Mystery metatarsals.

December 13, 2012 6:35 AM

For the past few months, when I wake up in the morning (or get up in the middle of the night), I experience pain between/around my 4th and 5th metatarsals when I put any weight on that foot--more on the side and top than the sole (it is not plantar fasciitis). Within 5-10 minutes, it stops and doesn't hurt at all for the rest of the day. My GP, orthopedist and physical therapist are stumped. Any ideas?

The foot never hurts if there's no weight on it, and only hurts in those first 5-10 minutes I'm getting up--though if I contort my foot (as if I were trying to walk on the joint of my pinky toe) I can kind of "find" the pain, but it's not 100% the same. One the pain clears up in the morning, I have full, pain-free use of my foot--I walk three miles a day, and use an elliptical machine at the gym most nights.

X-rays show nothing. This is not plantar fasciitis or gout, and apparently not a broken bone (which was my guess). I may have hit the foot on a car door two years ago, but this is a more recent phenomenon. Again, it doesn't feel like the sole at all; it feels like the top/side/skeletal structure of the foot.

You are not my doctor, and I am not relying on you for medical advice. However, I would appreciate any input you may have so I can take your ideas to my PT session next week. Thanks!

posted by Admiral Haddock to Health & Fitness (6 answers total)

My son had Sever's disease a couple years ago and it presented the exact same way (but in his heel). Sever's is specifically located in the heel but the underlying problem is an inflamed ligament. Perhaps that's what's going on with you? Is there any chance all the walking and elliptical is causing a bone to rub against a ligament?

Related, I broke the sesamoid bone in my foot about 15 years ago. Every now and then I get the same pain as you describe between my big and second toe especially after a lot of walking. It feels like someone is stabbing my foot with teeny, tiny flaming needles but it goes away after a few minutes of stretching my foot and walking gingerly. Doctors tell me it's ligament irritation.

Good luck, I know how much it hurts.
posted by _Mona_ at 6:52 AM on December 13, 2012

I had similar symptoms until one day I could not walk all day and it took about 2 days of this before I went to see my orthopedist. I thought I had a stress fracture of my foot. Turns out, they thought it was gout. I did cut back on carbs and beer and it went away. Has not come back, but I drink my beer.
posted by JohnnyGunn at 7:41 AM on December 13, 2012

On review, you said it is not gout, but same symptoms I had.
posted by JohnnyGunn at 7:42 AM on December 13, 2012

I'll suggest Morton's Neuroma, but that is pretty common and wouldn't stump the doctors.
posted by CathyG at 8:44 AM on December 13, 2012

I had a bout of tendinitis in that exact spot a few years back. Mine was pretty severe; it hurt whenever I had any pressure on it, and I couldn't even swim right because the kick absofucking killed it. I limped around for a few weeks before going to rule out a stress fracture, and my doctor prescribed ibuprofen 3x/day for at least two weeks. It was like a miracle drug; within a few days, the inflammation was down, and that nagging background pain went away.
posted by disconnect at 10:39 AM on December 13, 2012

I was about to suggest Morton's neuroma too. I knew someone who had trouble getting that diagnosed, maybe it's not universally considered obvious?
posted by Coaticass at 2:59 PM on December 13, 2012