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Sunday, July 24, 2016

2nd Metatarsal Pain: Email Advice

Hi Dr Blake

I am a 37 yr old female of average size and weight - on the thin side actually- presented with foot pain predominately to the first and second digit as well as the metatarsal-phalangeal region.
Dr Blake's comment: What type of pain are we talking about? How does it affect your function, day to day and athletics?

Tried the walking boot for one month without relief. Second opinion doctor ordered mri which showed 2cm bursitis in that region as well as inflammation of the second toe joint.

 I am an active mother but not a runner or extensive athlete. Possibly ill fitting shoes at times. Had a cortisone injection 4 days ago. Have had some nerve pain in the first and second toe but not terrible post injection, but I am not having total relief from the foot pain. 
Dr Blake's comment: It can take 2-3 weeks, if long acting cortisone was used, to see the overall effect. 

Still it is there as before but slightly reduced. The initial injury pain began 4 months ago. Took oral steroid first and antibiotic - now injection. 
Dr Blake's comment: Do you have the option of physical therapy? Have they tried met pads, Budin splints, accommodative padding, toe crests, etc to check its effect on the pain syndrome? 

Mother recently diagnosed RA however negative bloodwork but positive on clinical presentation. Should I be concerned of an impending RA diagnosis for myself ? Should I be having full relief from the injection and if so why am I not ?
Dr Blake's comment: If you see my post on cortisone shots, it can take 2 to 3 shots to check the effectiveness. It is easy to get several arthritis lab screens done, which I would do in your case. 
Sincerely

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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.