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Sunday, February 5, 2012

Chronic Metatarsal Pain in a Runner

Hi Dr. Blake,

I saw you about a month ago.  I have chronic ball of foot pain (had been present for 3 months) that although lessening is still stubbornly persisting.  The budin splint you suggested I get has helped.
Budin Splint with Metatarsal Pad attached to limit motion and re-distribute weight around the 2nd Metatarsal.

  The pain is has "moved" and is now below my second metatarsal.  I've been running on it 3 days a week and this definitely aggravates it.    Do you think the Neuro-eze cream might help me?
Do you think that cortizone could help (oral or injection)?  I would like to keep training.  
I will make an appointment to see you again if you think it would be beneficial.

Thanks in advance for any comments/advice. Tom


     Thanks for the email followup. Neuro-Eze may help if the symptoms are neurological. Probably more inflammatory. I could give you a Rx for Voltaren Gel to massage in 3 times daily. I will leave with my asst Kathy. Call her Monday with the pharmacy number.

     If the Budin Splint is working, tighten it alittle each week. 

 Definitely continue to ice massage for 5 minutes three times daily. Stay away from cortisone since we are probably dealing with a slightly injured ligament and cortisone can weaken it further.Come back after 2 weeks with the Voltaren gel and bring in your running shoes. When you say that the running aggravates it are you back to the same level of soreness when you run again? Very important, and no limping. Read my blog post on Good Pain vs Bad Pain to make sure you are staying in the Good Pain part. Hope this helps.And, it is normally great when the pain begins to move, as the original problem is being isolated by the treatment prescribed. Rich

Hi Rich,

Thanks so much for your prompt response.  It means alot to me!  I will call Kathy in the morning for the Valtaren gel.  I tightened the splint today and felt some more relief so I think that is a good sign.   The soreness after I run is managable and does not affect my gait and definitely no limping or anything like that.   It's very stubborn though!   I'm trying to balance the running with cross training and I'm being as conservative as I can without losing my fitness.   I will review your good pain bad pain post.

Thanks again.

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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.