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Tuesday, October 22, 2013

Ball of the Foot Pain: Email Advice

Hi Dr.Blake,

 I have been diagnosed with sesamoiditis and have had this foot pain for over a year now. It is beginning to develop in my other foot as well.

 I have tried almost everything imaginable: two different orthotics, cortisone injection, active release, had a chiropractor tape the joint with kinesio tape and even one of those electric wave machines.

 I really do not know what else to do the pain keeps getting worse. Do you have any other suggestions? I am extremely desperate. - Thanks, Ann (name changed)

Dr Blake's comment: 

     All we know from what you have said is that you have pain under the ball of your foot, that no one feels is broken or arthritic, and the pain is not getting better with people doing things to you. So, I would begin to be more active in your approach (very sports medicine) and begin to see what happens. Take this one month at a time and you can give me a followup 30-40 days from now. So, what can be done:


  1. Attempt some form of better diagnosis (xrays, etc).
  2. Ice pack the area for 15 minutes twice daily.
  3. If swelling or stiffness noted, do contrast bathing once daily or once every other day.
  4. Find a shoe that works best whether it is padding or stiff or flat, etc. Try to decide what is best.
  5. Put your self in the Immobilization Phase I of Injury Rehabilitation by staying in an Anklizer removable boot or Ovation Medical Boot with EvenUp on the other side.
  6. Spica tape your toe daily.
  7. See if your doc will prescribe voltaren gel or flector patches for you (at least for when you sleep).
  8. Figure out if either of the two pairs of orthotics actually do protect the ball of the foot (we need function not number of). 
  9. To specifically deal with the pain, see a pain specialist. Avoid NSAIDs since you could have a bone injury.
  10. See if any other activities you are doing daily is irritating things and make some change. 
  11. Apply Neuro-Eze to the sore area 3 times daily (buy online).
  12. Do Metatarsal Doming and Single Leg Balancing daily to keep some strength in the foot (painlessly). 
I hope this gets you started in a good direction. Rich

1 comment:

  1. You offered a lot of great advice. If I were her one of the first things I would look to do is get a second opinion or a better diagnosis. It sounds to me like there may be a chance of arthritis if the pain is continuing and not getting better. For arthritis you could try stretching, acupuncture, or medications all geared towards lessening foot pain.

    ReplyDelete

Thank you very much for leaving a comment. Due to my time restraints, some comments may not be answered.I will answer questions that I feel will help the community as a whole.. I can only answer medical questions in a general form. No specific answers can be given. Please consult a podiatrist, therapist, orthopedist, or sports medicine physician in your area for specific questions.