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foot pain

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    Posted: Jul 08 2008 at 11:44pm
Our user asked: "Hi, I have been getting PT for foot pain for 3 weeks. I was a runner up to 2 months ago when I finally had to quit due to this nagging injury. I have a bruise type of pain between my 3rd and 4th digits that is worse with my first steps in the morning and right after a run. I have had this since March. The x-ray was negative. I have been getting massage and ultrasound to the area as well as using ice and ibuprofen. I am really not feeling better and they don't seem to know what is wrong with me. Any suggestions on additional treatments? I am very frustrated and very sad that I can't run! Anything you could suggest would be appreciated. thanks"
 
Ask a PT Response: "I was just wondering how you developed this pain? Was it insidious or was it from running on uneven surfaces, or etc? Have they also ruled out a neuroma? Otherwise, sounds like you are receiving the appropriate treatment. Are you able to tolerate the bike or elliptical? These forms of activities are low impact and may not affect your foot as much. Aquatic therapy or swimming/running in the pool could help keep up your cardio and be an option as well while you work on your recovery. If things don't improve a bone scan may be warranted as an x-ray may not show micro fractures." 
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Ask a PT Quote  Post ReplyReply Direct Link To This Post Posted: Jul 09 2008 at 2:35pm

Our user responded: "Hello, and thanks for getting back to me...  The pain actually began when I was on vacation in Boston and was not wearing good walking shoes (I wore dress boots with a heel) while I was being a tourist all day. The pain was initially like a deep bruise type of pain, but over time, it began being really painful in the morning and then after a run.  It just never got better.... I finally decided in May to stop running all together to see if the pain subsided and it really didn't which is why I went to my MD. I had a negative x-ray and he was really unsure what was going on with me so he sent me to PT. My PT thinks I may have Morton's Neuroma (?) due to the location of the pain but he is puzzled by the timing of the pain since the description sounds more like a plantar fasciitis.  I guess my question is, really, whether it be a neuroma or PF, are the treatments about the same and how long should it take to begin feeling improvement? My PT basically said that if I'm not noticing improvement by next week, he thinks I should go back to my MD and get an MRI. Does that sound logical? Thanks for your input!"

Ask a PT Response: "From where you are describing the location of the pain, it is more consistent with a neuroma versus plantar fasciitis. Increase pain initially in the AM is consistent with plantar fasciitis but the pain for this condition is located at the bottom of the foot in the region of the arch and heel. Improper or poor footwear could result in a neuroma at the digital space between the 3rd and 4th toes. Medical imaging such as a MRI would be appropriate to rule out the neuroma or to rule out other possible conditions as well. Surgical intervention may be required to remove the neuroma in the case that you may have one. Good luck with your recovery and let me know how things go."
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