What's up with my toes?

November 5, 2006 1:06 AM

What's up with my toe/foot?

I often experience pain in my right foot, specifically the area around my big toe. The toe itself often hurts, and feels like I've stepped on it or stubbed it. I also experience pain in what feels like the muscle connecting that toe to my ankle. The pain seems isolated to the "top" of my toe and foot.

This pain seems to appear most often when I'm putting a lot of pressure on it. I'm wondering if it has something to do with the way I drive; I tend to manipulate the pedals with the top part of my foot because I feel I have more control that way. The angle of my foot is such that most of the pressure seems to be on the big toe and the toe next to it. The pain also appears when I walk too much.

The other possible explanation I'm considering is that it's related to plantar fasciitis (which I have been diagnosed with). The only explanation thus ruled out is gout (according to a doctor).

I've recently changed jobs and am still waiting for my new insurance to come through, but when it does, I do plan on following up on this problem with a doctor. In the meantime, two questions:

1. Does my "the pain is caused by driving or similar pressure" explanation sound plausible? If not, any thoughts on what could be causing the pain?

2. Any recommendations on what I can do to prevent or relieve this kind of stress on my toes? Stretches? Suggestions on learning how to manipulate the pedals of my car in a different way?

posted by rikhei to health (8 comments total)

Sounds like plantar fascia
posted by A189Nut at 3:01 AM on November 5, 2006

As a former plantar fasciitis sufferer myself, I am a bit skeptical of that being your problem. You don't give the classic description of it being worse on awakening and the location doesn't seem typical, either. If you have had plantar fasciitis before then you probably know what I am talking about. Beyond that, you may have a bunion or ganglion cyst or other structural abnormality that is causing your pain; there is obviously no way to diagnose it with any certainty on AskMe, so you are right to get it checked out in person. Also remember that gout can be an intermittant condition that is sometimes missed, so that is not completely ruled out. While waiting for your insurance to go through one thing you can try is changing your footwear or using some sort of pressure-relieving insert. If you have a good athletic footwear or orthopedic shoe store in your area, they may be able to give you some recommendations.
posted by TedW at 6:55 AM on November 5, 2006

I'm a first year med student in an osteopathic physician course, I would suggest looking one of these physicians up who can perform OMT--osteopathic manipulative treatment (no drugs--just hands on manipulations of the underlying tissues, etc)--this stuff isn't quack medicine--they're fully licensed physicians and personally i'd rather have a nice foot massage than having to take pain killers. Find a DO and they may be able to do more about your situation.
posted by uncballzer at 8:56 AM on November 5, 2006

Mine was maybe arthritis in the joint at the base of the big toe, and one of the kids from the chiropracter school worked it out in a few months. (I was actually going for a neck/back thing, but his instructor used to say, "That's for dessert.")
I went from being barely able to walk to now it snaps painlessly once in a while. So, yeah, I'd say it's worth a try for a few trips.
(People either like chiropracters and D.O.s or they don't, if you don't, sorry.)
posted by unrepentanthippie at 9:40 AM on November 5, 2006

I have a neuroma (sp?) in my foot and it sounds a bit like that. It's on the top of my foot and is a stabbing pain that shoots from the big toe to the ankle. Basically it's made wors by pressure so if I don't lace my shoes up tight it goes away. If you had a neuroma then using the top of your foot to drive sounds like it would definetely make it worse. Which by the way fascinates me, how on earth do you do that?
posted by fshgrl at 10:12 AM on November 5, 2006

fshgrl: I think the OP meant the top half of the foot, as in not the heel. (Not the top where the shoelaces go, although I got that image when I read it too.) Which, incidentally, sounds like they're driving with the foot sort of bent in the middle or flexed, which could be part of the problem. It could be something positional, although I like the neuroma theory too.

Gender isn't stated, you aren't trying to drive in heels, are you? To address the question of changing the position you drive in, I'd think about getting a different pair of shoes to drive in, that seem more likely to hold your foot in a better position. They don't have to be expensive, because you aren't going to do anything but drive in them, so you could try a couple of different configurations. Partly that's to change the way you hold your foot, and partly, it's to fake your foot into thinking the new way just feels funny to you because of the shoes, and it might be less annoying that it's different. You'd be relying on the shoes to hold your foot in the better position, instead of trying to remember to do something different all the time. (Wow, that's an incredibly *bad* explanation. Sorry.)

Good luck, anyway.
posted by unrepentanthippie at 2:08 PM on November 5, 2006

I agree with uncballzer. I'm a massage therapist and a pain specialist, and osteo manipulation sounds like a good idea - certainly its the point where you should begin treatment. I also agree with TedW - it doesn't sound much like plantar faciitis - but only a second opinion by an MD can confirm that.

My best advice is to do just that - get a second opinion, preferably with a podiatrist. This is obviously work related, and it will probably get worse if not diagnosed and treated. If it is something like an inflamed tendon, stenosis, a tear at the tendon attachment, a podiatrist will be able to give you an experienced opinion.

In the meantime, for pain -
A Dead Sea Salts foot bath, in bearably hot water for about 15 min.s, will help alot. Use about one cup for a container that can hold both feet and enough water to cover them to the ankles. (but make sure you wash the salt off when done.)

Good topical pain relief can be found in Lavendar essential oil, which can be applied neat to the painful area. (barring any allergies and making sure the bottle says essential oil.)
Same goes for emu oil - both can be found online.

Lastly - make sure you are wearing properly fitted shoes that support your foot. Your feet bear the weight and strain of your whole body - footwear is not just about fashion.

Good Luck
posted by SalvoSensu at 10:48 PM on November 5, 2006

Just to clarify: I do have plantar fasciitis. I wasn't trying to say that the toe pain is plantar fasciitis - I was wondering whether it might somehow be related to it. If that makes sense.

To answer your question, fshgirl, I tend to drive barefoot in the summer a lot. (It's not illegal here in Michigan, actually.) I tend to work the pedals with my heels on the ground, and the front part of my foot on the pedals. Since my big toe is, well, the biggest, it seems to do most of the work. In essence, though, I am straining my toes up in order to drive.

Thanks for all the advice, folks!
posted by rikhei at 7:13 AM on November 6, 2006