with this.

I drink plenty of water habitually, I have not found water intake to correlate with the foot symptoms.

Also to note, I am on 600mg/day of Lyrica for the leg pain secondary to my spine surgery, and this does not help my foot symptoms described above.
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  #10  
Old 18th February 2012, 09:17 AM
glchurchill
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Default Re: Lateral Foot Pain and Abnormailty

I have pain in the lateral aspect of my left foot. It doesn't hurt all of the time. When it does hurt it is a very painful burning senstation. There seems to be no outward signs of abnormalty. I notice it does hurt more when I walk. I do walk fo exercisr.
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