Posts Tagged ‘toe pain’
Many people engaged in recreational and professional sporting activity suffer from foot pain at one time or another. However, foot pain can be secondary to many situations – some related to sports and other are not. A famous cause of toe pain, for example, is podagra secondary to gout. This post will not discuss gout… Sports related foot pain is also diverse and can actually be secondary to several causes. This post will discuss pain in the plantar (bottom) aspect of the foot.
Foot sesamoid bone fracture
Sesamoid bones are bones that form within tendons. Two such sesamoid bones are present around the sheath of the flexor hallucis longus in the plantar aspect of the big toe. These are the medial and lateral sesamoid bones. With repeated stress (that can be induced by many types of sports) these bones can break.
Sesamoid stress fracture often has an insidious start. It is exacerbated by activity. Clinical features of sesamoid bone stress fractures include local tenderness over the plantar aspect of the big toe, swelling and pain on movement (up and down of the toe).
Imaging studies to diagnose toe sesamoid bone fracture include computed tomography, MRI and bone scan. If there is frank fracture plain radiograph might show it:
The medial sesamoid is more commonly affected
Treatment for sesamoid bone fractures can be conservative or surgical. However, these bones tend not to heal and therefore, surgical attachment is often necessary.
Morton’s neuroma
Morton’s neuroma is not a cause of foot pain per se, but rather a cause of a specific painful area in the bottom of the foot (plantar aspect). Morton’s neuroma is actually located between the 3rd and 4th toes.
The pain is caused because of irritation of the nerves that pass through that area. The characteristics of the foot pain in Morton’s neuroma are of burning, shooting pain (“neuropathic” pain). A common cause of Morton’s neuroma is therefore wearing shoes that are too tight.
Morton’s neuroma can be diagnosed by pressing over the 3rd inter phalangeal space. The pressure is applied from above, not from the plantar aspect.
Treatment of Morton’s neuroma is often conservative (changing shoes, rest) and surgery is only performed when all other measures fail. Surgery involves excising the inciting nerve.
Plantar faciitis
Plantar faciitis, a cause of foot pain near the heel, is discussed here.